At the 2023 ASA annual meeting, the House of Delegates approved an ASA statement titled “Statement on Fundamentals of a Safe and Healthy Workplace for Anesthesiologists.” Unlike traditional ASA declarations, this unique statement doesn’t introduce new policies, but rather consolidates existing ASA statements. It serves as a compendium of knowledge on various workplace challenges faced by anesthesiologists and other anesthesia clinicians.
In recent years, anesthesiologists have grappled with mounting challenges that contribute to burnout risks. These challenges include escalating workloads, a sense of powerlessness in shaping work conditions and schedules, and the complexities of advocating for improved policies and procedures to combat burnout while preserving patient safety. Despite the abundance of ASA statements addressing these concerns, many of our members, along with their employers, facility administrators, and policymakers, remain unaware of these valuable guidelines. Moreover, ASA has lacked a concise document that anesthesiologists can present to decision-makers, bridging the gap between patient safety and clinician well-being.
In early 2023, an ad hoc committee was formed under the leadership of then-ASA President Michael W. Champeau, MD, FASA. This committee consisted of representatives from various ASA committees and embarked on a mission that held deep personal significance for us. We recognized the pressing need for a more effective means to communicate the essential workplace expectations for anesthesiologists. It wasn’t just about policies; it was about safeguarding our collective well-being and that of our patients.
Our committee’s approach was to exclusively reference existing ASA statements, tapping into the wealth of knowledge within our organization. Our goal was to present this critical information on a single page, providing easy access to the detailed ASA statements and documents for those seeking deeper insights, discussions, and references on specific issues.
The result of this collaborative effort is the “Statement on Fundamentals of a Safe and Healthy Workplace for Anesthesiologists,” which can be downloaded at asahq.org/standards-and-practice-parameters/statement-on-fundamentals-of-a-safe-and-healthy-workplace-for-anesthesiologists. This statement encapsulates the collective wisdom of our profession and serves as a rallying call to action. It reminds us of our shared responsibility to advocate for workplace well-being, especially in light of the current challenges facing health care, including issues at the VA level.
Statement on Fundamentals of a Safe and Healthy Workplace for Anesthesiologists
Preamble: The American Society of Anesthesiologists (ASA) is dedicated to enabling its members in the delivery of high-quality and safe physician-led care models. As part of this commitment, the ASA aims to foster work environments that prioritize efficient diagnosis and treatment, to advocate for policies that emphasize overall health and well-being, and to ensure equitable workplace arrangements and fair compensation. With these objectives in mind, the ASA has developed the “Anesthesiologist’s Fundamental Workplace Standards” to outline the workplace standards that every anesthesiologist should expect.
Anesthesiologists should expect:
Patient Care and Safety:
- To practice physician-led anesthesia care. The ASA, WFSA, and WHO believe that wherever and whenever possible, anesthesia should be provided, led, and overseen by an anesthesiologist (WHO-WFSA International Standards for a Safe Practice of Anesthesia and ASA Statement on Physician-Led Anesthesia Care).
- To perform a pre-anesthesia assessment for every patient under their care (ASA Guidelines for the Ethical Practice of Anesthesiology).
- To report safety or quality concerns without fear of retaliation (ASA Statement on Safety Culture).
- To work with qualified anesthesia clinicians in a physician-led team-based model (ASA Statement on Students Involved in Anesthesia Care).Optimized Health:
- Family leave (ASA Statement on Personal Leave).
- Access to health services, including mental health services (ASA Statement on Creating a Culture of Well-Being for Health Care Workers).
- Reasonable accommodations, including lactation policies, that are necessary for a return to work (ASA Statement on Lactation Among Anesthesia Clinicians).
- A policy that clearly outlines how burnout is recognized, reported, and addressed (ASA Statement on Burnout).
- Relief from fatigue (ASA Statement on Fatigue).
- Peer and institutional support following adverse events. This may include relief from duty in some circumstances (ASA Statement on Peer Support After Unexpected Outcomes – Treatment of the ‘Second Victim’).Work Environment:
- Limitation of excessive noise and distractions in the workplace that compromise patient care (ASA Statement on Distractions).
- For safety incidents, patient complaints, and professionalism complaints to be evaluated and addressed under a Just Culture process (ASA Statement on Safety Culture).Fair and Equitable Compensation:
- Fair and equitable compensation based on comparable work is essential to ensure that anesthesiologists are paid appropriately. This includes considering factors such as board certification, experience, education, and the complexity of the work performed (ASA Statement on Compensation Equity Among Anesthesiologists).
- Compensation and advancement to be determined by objective assessment and established criteria. Anesthesiologists should be evaluated based on their performance, skills, and contributions to the organization, rather than any personal characteristics. Employment decisions cannot be made because of race or color, gender, sexual orientation, pregnancy or parental status, religious belief, or genetic information whether overtly stated or implied (ASA Statement on Compensation Equity Among Anesthesiologists).
The anesthesiologist should be able to advocate for all fundamental workplace standards without fear of retaliation or reprisal.