The ongoing anesthesia provider shortage is a major hurdle for ASC leaders, who are trying to balance workforce demands with soaring operational costs and declining reimbursement rates.
Here is what five leaders have recently told Becker’s about their perspective on the anesthesia provider shortage:
1. Bruce Feldman, former administrator of Eastern Orange Ambulatory Surgery Center (Cornwall, N.Y.): “We live in a world today where you have to be creative and strategic,” he told Becker’s while discussing a new method of managing operating room block times and anesthesia payment. “The old days of just paying anesthesia stipends don’t solve the problem anymore, especially as the acuity level of ASC cases increases.”
2. Les Jebson. Administrator of Prisma Health Orthopedics & Sports Medicine Institute (Columbia, S.C.): “I would submit that highly successful ASCs are anchored by well-trained nurse anesthetists and anesthesiologists. The essential team members leverage advancements in anesthetic and analgesic agents to provide optimal sedation and pain management. Regional blocks and appropriate ASA [American Society of Anesthesiologists] candidacy are important components. I would say that anesthetists continue to stay well apprised and trained on the best anesthesia care plans.”
3. Aaron Kalin, DO. Medical Director and Chair of Anesthesiology at Adventist Health and Rideout (Marysville, Calif.): “I think the vacuum effect is going to remain. I believe you’re going to see ambulatory surgery center volumes continue to grow as the population gets more cataract surgery, more phaco surgery, more ENT surgeries. I think the ambulatory footprint is going to grow, which means you’re going to need more clinical assets, which means you’re going to have to hire more anesthesiologists and certified registered nurse anesthetists.
There’s going to be tremendous pressure to churn out or freshly mint new graduates, to get people into the workforce, to solve the demand problem, which is going to be primarily on the ambulatory side. I see inpatient volumes going down. I see ambulatory surgery volumes going up. I don’t see that trend stopping for a long time. In fact, I see an increase in the velocity of cases going into the outpatient setting. And when we say ambulatory surgery center, that can also be freestanding gastroenterology centers for endoscopy. When you look at two, five, 10 years out, the trend is more outpatient surgery and quicker throughput, which puts a lot of pressure on us to hire more anesthesia assets, but we can’t get them unless we graduate more assets. Now you have more programs opening up. They’re looking at programs that maybe don’t need to be four years. Maybe you can do residency in three years. Maybe nurse anesthetist school doesn’t have to be 36 months. Maybe it can be 28 months. So, I think that they’re looking at how we can manufacture, train, credential or educate people quicker so we can graduate more people that are entering the workforce, particularly in anesthesia, to keep up with the demand, particularly on the outpatient basis.”
4. Peter Bravos, MD. Chief Medical Officer of Sutter Health, Surgery Center Division (Sacramento, Calif.): “The demand for anesthesia staffing will increase as ASCs manage greater volumes and more complex cases, against the backdrop of an increasingly constrained clinician pipeline. We are preparing by diversifying our staffing models, building academic partnerships and developing regional coverage strategies to ensure reliability and quality.”
5. Jason Manella, MD. Director of Anesthesia Operations at Endeavor Health (Chicago): “Anesthesia is a critical element for many operations and procedures performed across the healthcare system. If the anesthesia staffing shortage goes unaddressed, we could start seeing delayed patient care due to acuity prioritization, increased burnout of anesthesia providers, a decrease in access to certain procedures in rural communities and a decrease in revenue for healthcare systems overall. “
