ANESTHESIA WORKFORCE
Abstract
The ongoing anesthesia workforce shortage continues to affect patient care, availability of services, and anesthesiologist job satisfaction (asamonitor.pub/48z4OnS). After the start of the COVID-19 pandemic, a surge in demand for services, without a concomitant rise in available labor, has led to compromised health care facilities, increased cost of care, increased clinician burnout, disrupted procedural schedules, and alterations in training and education. The imbalance between available anesthesia clinicians and the need for services is most pronounced in nonoperating room locations where the number of specialists has increased by 26% between 2018 and 2023, whereas the anesthesia workforce increased by 18% during the same period.
Although COVID caused a brief period where the need for anesthesia services was significantly diminished, a subsequent surge has led to widespread shortages; two years after the pandemic started, an astonishing 78% of all facilities reported anesthesia staffing shortages. The additional stress created on the system by the relative scarcity of resources has led to increased work intensity and stress, unsustainable workloads, and higher rates of retirement. Authors Abouleish et al. characterize this as a “dangerous spiral” leading to decreased health care access and diminished quality of care and patient safety.
Why it matters
The long-term implications of an anesthesia workforce shortage include not only dramatic effects on the present state of health care availability and quality of services, but also effects on the future of anesthesia education, residency workforce allotment, and economic considerations. Though expansion of residency training slots is almost certainly a needed solution, it takes time to expand educational capacity, fund it appropriately, recruit candidates, and train them before they enter the independent practice workforce. There may also need to be changes to anesthesia team care models and reapportionment of anesthesia availability between types of procedural locations, including inpatient centers and ambulatory surgery facilities, as well as ORs and nonoperating room anesthesia locations. It will take a concerted effort between anesthesiologists, lawmakers, and administrators to avoid the “dangerous spiral” that leads to decreased job satisfaction, burnout, and further attrition.
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