Facing an ongoing staffing crisis and declining reimbursement rates, the recruitment, retention and financial management of anesthesia providers and their services persist as a top concern among ASC leaders.
Leaders have turned to a wide range of strategies to attract high-level anesthesia providers, including both monetary and non-monetary benefits.
However, for some leaders, the anesthesia staffing crisis bubble is emblematic of deeper, more existential concerns facing the specialty.
“If you look back 10 years ago, anesthesia … nobody cared,” Vijay Sudheendra, MD, president of Providence, R.I.-based Narragansett Bay Anesthesia, said in an Oct. 16 panel at Becker’s 31st Annual Meeting: The Business and Operations of ASCs, which took place in Chicago. “We were just an afterthought for surgeons, for hospital administrators. Nobody cared whether we existed or not.”
However, things have since shifted, Dr. Sudheendra said. The staffing crisis has brought anesthesiologists, certified registered nurse anesthetists and other providers into the center of conversations about healthcare operations, presenting both new challenges and opportunities.
“With that being said, empowering anesthesiologists and getting a seat at the table with the surgeons, hospital administrators is key, even in the ASC,” he said. “But we also have to do our jobs. Yes, respect is a two-way street. We can’t just be the intubation-to-extubation paradigm and go home at 3:30. You have to be part of a system.”
This idea that anesthesia professionals must enhance the value of their services to ASCs isn’t new for Dr. Sudheendra. In 2024, he told Becker’s that his group practices’ approach to anesthesia practice emphasized the “perioperative home,” expanding their focus to support patients through the full preparation and recovery periods of a procedure.
His group is emphasizing transitional pain services and innovative approaches like cryoanalgesia to reduce opioid use and accelerate rehabilitation. By leading postoperative care initiatives and investing in physician leadership, anesthesia practices can play a more significant role in determining how the industry responds to the ongoing staffing crisis and beyond.
“You have to add value above and beyond what we have been doing. Then the surgeons and the hospital and the cardiologists will recognize our value, and then that increases credibility,” Dr. Sudheendra said. “And when there is value and there is credibility, you can ask for money and they will give it to you, because there is quality and there is consistency and there is reliability.”
This is of particular importance as anesthesia reimbursements continue to face declines from both CMS and private payers and ASCs sink further into the gap between anesthesia expenses and revenue.
“At some point this is going to collapse. So you have to add value to our profession,” Dr. Sudheendra said. “Use this crisis as an opportunity, not because, ‘Oh, someone else is paying more, I need to go there.’ [Or because] somebody else is going to give you a better work life balance. No, the profession is actually going to go down, because people are going to look for alternative providers to be able to do that.”
He said that, anecdotally, this is already happening in some areas of healthcare, such as emergency rooms being created with their own sedation radiologists.
“We will have an existential crisis,” Dr. Sudheendra said. “It’s very important for us to use this as an opportunity and to elevate ourselves, create and be seen in the hospital as a reliable provider.”