Meeting Anesthesiology Specialist Demand with Effective Recruitment Strategies
Anesthesiology is one of a variety of specialties for which there is a rising demand in the U.S. and a limited supply. In its June 2021 report, the Association of American Medical Colleges (AAMC) projected a shortage of up to 124,000 physicians nationally by 2034. This will include a shortage of up to 47,000 primary care physicians, but an even larger shortage of up to 77,100 specialists.
The AAMC report identifies population aging as the primary driver of the physician shortage. Though senior citizens aged 65 or older comprise only 14% of the population, they account for 34.0% of inpatient procedures and 37.4% of diagnostic treatments and tests, according to the Centers for Disease Control and Prevention (CDC). With 10,000 Baby Boomers turning 65 every day, population aging is causing an increase in a wide range of procedures requiring anesthesia and therefore anesthesiologists.
The proliferation of sites of service providing consumer convenience, such as urgent care centers and outpatient clinics, also has been driving the utilization of procedures requiring anesthesia. The longstanding shortage of anesthesiology and other specialty services in rural and other traditionally underserved areas also contributes to continued demand for anesthesiology.
The Lasting Impact of COVID-19
COVID-19 has had a significant, but temporary, inhibiting effect on demand for anesthesiology and other medical services, due in part to the 2020 ban on elective procedures put in place by many healthcare facilities.
The reluctance or inability of patients to undergo elective procedures negatively affects care quality, partly by creating procedure backlogs which now drive the need for anesthesiologists upward. Though these procedures may be classified as “elective,” it is inaccurate to say they are unnecessary. The designation “elective” simply divides emergent from non-emergent care. Necessary preventive procedures such as colonoscopies are classified as electives, as are essential surgeries such as cataract removal.
Anesthesiologists Remain Among the Most Recruited Specialties
In its annual Review of Physician and Advanced Practitioner Recruiting Incentives, AMN Healthcare Physician Solutions (formerly Merritt Hawkins) tracks national recruiting trends, including which types of providers are among the most recruited. The 2022 Review indicates that anesthesiologists ranked 7th on AMN Healthcare’s list of most recruited providers. CRNAs ranked 11th. Both these rankings reflect growing utilization of procedures requiring anesthesia as COVID-19 becomes less of an impediment to patient access to care.
Anesthesiology Specialty Demographics
| Total |
45,700
|
| Active in Patient Care | 37,461 |
| Board Certified | 31,467 (84% of those active) |
| International Medical Graduates (IMG) | 7,867 (21%) |
| Aged 55+ | 21,353 (57%) |
| Male | 28,095 (75%) |
| Female | 9,366 (25%) |
| Final-Year Medical Residents | 1,037 (3%) |
As these numbers indicate, about one quarter of anesthesiologists (21%) are international medical graduates (IMGs), compared to approximately 25% of all physicians. In addition, a comparatively low number are female – 25% compared to approximately 35% of all physicians. The supply of new anesthesiologists remains somewhat limited, with about slightly over 1,000 completing their training and joining the workforce each year.
Anesthesiology Recruiting Recommendations
As demand for anesthesiologists increases, so will the difficulty of recruiting these specialists. Hospitals, medical groups, and other healthcare facilities seeking anesthesiologists should prepare to commit the required effort, flexibility, responsiveness, and resources required to be successful in today’s challenging market.
More Candidates Seeking Independent Status
In the reverse of a longstanding trend among physicians, a growing number of anesthesiologists are seeking practices that offer independent, 1099 status while fewer are seeking employed, W-2 status. Anesthesiologists are finding that they can achieve higher incomes and practice autonomy at independent practice settings.
As with other practice areas, it is important to be flexible. For example, in a search at an academic institution, an AMN Healthcare client needed to recruit multiple general anesthesiologists in a short time frame. To attract a wide pool of candidates, they decided to create a new “staff” role that blended the positives of a 1099 faculty position with aspects of the employed model, while also providing full benefits. The “staff” role offered no call, no overnight duties, and a fixed salary of $400,000, plus full benefits. Anesthesiologists still participate in the general OR rotation and work at the same premier teaching facilities while enjoying a level of independence.
Scope of Practice and Candidate Parameters
Flexibility also can be extended to the scope of practice. As anesthesiology training becomes more advanced, a growing number of anesthesiologist candidates are looking for subspecialty work or to focus on one aspect of anesthesiology.
Because the market is extremely competitive, it is important to be flexible on candidate parameters. Age, gender, and country of origin should be secondary considerations when evaluating candidates, taking a back seat to training, skill levels, work ethic, and other personal characteristics of candidates. As was noted above, 54% of anesthesiologists are 55 or older, so it may be important to consider these candidates even if they only plan to work for a limited number of years.
It has not been uncommon in the past for academic medical centers to turn down qualified candidates based on lack of academic experience. Today, however, academic centers are finding that many anesthesiologists and other types of physicians can make the transition to a teaching environment seamlessly, so that broad academic experience is no longer a prerequisite for candidates.
Competitive Compensation
Compensation should be competitive and in line with national rather than local standards, because you are likely going to be competing for candidates with facilities outside your area or state. The data above shows compensation ranges for anesthesiologists, which are a moving target due to rising demand. Today, the base salary for anesthesiologists in nonacademic settings is moving toward the $450,000 range, with signing bonuses averaging about $40,000.
For anesthesiologists, production is tracked in additional shifts, which, in non-academic settings, can boost income into the $150,000 range. It is important to compensate anesthesiologists for working extra shifts as not doing so is a cause of complaint and dissatisfaction. It may be advisable to consider adding equity lines if the facility is hiring into a new ambulatory surgery center or other venue.
About AMN Healthcare Physician Solutions
AMN Healthcare Physician Solutions was originally established in 1987 as Merritt Hawkins. AMN Healthcare provides permanent physician, locum tenens, advanced practitioner, plus, leadership, language services, nursing, and allied staffing and search services to hospitals, medical groups, community health centers, telehealth providers and many other types of entities nationwide.
As a thought leader in our industry, AMN Healthcare produces a series of surveys, white papers, books, and webinar presentations internally and produces research and thought leadership for third parties.
