Status of the anesthesia workforce in 2011: Evolution during the last decade and future outlook

Anesthesia and Analgesia

Volumn 115, Issue 2, 2012, Pages 407-427

  Schubert, Armin ^a   Eckhout, Gifford V ^b   Ngo, Anh L ^c   Tremper, Kevin K ^d   Peterson, Mary D ^e  

^a OCHSNER CLINIC FOUNDATION   (United States)

^b Trinity Mother Frances Health System   (United States)

^c UNIVERSITY OF SOUTHERN CALIFORNIA   (United States)

^d UNIVERSITY OF MICHIGAN HEALTH SYSTEM   (United States)

^e UNIVERSITY OF TEXAS MEDICAL BRANCH   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AGING; ANESTHESIA; ANESTHESIST; BARIATRIC SURGERY; BODY BURDEN; COMPENSATION; DIABETES MELLITUS; ECONOMICS; GENDER; HEALTH CARE NEED; HEALTH CARE PERSONNEL; HEALTH CARE POLICY; HEALTH SERVICE; HUMAN; INTENSIVE CARE; JOB MARKET; MEDICAL ASSISTANT; MEDICAL EDUCATION; MEDICAL TECHNOLOGY; MORTALITY; NURSE ANESTHETIST; OBESITY; OPERATING ROOM; PARAMEDICAL PERSONNEL; PRIORITY JOURNAL; PRODUCTIVITY; RETIREMENT; REVIEW; SURGEON; SURGICAL TECHNIQUE; WORK ENVIRONMENT;

ANESTHESIOLOGY; CAREER CHOICE; FORECASTING; HEALTH MANPOWER; HEALTH PERSONNEL; HEALTH SERVICES ACCESSIBILITY; HEALTH SERVICES NEEDS AND DEMAND; HISTORY, 21ST CENTURY; HUMANS; NURSE ANESTHETISTS; PHYSICIAN ASSISTANTS; UNITED STATES;

EID: 84864418440     PISSN: 00032999     EISSN: None     Source Type: Journal    
DOI: 10.1213/ANE.0b013e3182575b4e     Document Type: Review

References (79)

1. Estimation of Physician Work Force Requirements in Anesthe-siology. Bethesda, MD: Abt Associates, Inc., 1994:1-53
2. Schubert A, Eckhout G, Tremper K. An updated view of the national anesthesia personnel shortfall. Anesth Analg 2003; 96:207-14 (Pubitemid 36042062)
3. Mastropietro CA, Horton BJ, Ouellette SM, Faut-Callahan M. The National Commission on Nurse Anesthesia Education 10 years later. Part 1. The commission years (1989-1994). AANA J 2001;69:379-85
4. Schubert A, Eckhout G, Cooperider T, Kuhel A. Evidence of a current and lasting national anesthesia personnel shortfall: scope and implications. Mayo Clin Proc 2001;76:995-1010 (Pubitemid 32946012)
5. Guide to Healthcare Market Segments. Chicago: SMG Marketing Group, Inc., 2000
6. Fallacaro MD, Ruiz-Law T. Distribution of US anesthesia providers and services. AANA J 2004;72:9-14 (Pubitemid 38428821)
7. Bierstein K. Survey of Hospital Administrators About Anesthesia Coverage Internet. ASA Newslett 2002;66:29-31. Available at: http://www.asahq.org/For- Members/Publications-and-Research/Periodicals/ASA-Newsletter.aspx?year= 2002&ypp=1#archive. Accessed July 5, 2011
8. Stewart W, Nienaber B. The Tarrance Group Executive Summary. Alexandria, VA: The Tarrance Group (http://www.tarrance. com/). July 3, 2002. http://www.asahq.org/For-Members/Advocacy/Office-of-Governmental-and-Legal- Affairs/Practice-Management-Documents-for-Download.aspx. Accessed July 1, 2011
9. Cooper RA, Stoflet SJ, Wartman SA. Perceptions of medical school deans and state medical society executives about physician workforce. JAMA 2003;290:2992-5 (Pubitemid 37505532)
10. The Center for Health Workforce Studies. Physician Supply and Demand Indicators in New York, 2000-2005: A Summary of Trends for 35 Specialties. State University of New York, November 2006
11. Kheterpal S, Tremper K, Shanks A, Morris M. Seventh and eighth year follow-up on workforce and finances of the United States anesthesiology training programs: 2007 and 2008. Anesth Analg 2009;109:897-9
12. Frequently-Asked Questions About the ACGME Common Duty Hour Standards (Updated October 2005). ACGME website 2005. Available at: http://www.acgme.org/ acWebsite/dutyHours/dh-faqs2011.pdf. Accessed July 1, 2011
13. Merwin E, Stern S, Jordan L. Supply and demand of nurse anesthetists: present and future projections. Unpublished information courtesy of Lorraine M. Jordan, PhD, Director of Research and AANA Foundation, 2003
14. Schubert A. National Resident Matching Program results for 2007: recruitment maintains all-time high for specialty of anesthesiology. ASA Newslett 2007;71:17-27
15. Grogono AW. National Resident Matching Program results for 2004: slight decline in recruitment. ASA Newslett 2004;68:18-23
16. Tremper K, Shanks A, Morris M. Five-year follow-up on the work force and finances of United States anesthesiology training programs: 2000 to 2005. Anesth Analg 2007;104:863-68 (Pubitemid 46548312)
17. Eckhout G. Where are those anesthesiologists? Deciphering the numbers. ASA Newslett 2004;68:14-6
18. Schubert A, Christiansen EK, Peterson MD. Workforce Contribution of Anesthesiologists over 50: Results of a 2006 National Survey. Proceedings of the ASA Annual Meeting, 2009
19. Ryan-Maher MB. Anesthesiology pay lagging productivity, inflation. Anesthesiol News 2007;33:1, 10
20. ASA House of Delegates Report, 2006
21. Daugherty L, Finseca R, Kumar KB, Michaud PC. An Analysis of the Labor Markets for Anesthesiology. Santa Monica, CA: RAND Corporation, 2010:1-155
22. Fordyce MA, Chen FM, Doescher MP, Hart LG. 2005 Physician Supply and Distribution in Rural Areas of the United States. Rural Health Research and Policy Centers, University of Washington School of Medicine, November 2007
23. United States Government Accountability Office. Many Medical Facilities Have Challenges in Recruiting and Retaining Nurse Anesthetists. GAO-08-56, December 2007. Available at: http://www.gao.gov/new.items/d0856.pdf. Accessed July 1, 2011
24. Merwin E, Stern S, Jordan LM, Bucci M. New estimates for CRNA vacancies. AANA J 2009;77:121-9
25. Dutton RP. Anesthesia in the United States. Anesthesia Quality Institute, American Society of Anesthesiologists, 2009:1-30
26. Merritt Hawkins. Available at: www.merritthawkins.com. Accessed July 5, 2011
27. Greene L. Hospital Boom Is Sheer Survival. St. Petersburg Times Online Tampa Bay Internet, 2004:A1. May 16, 2004. Available at: http://www.sptimes.com/ 2004/05/16/Tampabay/Hospital- boom-is-shee.shtml. Accessed July 5, 2011
28. Abouleish A, Dexter F, Epstein R, Lubarsky D, Whitten C, Prough D. Labor costs incurred by anesthesiology groups because of operating rooms not being allocated and cases not being scheduled to maximize operating room efficiency. Anesth Analg 2003;96:1109-13 (Pubitemid 36359052)
29. Dexter F, Epstein R, Marsh H. A statistical analysis of weekday operating room anesthesia group staffing costs at nine independently managed surgical suites. Anesth Analg 2001;92: 1493-8 (Pubitemid 32493169)
30. Strum D, Vargas L, May J. Surgical subspecialty block utilization and capacity planning. Anesthesiology 1999;90:1176-85
31. Poley S, Belsky D, Gaul K, Ricketts T, Fraher E, Sheldon G. Longitudinal trends in the U.S. surgical workforce 1981-2006. Bull Am Coll Surg 2009;94:27-31
32. Donen N, King F, Reid D, Blackstock D. Canadian anesthesia physician resources: 1996 and beyond. Can J Anaesth 1999;46:962-9 (Pubitemid 29522838)
33. Kaplan RF, Yang CI. Sedation and analgesia in pediatric patients for procedures outside the operating room. Anesthe-siol Clin North Am 2002;20:181-94 (Pubitemid 34213259)
34. Lalwani K, Michel M. Pediatric sedation in North American children's hospitals: a survey of anesthesia providers. Paediatr Anaesth 2005;15:209-13 (Pubitemid 40364746)
35. Berkowitz R, Wadden TA, Tershakovec AM, Cronquist JL. Behavior therapy and sibutramine for the treatment of adolescent obesity: a randomized controlled trial. JAMA 2003; 289:1805-12 (Pubitemid 37430250)
36. Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, Van Lente F, Levey AS. Prevalence of chronic kidney disease in the United States. JAMA 2007;298:2038-47 (Pubitemid 350074801)
37. Centers for Disease Control and Prevention (CDC). Prevalence of self-reported arthritis or chronic joint symptoms among adults: United States, 2001. MMWR Morb Mortal Wkly Rep 2002;51:948-50
38. Boyle JP, Honeycutt AA, Narayan KM, Hoerger TJ, Geiss LS, Chen H, Thompson TJ. Projection of diabetes burden through 2050: impact of changing demography and disease prevalence in the U.S. Diabetes Care 2001;24:1936-40 (Pubitemid 33716504)
39. Angus DC, Kelley MA, Schmitz RJ, White A, Popovich J. Current and projected workforce requirements for care of the critically ill and patients with pulmonary disease. JAMA 2000;284:2762-70
40. Etzioni DA, Liu JH, Maggard MA, Ko CY. The aging population and its impact on the surgery workforce. Ann Surg 2003;238:170-7 (Pubitemid 38174489)
41. ASA at a glance. ASA Newslett 2008;72:26-7
42. Smart DR, Sellers J. Physician Characteristics and Distribution in the US, 2010 Edition. Chicago: American Medical Association, 2010:21, 439, Tables 1.9 and 6.2
43. Blough GG, Scott SJ. Creative Scheduling for Anesthesiologists: Accommodating the Workforce in 2007, Syllabus of the 2007 ASA Conference on Practice Management Physician Specialty Data: A Chart Book. Washington, DC: Association of American Medical Colleges, 2006
44. Graduate Medical Education in the United States 2005: JAMA 2005;294:1129-32
45. Smart DR, Sellers J. Physician Characteristics and Distribution in the US, 2008 Edition. Chicago: American Medical Association, 2007:20
46. Amburgey B, Fordham M, Payne B, Trebelhorn M. Kentucky State Legislature Study. In: ASA House of Delegates 2007 Session Handbook, 2007:1
47. American Board of Physician Specialties. Available at: www.abpsus.org. Accessed July 5, 2011
48. Schubert A. National resident matching program results 2010: has recruitment into our specialty crested? ASA Newslett 2010;74:24-9
49. Nakata DA, Powell PT, Choi A. What effect does income have on anesthesiologist retirement rates? Anesthesiology 2004;101: A1325
50. Dorsey ER, Jarjoura D, Rutecki GW. Influence of controllable lifestyle on recent trends in specialty choice by US medical students. JAMA 2003;290:1173-8 (Pubitemid 37430422)
51. Dulisse B, Cromwell J. No harm found when nurse anesthetists work without supervision by physicians. Health Aff (Millwood) 2010;29:1469-75
52. Abenstein JP, Long KH, McGlinch BP, Dietz NM. Is physician anesthesia cost-effective? Anesth Analg 2004;98:750-7 (Pubitemid 38252671)
53. O'Riordan J, Kozakowski M, Hennessey S, Hosmer K. Value at the Center: State of Our Industry 2007. Washington, DC: The Healthcare Advisory Company, 2007:3
54. National Center for Health Statistics: Ambulatory and Inpa-tient Procedures Internet. U.S. Department of Health and Human Services Centers for Disease Control and Prevention, 2006
55. Williams TE, Satiani B, Thomas A, Ellison EC. The impending shortage and the estimated cost of training the future surgical workforce. Ann Surg 2009;250:590-7
56. Hawkins JL, Gibbs CP, Orleans M, Martin-Salvaj G, Beaty B. Obstetric anesthesia work force survey, 1981 versus 1992. Anesthesiology 1997;87:135-43 (Pubitemid 27438633)
57. Health Resources and Services Administration Report to Congress: The Critical Care Workforce-A Study of Supply and Demand for Critical Care Physicians. Washington, DC: U.S. Department of Health and Human Services, May 2006:1-34
58. NewsRX™: World's Largest Source of Health Information Internet. 2004. Available at: http://www.NewsRx.net. Accessed July 5, 2011
59. Etzioni DA, Liu JH, Maggard MA, O'Connell JB, Ko CY. Workload projections for surgical oncology: will we need more surgeons? Ann Surg Oncol 2003;10:1112-7 (Pubitemid 40486837)
60. Pennington DG. Impact of new technology on cardiothoracic surgical practice. Ann Thorac Surg 2006;81:10-8 (Pubitemid 41815366)
61. Freund PR, Posner KL. Sustained increases in productivity with maintenance of quality in an academic anesthesia practice. Anesth Analg 2003;96:1104-8 (Pubitemid 36359051)
62. Pondrom S. Can generics be trusted? Am J Transplant 2010;10:708-9
63. Kheterpal S, Tremper K, Shanks A, Morris M. Six-year follow-up on workforce and finances of the United States anesthesiology training programs: 2000 to 2006. Anesth Analg 2009;108:263-72
64. Smith M, Sandberg WS, Foss J, Massoli K, Kanda M, Barsoum W, Schubert A. A high-throughput operating room process for joint arthroplasties routinely outperforms normal counterparts. Anesthesiology 2008;109:25-35
65. Kheterpal S, Tremper KK, Shanks A, Morris M. Brief report: workforce and finances of the United States anesthesiology training programs: 2009-2010. Anesth Analg 2011;112:1480-6
66. Adamy J. Law Won't Dent Health Outlays. The Wall Street Journal, September 9, 2010
67. Sandberg WS. Barbarians at the gate. Anesth Analg 2009; 109: 695-9
68. ACGME Data Resource Book. Chicago: Accreditation Council for Graduate Medical Education, 2009-2010:41-56. Available at: http://www.acgme.org/ acWebsite/dataBook/dat-index. asp. Accessed January 20, 2012
69. Abouleish AE, Stead SS, Cohen NA. Myth or fact? Nurse anesthetists cost less than anesthesiologists. ASA Newslett 2010;74:30-4
70. The American Academy of Anesthesiologist Assistants. Available at: www.anesthetist.org. Accessed July 5, 2011
71. Cost Analysis for Anesthesia Practices, 2006: Report Based on 2005 Data. Physician Compensation and Production Survey 2006. Englewood, CO: Medical Group Management Association
72. Trends in Demand for Newly-Trained Primary Care and Non-Primary Physicians. Available at: https://www.aamc.org/download/187410/data/2011-pwc- forte-session-a.pdf. Accessed July 1, 2011
73. th Annual AAMC Physician Workforce Conference. Available at: https://www.aamc.org/download/185580/data/2011-pwc- erikson.pdf. Accessed July 1, 2011
74. Health Status of the Uninsured and Implications for Physician Requirements Under Expanded Coverage. Available at: https://www.aamc.org/ download/185578/data/2011-pwc- turner.pdf. Accessed July 5, 2011
75. Healthcare Reform and the Health Workforce: Some Observations. Available at: https://www.aamc.org/download/187418/data/2011-pwc-weiner.pdf. Accessed July 5, 2011
76. Wiggins AR. A Description of the Management Characteristics of Anesthesia Care Delivery in Small, Medium, Large, Teaching and Non-Teaching Hospitals in the U.S. Navy Thesis. Uniformed Services University of the Health Sciences, October 1998. Available at: http://www.dtic.mil/cgi-bin/GetTRDoc? Location=U2&doc=GetTRDoc.pdf&AD=ADA421192. Accessed July 8, 2011
77. Gunn IP. Rural health care and the nurse anesthetist. CRNA 2000;11:77-86
78. Silber JH, Kennedy SK, Even-Shoshan O, Chen W, Koziol LF, Showan AM, Longnecker DE. Anesthesiologist direction and patient outcomes. Anesthesiology 2000;93:152-63 (Pubitemid 30436690)
79. Record JC, McCally M, Schweitzer SO, Blomquist RM, Berger BD. New health professions after a decade and a half: delegation, productivity and costs in primary care. J Health Polit Policy Law 1980;5:470-97 (Pubitemid 11181123)