As procedures continue to shift to the outpatient setting, anesthesia providers are seeing an increase in demand for their services.
At the same time, staffing shortages and reimbursement declines persist in the specialty, raising questions about how the industry will move forward over the next several years.
Udaya Padakandla, MD, an anesthesiologist at Baylor Scott & White Health in Dallas and immediate past president of the Texas Society of Anesthesiologists, recently joined Becker’s to discuss anesthesia’s role in outpatient migration and where the industry is headed next.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: Where do you see anesthesia’s place in the ongoing migration to outpatient surgeries/ASCs? How are anesthesiologists adapting to the increased volume of outpatient surgeries?
Udaya Padakandla: The increasing volumes of surgeries in ASC’s forces [the] anesthesiology community to seek financial assistance from ASCs because of their ongoing poor CMS and private payer compensation. Since ASCs do not benefit from Outpatient Prospective Payment Services that ensure higher site-differential payments to [HOPD]s, ASCs face an uphill battle retaining anesthesiologists on their staff. This will necessitate higher throughput from anesthesiologists to keep up with the revenue generation and in the long run lead to increased burnout and difficulty in retaining physician and anesthesia provider talent.
Q: I read about your advocacy efforts in anesthesia residency programs in Texas.
What do you think needs to change to address the ongoing shortage of anesthesia providers? Can you say more about why advocacy from other anesthesiologists key in addressing this issue?
UD: I strongly believe in incorporating education on advocacy at both the medical school level and at the residency level. Advocacy involves educating residents on multiple levels, including one pertaining to health policy and healthcare marketplace and one pertaining to scope of practice expansion issues.
To address the ongoing shortage of anesthesia providers, several things need to be addressed: medical education needs to be made more affordable, the number of residency slots need to be increased, economic incentives need to be provided to lure more anesthesiologists to their rural communities and loan repayments need to be made less burdensome.
Advocacy from fellow anesthesiologists is key in addressing this issue because greater numbers of anesthesiologists advocating for their own profession will lead to increased awareness among legislators at both the state and the federal level.
The recent passage of the DOCTOR [Decreasing Occupational Certification Timelines, Obstacles and Regulations] Act in Texas will hopefully lead to attracting some established physician talent from other countries to the rural communities and help in easing physician shortage to some degree. However, the passage of HR 1 in U.S. Congress will limit the loans medical students can borrow from the federal government, and is likely to decrease recruitment of a greater number of students to the medical community. Also, the Resident Education Deferred Interest Act REDI Act [SB 942] in the U.S. Senate is a bipartisan bill aimed at easing loan repayments after graduation from medical schools. It has been filed two or three times in Congress now, but has gained little traction