This is the second installment of our “Anesthesia Subsidies” series. The first installment on fair market value compensation can be found here.
The second key driver of Anesthesia Subsidies is Required Staffed Anesthetizing Locations. That is the number of locations anesthesia is expected to cover by day of the week and time of day. It is the primary basis for anesthesia staffing and is determined by the facility or healthcare system.
Typically, hospital executives respond to the challenge of retaining talented surgeons and proceduralists in a competitive market by offering first case starts and flexible booking times, resulting in a need for additional late anesthetizing locations. In both the OR and NORA sites (Endoscopy, Cath Lab, IR), adding locations, increasing late afternoon OR time, and adding subspecialty (cardiac, trauma) call requirements without increasing the number of surgical minutes leads to decreased utilization of expensive anesthesia resources. Decreased provider productivity leads to less total revenue collected by the anesthesia group, which directly results in a higher anesthesia subsidy.
Determining the number of anesthetizing locations is a complex and multifactorial business decision and should not be viewed simply through the lens of anesthesia financial support. Hospital executives and OR nursing leadership should consider actual block utilization in the OR and NORA, perioperative inefficiencies, and the competitive market of the facility. “Build it and they will come” may be a valid and profitable long-term strategy, however expecting to increase capacity by overstating anesthesia availability will be costly.