Anesthesia workforce shortage poses threat to health care: Study

Growing imbalance in the supply versus demand for anesthesia care providers poses difficult challenges for the U.S. health care system. Expert viewpoints on the evolving shortage and potential solutions to meet the need for anesthesia clinicians are discussed in a special article in the online edition of Anesthesiology.

"The labor supply-demand imbalance for anesthesia clinicians has reached critical levels, with major implications for safe and effective patient care," said lead author Amr E. Abouleish, M.D., M.B.A., FASA, professor of anesthesiology at the University of Texas Medical Branch, Galveston.

"Building on two recent workforce summits held by ASA, our paper outlines emerging trends affecting the unfolding staffing crisis, with a view toward developing much needed sustainable short- and long-term solutions."

As surgery and other procedures resumed after the height of the COVID-19 pandemic, surging demand placed additional stress on "an already fragile workforce." The percentage of facilities reporting an anesthesia staffing shortage increased from 35% in early 2020 before the pandemic to 78% in late 2022.

That creates "a dangerous spiral of work intensity and stress, unsustainable workloads, and retirements from clinical practice," Dr. Abouleish said. While staffing shortages are seen throughout the health care system, "Reliable anesthesia staffing is essential to provide high-quality, safe, and timely procedural care, which is a major financial driver for health systems."

The authors outline the converging trends affecting the anesthesia workforce—including an aging patient population, the ongoing shift toward outpatient and minimally invasive procedures, and the shifting numbers and characteristics of clinicians entering the workforce. Despite a net increase in workforce supply, the growing demand and increasing complexity of procedures continues to strain resources.

Building on discussions at ASA workforce summits held in June 2022 and November 2023, the authors propose potential solutions—short-term and long-term—to the anesthesia supply-demand imbalance:

• Increasing the number of physician anesthesiologist residency positions.
• Taking steps to enhance staff retention, including initiatives to address burnout and other workplace issues linked to departures from clinical practice, flexible scheduling for work-life balance, and creating opportunities to allow clinicians to transition to part-time prior to full retirement.
• Expanding anesthesia coverage capacity through practice innovations, including more efficient use of sedation for outpatient procedures and new approaches to the supervision of anesthesia care in lower-risk settings.
• Using artificial intelligence and emerging technologies to aid decision-making and deliver care more efficiently, such as increased use of automation and new solutions for augmenting clinical and technical skills.
• Easing financial constraints, including Medicare payment reform for anesthesiologist services, as well as steps to remove barriers to anesthesiologist provided and led care in rural communities and other inequities in patient care.

"Successfully addressing the workforce imbalance will require reassessment of strategies and the introduction of new ones," Dr. Abouleish concluded, suggesting that ASA hold annual stakeholder summits to review trends, monitor progress, and modify strategy related to the anesthesia workforce.

Further information and resources are available from the ASA Center for Anesthesia Workforce Studies. Additionally, through a partnership with the American Hospital Association (AHA), ASA has an e-book on addressing the surgical backlog by optimizing perioperative performance in today's resource-constrained environment, as well as an e-book focused on enabling growth in nonoperating room anesthesia procedures amid workforce shortages.