Bottleneck In the OR: How Anesthesiologist Shortages Threaten Surgical Care

Like all surgical specialties, otolaryngology is affected by the anesthesiology provider workforce shortage and changes. Mary Dale Peterson, MD, executive vice president and chief operating officer at Driscoll Health System and past president of ASA, said that the ASA does not have specific data for how different surgeons are staffed, but that otolaryngology is definitely prioritized at Driscoll Health. “Our ENT surgeons are very efficient and flexible, willing to fill in scheduling gaps with their patients in addition to their block schedules,” she said. “CARE teams help us be more efficient with our ENT surgeons as well.”

Experts Weigh In

Anthony Sheyn, MD, professor of otolaryngology–head and neck surgery at the University of Tennessee Health Center and division chief of pediatrics and otolaryngology at Lebonheur Children’s Hospital and St. Jude Children’s Research Hospital, all in Memphis, Tenn., said that the biggest impact of COVID-19 at his institution is that it forced a lot of people, including anesthesiologists, to either retire or move closer to their families, and the newly hired providers, specifically CRNAs, are recent grads and bring less experience and training during the expected acclimation period before they become more efficient. “This has slowed things down,” he said. He said that after the initial struggle to get anesthesiology coverage coming out of COVID-19, which made it difficult to schedule surgeries, his institution has now “passed a corner and is back to the volumes we used to have to provide access to our patients.”

He attributes this rebound largely to his hospital’s leadership, who, for the most part, come from a clinic background and almost all of whom have directly cared for patients in the past, including the president of the hospital, who previously served as the surgeon in chief. “So, our anesthesia departments are growing, [and] our surgery center has been able to open up more rooms and is more efficient than a tertiary center,” he said.

He said the bigger challenge currently, like other otolaryngology practices, is not having enough surgeons to perform procedures. “But we are going from six to eight surgeons in July,” he said, “so our staffing will be good, or at least better.”

Dr. Sheyn emphasized that despite some problems with getting anesthesiology provider coverage before COVID-19, he believes his institution was not as affected because of the leadership of a clinician who understood the importance of otolaryngology as a specialty that generates a lot of finances for the hospital.