The Employment Outlook in Anesthesiology for 2019
With an aging population requiring more medical services and a majority of Americans with insurance coverage, anesthesiology in 2019 will remain a popular specialty.
“For physician anesthesiologists, it’s still a high-demand specialty,” said Mary Dale Peterson, MD, MSHCA, FACHE, FASA, president-elect of the American Society of Anesthesiologists (ASA). “Anesthesia is attractive to physicians who love science. We do a lot of pharmacology and physiology. It’s also attractive to the physician who loves medicine and surgery. We are the bridge between those two specialties.”
Anesthesiology jobs also appeal to people who enjoy working under pressure and with technology, Peterson added. Full-time anesthesiologists often work long hours, up to 60 hours weekly according to some recent surveys, she reported. The Medscape Medical Student Life & Education Report 2018 indicated that anesthesiology is the seventh most popular choice of specialty.
Where are all the jobs anesthesiology jobs?
ASA reports most anesthesiologists to work in private practice, providing anesthesia in hospitals, surgical centers, or in endoscopy, radiology, or interventional-cardiology suites. Group practices often provide services in multiple settings. Some anesthesiologists pursue additional education and practice in critical care and in pain clinics. Anesthesiology jobs and CRNA jobs can be found in a number of settings.
Certified registered nurse anesthetists (CRNAs) work in every setting where anesthesia is delivered, according to the American Association of Nurse Anesthetists (AANA).
“For certified registered nurse anesthetists, the demand is extremely high, and over the next five to seven years, that will continue to strengthen,” said Garry Brydges, DNP, MBA, ACNP-BC, CRNA, FAAN, AANA president.
Several factors are driving CRNA growth, including reimbursement strategies and clinical outcomes associated with reimbursement, he said. CRNA jobs are plentiful.
Both anesthesiologists and CRNAs can work locum tenens anesthesiology jobs, in a variety of settings; demand is strong.
The demand for permanent clinicians also remains healthy, according to industry surveys. Anesthesiology was one of the 20 most requested searches by clients of Merritt Hawkins, according to the company’s 2018 Review of Physician and Advanced Practitioner Recruiting Incentives. The report indicated physicians in the specialty receive an average guaranteed base salary of $371,000 per year.
Anesthesiologists and CRNAs often practice in care teams, sometimes with anesthesia aides. Team-based, patient-centered perioperative surgical homes, in which the anesthesiologist works as part of a team from preoperative care through intraoperative to post-operative and long-term management, also are becoming popular.
“We see the anesthesiologist being the leader in helping with the perioperative surgical home,” Peterson said. “We are looking at new ways of delivering care that, hopefully, will fulfill the triple aim of reducing cost, improving equality and patient satisfaction.”
Drivers for growth
Several factors contribute to the demand for anesthesiology professionals, including the aging of providers – both anesthesiologists and CRNAs, with eligibility for the retirement of 30 percent within five years and 24 percent within seven years, respectively.
Currently, 121 university programs graduate CRNAs. By 2022, all CRNAs must be doctorally prepared. About 85 percent of programs have already transitioned to DNP programs.
CRNAs often come to the specialty after working in a critical care setting, where they can become burned out when staffing levels stretch their abilities to provide quality care in a high acuity setting.
“Coming into anesthesia, you only have one patient at a time to worry about. There is an attraction of focusing your entire care on one patient,” Brydges said.
The Medscape Anesthesiologist Compensation Report 2018 indicated an annual salary for anesthesiology physicians of $386,000, including bonuses and profit-sharing contributions, a 6 percent increase from 2017. Self-employed anesthesiologists earned more, $433,000 compared with $358,000 for employed anesthesiologists, but only 37 percent of the respondents to the survey were self-employed.
Locum tenens anesthesiologist salaries can range from $160 to $215 per hour, with options for overtime pay and bonuses, depending on the contract.
The Medscape report also found that men earned more than women. Eighty-five percent of the anesthesiologists responding to the survey said they would choose the same specialty again.
Anesthesiologists seem to allow themselves a healthy amount of vacation time each year. The Medscape Lifestyle Report 2018 found 34 percent of those surveyed take three to four weeks’ vacation each year, and nearly half (49 percent) take more than four weeks.
AANA reports a median annual income for CRNAs of $187,000. CRNAs working in hospitals are typically paid more, $195,000, than employees of a group at $180,000 annually. From 2007 to 2017, CRNA salaries have increased across settings. Locum tenens CRNA salaries can range from $108 to $140 per hour, with opportunities for overtime and bonuses.
CRNAs for cost-effective care
A major driver for the growth in CRNA jobs is the cost efficiency of nurse anesthetist care, Brydges said.
“[CRNAs] add incredible economic value to the health care system,” she explained. “They are highly qualified, and with the quality of care they provide, they are able to achieve incredible outcomes.”
About 89 percent of CRNAs work full-time. Forty percent are employed by hospitals and 36 percent are employed in a group practice. Only 11 percent are independent contractors. A small number of CRNAs work in pain management and can be certified in the subspecialty.
“[Pain management CRNAs] are predominantly in rural sections of the United States and open access to care,” Brydges said. “If it wasn’t for them, some patients would have to travel four to six hours for a steroid injection.”
Both anesthesiologists and CRNAs are delivering multimodal and opioid-sparing pain-relief techniques and enhanced recovery, according to Brydes, and patients are going home with fewer medications than in recent years.
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