Bottleneck In the OR: How Anesthesiologist Shortages Threaten Surgical Care

Numerous studies have documented the shortage of anesthesiologists and its effect on surgical specialties. The shortage is largely a result of the imbalance of supply and demand, which, as described in a 2024 study by the American Society of Anesthesiologists (ASA), is not unique to anesthesiology but cuts across all areas of healthcare (Anesthesiology. doi.org/10.1097/aln.0000000000005052). As in other areas of healthcare, the COVID-19 pandemic further exacerbated the already growing healthcare staffing shortages and significantly affected the shortage of anesthesia providers. The 2024 ASA report, which is based on two workforce summits held in 2022 and 2023, describes how the surge in demand for surgical procedures post COVID-19 put additional stress on an anesthesiology workforce that, before the pandemic, was already feeling a slight shortage. A 35% anesthesiology workforce shortage reported by facilities before the pandemic became a 78% shortage two years after the pandemic.

The ASA report also describes trends affecting the anesthesiology workforce that will impact surgical specialties, including the need for increased anesthesiology providers for an aging population with increased medical morbidities that require a disproportionate number of surgeries and procedures; the evolution of procedures from hospital-based to outpatient, which will result in an increased demand for non-operating room anesthesia care; an aging workforce, with 57% of anesthesiologists older than 55 years of age; and the number of anesthesia providers estimated to have left the workforce in 2022 (2,500 anesthesiologists, 2,200 nurse anesthetists, and 65 anesthesiologist assistants).

Although training programs for anesthesiology providers who have entered the workforce since 2023 (1,900 anesthesiologists, 3,000 nurse anesthesiologists, and 300 anesthesiologist assistants) have made up for some of this deficit, it is estimated that inefficiencies in scheduling will continue to put a strain on anesthesiology providers as the number of procedures, and the increased complexity of those procedures, only continue to grow.

Along with the pandemic, other factors continue to influence the shortage of anesthesia providers (Journal of Medicine, Surgery, and Public Health. doi.org/10.1016/j.glmedi.2024.100048; see Table 1).

Looking ahead, recent data from Medicus Healthcare Solutions, a leading locum tenens staffing firm, highlight the projected growing gap between supply and demand of anesthesiologists. About 52,300 anesthesiologists currently practice in the U.S., a number that is projected to see a shortage of 8,450 by 2037 (Medicus. https://tinyurl.com/2s48svzz). Making up for some of this is the increasing demand for certified registered nurse anesthetists (CRNAs), with a projected 10% growth from 49,900 in 2023 to 55,100 in 2033. Furthermore, demand for certified anesthesiologist assistants (CAAs) is predicted to increase as part of team-based anesthesia staffing models. Currently, CAAs can practice in 19 states and jurisdictions.