Q: There have been a number of reports in the news over the past few years describing a shortage of anesthesia providers throughout the United States. Just how great is this shortage?
Marc Koch: Right now, the U.S. Department of Health and Human Services estimates a nurse anesthetist shortage of approximately 5,000, and this is expected to worsen over time. Additionally, there has been a decrease in the number of medical students entering anesthesiology residency programs and a "graying" of current practicing anesthesiologists. According to some estimates, 85 percent of the approximately 30,000 practicing anesthesiologists today are 45 or older. These are not welcoming statistics.
Q: Will this shortage stabilize or continue to get worse?
MK: We have certainly not hit bottom yet. As baby boomers age and require surgery, the demand for anesthesia providers will grow, further restricting the current supply of providers. In addition, as more and more operating rooms develop outside of the hospital setting, we will see this demand magnified as an increasing number of facilities compete for these providers.
Q: What does this mean for the provision of anesthesia services?
MK: To start, we will see increases in anesthesia costs. Additionally, I believe we will find fewer and fewer anesthesia providers willing to work holidays, weekends and nights or be on-call. As a result, leaders of hospitals and other facilities may feel like they are forced to choose between directing more funds toward anesthesia or delaying procedures. In fact, in a recent ASA study, approximately half of hospital administrators reported reducing, redirecting or delaying OR procedures due to inadequate anesthesia support. The bottom line is that hospitals and other facilities will have to pay more and more to get less and less coverage.
Q: How are hospitals and other facilities responding to this shortage?
MK: If hospitals continue to maintain their current financial models for anesthesia services, they will eventually be forced to choose between providing additional funding for anesthesia or reducing or delaying surgeries. Finding additional funds for anesthesia is becoming increasingly difficult in today's tight market, and reducing the number of surgeries hurts the bottom line because it restricts volume.
Q: Are there other options for hospitals and other facilities besides increasing funding or reducing volume?
MK: Facilities that use a MD/CRNA cooperative model, where anesthesiologists and certified nurse anesthetists work together to provide services, will be best equipped to handle the anesthesia provider shortage. Hospitals and other facilities should consider outsourcing to anesthesia management companies to staff their anesthesiology departments. Anesthesiology management companies can help provide complete coverage and work to increase collections for anesthesiology services. The main point is that hospitals and other surgical facilities do not have to choose between spending more money or reducing volume.
Q: What should hospitals and other surgery facilities consider when selecting an anesthesia management company?
MK: Hospital and ASC leaders need to request data that proves the quality of the service group. Statistics on coverage and surgeon satisfaction are important indicators of the quality of an anesthesia service provider. It is also critical that hospitals check references and look for providers who have existing contracts with third-party payors. You should request to see payor rates and look for providers that have reimbursement rates that exceed your pre-existing rates.
Dr. Koch is president and CEO of Somnia Anesthesia, a physician-owned and operated clinical anesthesia management company servicing healthcare facilities nationwide. Learn more about Somnia.
Learn more about the anesthesia shortage and the growing trend of anesthesia subsidy requests by reading "Anesthesia Subsidy Requests: What They Are and How to Prepare for Them."