As the anesthesia shortage strains OR capacity nationwide, leaders say the fastest fixes will come from expanding training while redesigning how the workforce is deployed.
From keeping older anesthesiologists in meaningful roles to rethinking scheduling peaks, eight anesthesiologists joined Becker’s to discuss the changes needed to ease the workforce shortage.
Editors’ note: Responses have been edited lightly for clarity and length.
Question: If you could change one thing to meaningfully ease the anesthesia workforce shortage, what would it be?
Michael Bernard, MD. Anesthesiologist and Chief Medical Officer of Ambulatory Anesthesia Solutions (West Bloomfield Township, Mich.): If I could change one thing to meaningfully reduce the anesthesia workforce shortage, it would be to expand training capacity for anesthesia providers. This includes physician anesthesiologists, CRNAs and anesthesia assistants. There is no shortage of qualified applicants eager to enter these programs. The limiting factor is available training slots and program capacity.
Each of these clinician types plays an important role in meeting community needs, and increasing the number of trained providers would have a direct impact on access to surgical and procedural care. This effort would also benefit from greater alignment among governing bodies, working collaboratively to expand access and capacity, rather than treating each other as competitors.
Barry Brasfield, MD. Anesthesiologist at Scope Anesthesia of North Carolina (Charlotte): It would be easy to say increase the number of trainees in the three sources of providers (physicians, CRNAs, [anesthesia assistants]), but I would suggest a different approach: 57% of anesthesiologists in 2025 were 55 years and older. We need a more aggressive approach to crafting positions for older anesthesiologists that not only afford them the opportunity to remain in meaningful roles, but that also recognize their leadership skills and willingness to contribute in part-time positions that compensate them commensurate with the workload equivalent to that of their younger colleagues.
Antonio Hernandez Conte, MD. Past-president of the California Society of Anesthesiologists: The anesthesia workforce shortage shows no signs of abating despite slightly increasing pipelines of both anesthesiologists and nurse anesthetists. However, passage of licensure pathways for certified anesthesiologist assistants remains a major obstacle in most states. CAA licensure in all 50 states would lead to further expansion of CAAs practicing in the Anesthesia Care Team, as well as a likely accompanied increase in the number of CAA training programs around the U.S.
Corey Koenig, MD. Vice President of Operations at Providence Anesthesiology Associates (Charlotte): Anesthesia reimbursements need to be fixed to continue it being a desired field to work in. Many physicians wouldn’t recommend others go into our field. Many feel like our healthcare system is on an unsustainable track, leaving a huge unknown aspect of dedicating so much time, effort and money into making it a career. I believe that the system should identify physicians earlier and attempt to make undergraduate and medical school into a four- or six-year combined. While there is no alternative to the hands-on training, removing some of the unrelated classes could lower the debt burden and shorten the overall time commitment to becoming an anesthesiologist without lowering the clinical and nonclinical standards.
Andrew Leibowitz, MD. Chair of Anesthesiology at the Mount Sinai Health System (New York City): Improved scheduling and efficiency are the quickest steps to take in any practice to increase the work done without an increase in the number of providers, or their hours worked.
An increase in the number of residencies and residency size, an expansion of states recognizing anesthesia assistants, and optimal utilization of the rapidly growing CRNA workforce all will play a role going forward. The number of anesthetics delivered per year has been rising with an aging population, an explosion in minimally invasive procedures that require an anesthetic, and the increased screening for gastrointestinal cancers. This increase in the need for anesthesia appears inexorable.
Paul Patane, MD. Medical Director of Anesthesia Services for Cayuga Health System (Ithaca, N.Y.): There are too few providers of all stripes. Increases in federal funding for [graduate medical education] will, over the years, increase the number of anesthesiologist training slots and therefore the number of these providers. Similarly, outside funding for CRNA students with the expansion of schools, will increase this pipeline. However, these pipelines are years long and will not ease the shortage anytime soon.
Focusing on procedures and patients where we add the most value to the patient, and reducing the use of anesthesia for procedures that could be performed just as safely without sedation — e.g., cataract surgery, minor skin, some hand surgery, and imaging procedures — procedures where many are already performed without sedation. If not limiting the availability of anesthesia services to these patients, then restructuring schedules such that these procedures are scheduled when other demands for our service are less.
Michael Schostak, MD. Vice President of Physician Services at NorthStar Anesthesia: I might be in the minority here, but I think we have a manufactured labor shortage. The majority of anesthesia work is done in the first four hours of the day.
Hospitals create the shortage by prioritizing 7:30 [a.m.] starts. We staff heavy for a brief window so every surgeon can start early — staffing for peak concurrent rooms rather than spreading cases throughout the day. That strategy requires the most providers and operates on the most expensive part of the labor curve.
Changing scheduling practices would ease the shortage more than any recruitment effort.
Adam Spiegel. Chief Executive Officer of NorthStar Anesthesia: Ensuring our healthcare system has a strong pipeline of talented anesthesia clinicians is essential and a shared priority across our industry. But it’s not just about training more clinicians; an often-overlooked factor is how we can use our existing workforce most effectively to meet patient needs. We regularly work with our facility partners to lower coverage needs while still maintaining the same or higher volume. By rethinking how we deploy clinicians, the industry can reduce workforce strain, deliver high-quality care, and foster environments where professionals can truly thrive.
