Is there an anesthesiologist in the OR?
Healthcare facilities around the nation are facing a critical shortage of anesthesiologists. While some states have been hit harder than others, virtually all facilities have had to deal with staffing issues within the anesthesia specialty. According to a nationwide survey of senior hospital administrators conducted by the American Society of Anesthesiologists (ASA), 47 percent of hospitals reported a shutdown or reduction in OR hours due to the shortage of anesthesia providers.*
Why the shortage?
Medical liability rates
Anesthesiologists are high on the list among specialists who have had to withstand increased medical liability insurance premiums.
According to the National Physician Survey on Professional Medical Liability, (AMA Division of Market Research and Analysis, April 2003), in the past year, anesthesiologists' premiums have climbed 33.7 percent. The mean annual liability insurance premium jumped from $13,400 in 2001 to $18,000 in 2002, with an average premium for 2003 estimated at $26,000, a 96% increase in 2 years. These rates are alienating anesthesiologists, and in many cases driving them away.
Locum tenens work offers physicians freedom and the ability to focus on patient care, while alleviating much of the business-related burden of their career. According to ASA President, James E. Cottrell, MD, "Anesthesiology is consistently recognized for the contributions its practitioners have made in improving patient care. These on-going and unreasonable hikes in liability insurance have seriously hampered research in anesthesiology and other medical specialties."
Fewer anesthesiologists entering the market
In the late 1990s the number of anesthesiologists graduating from residency programs decreased dramatically. The drop is attributable to a few of factors. In 1994, the ASA commissioned a report by Abt Associates, one of the largest for-profit government and business research and consulting firms in the U.S. (www.abtassoc.com) on the future employment needs in the field of anesthesiology. The report concluded that there would be a future over supply of anesthesiologists. During this same time, large-scale health reform was on the Clinton Administration agenda. As a result, the Accreditation Council for Graduate Medical Education recommended limiting specialist training to 50% of all positions. The number of accredited anesthesiology programs decreased and the graduating residents dropped by 44 percent between 1994 and 2000, according the the ASA.
Increasing demand
With the general population of the U.S. aging and the medical resources used for treating this population increasing, a greater demand is placed on anesthesia services. According to the National Center for Health Statistics (NCHS), inpatient surgeries increased from 22.6 million in 1994 to 23.2 million in 2000. Add to this the increasing number of outpatient surgeries and then factor in the decrease in productivity when an anesthesiologist is moving from inpatient to outpatient settings on a daily basis, and you've got a serious supply and demand challenge.
Filling the gap
It's taken close to ten years for the shortage to get to the point where it is now, and it could take at least this long to correct itself. In the meantime, facilities need to be able to anticipate changes, act fast and keep their departments staffed, and locum tenens physicians can help them do just that.
Why locum tenens?
Locum tenens work offers physicians freedom and the ability to focus on patient care, while alleviating much of the business-related burden of their career. With insurance, paperwork, licensing and credentialing issues taken care of, locum tenens physicians are free to focus on their patients.
For a facility in need of anesthesia staff, locum tenens physicians play a vital role in providing continuity of care. And, among the specialties, anesthesiologists require little administrative infrastructure, giving the doctors the freedom and latitude they need to practice in a variety of settings.
* The report's executive summary and selected data tables
can be found on the ASA website
 www.asahq.org.
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