The anesthesia staffing crisis in the U.S. is generally understood to be caused by several factors that can be boiled down to a supply-and-demand issue.
Nearly 30% of anesthesiologists are projected to leave the practice by 2033, according to a 2023 white paper from Medicus Healthcare Solutions. Currently, the U.S. has a ratio of 1 anesthesiologist for at least 7,700 people, while over 17% of current providers are nearing retirement and over 56% are over 55.
The shortage also extends to certified registered nurse anesthetists, who make up more than 80% of anesthesia providers in rural counties. By 2033, the U.S. is projected to face a shortage of about 12,500 CRNAs, nearly 22% of the current workforce. But demand remains high, with the Bureau of Labor Statistics projecting 38% growth in the field by 2032, making the CRNA one of the fastest-growing healthcare roles.
However, medical schools are not producing enough newly trained anesthesia professionals to meet this demand, creating a bottleneck effect. While 178 anesthesiology residency programs and 1,695 anesthesiology residency positions remain available in the U.S., around 44% of medical students seeking residencies in anesthesiology did not match in 2024.
Between 2019 and 2023, pain medicine fellowships saw a 45% decline in anesthesia-based applicants, according to a study published in the January edition of Pain Practice.
In 2025, things have begun to change course. The 2025 match saw 99% of anesthesiology residency positions filled, according to data from the National Resident Matching Program. Still, the shortage remains far ahead of where residency slots will be able to catch up to in the immediate future.
In an Oct. 16 panel at Becker’s 31st Annual Meeting: The Business and Operations of ASCs, which took place in Chicago, anesthesia leaders discussed their strategies for working around the supply end of the shortage, including different recruitment initiatives and scheduling techniques.
Vijay Sudheendra, MD, president of Providence, R.I.-based Narragansett Bay Anesthesia, said that his practice runs its own anesthesia school through a hospital and academic medical center partnership, where it trains providers with the hopes of keeping as many as possible retained.
However, this isn’t always the case. As a smaller private practice, Dr. Suhdeendra said that it’s not always possible to meet prevailing compensation demands — a problem that many facilities are facing.
“With that being said, there’s also some amount of manufactured crisis in anesthesia. There are people who go to 1099, per diem, people who only want to work for 24, 30, 32 hours [per week], yet want to make the same as 40 hours,” he said. “There is a real crisis, and I get it, but there’s also some manufactured crisis because people are taking advantage of the situation.”
While Dr. Sudheendra clarified that he doesn’t have all of the answers to the “manufactured” aspect of the crisis, he has found collaboration and flexibility in his partnerships with ASCs.
“We are still struggling with our staffing, both in the hospital and ASC, but what we have found is the ASCs would like to partner with us because we are also in the hospitals,” he said. “So our recruitment pool is a lot better than if you’re just doing ASCs with one or two or three or four rooms, it’s not easy because then you’re also sitting on their [profit and loss]. For us, it’s very easy because we flex our staff.”
Narragansett Bay Anesthesia utilizes a regional coordination model in Rhode Island, which allows Dr. Sudheendra to adjust his staffing to meet the needs of partner facilities on any given day.
“So if, for example, if ASC is running three rooms instead of five rooms one day, we’re going to move those staff to another place,” he said. “Therefore, they’re not sitting on their P&L.”
He added that part of his strategy is to avoid excessive overstaffing.
“We never staff at 200%, we are only staffed 80% to 85%,” he said. “But the risk is that if there’s 10, 12, people calling out sick, then we have a problem. So far, we haven’t had the situation, so we’ve been able to be successful.”