A key aspect of anesthesia management is the recruitment of anesthesiologists and certified registered nurse anesthetists. This process begins with identifying the staffing model and the number of anesthesia professionals needed for a surgical facility. Staffing can be as straight forward as placing a single anesthesiologist or CRNA in an ambulatory surgical center one to two days per week or it can involve providing anesthesia coverage to an entire hospital system twenty four hours per day, 365 days per year.
Recruiting begins with identifying any requisite subspecialty experience. For instance, an ambulatory surgical center with orthopedic cases may prefer an anesthesia provider(s) with expertise in regional anesthesia. Anesthesiologists with sub-specialty training in pediatric anesthesia are preferred for pediatric cases, especially for complex surgeries that are performed in tertiary care hospitals or university-based children’s hospitals.
A search is initiated for board-certified anesthesiologists and/or CRNAs from the community local to the client facility. An anesthesia management company relies on an evolving network of anesthesiology professionals that it cultivates as it grows. If the geographic area is one where the management company has not provided services in the past, it can use one of several industry-specific job boards to post job ads or view curriculum vitaes. Anesthesia management companies frequently contract with staffing companies to assist in the recruiting process. Staffing companies also have an established network of healthcare professionals. They typically compensate the providers directly and invoice the management entity the amount they paid the provider(s) along with a mark-up or margin. This is referred to as a locum tenens arrangement and typically is a temporary staffing model. Staffing companies also engage in permanent placement arrangements where they charge a flat rate to the employer after which the employer is responsible for compensating the healthcare professional directly. It is in the financial interest of the management companies to recruit anesthesiologists and CRNAs directly. However, this may not always be feasible due to a variety of factors (i.e., limited network in a particular geographic area or time constraints.)
Another important facet of the recruitment process involves salary negotiations. This can become an involved process and is impacted by a variety of factors, such as the specific requirements of the position, on-call schedules, potential re-location costs, and the supply-demand ratio for anesthesia professionals for a specific geographic location.
Recruiting also involves finding “coverage” for anesthesia professionals when they take vacations and sick leave. Finding temporary coverage can be challenging for a variety of reasons especially if the coverage need arises suddenly. Anesthesia management companies typically strive to have a back-up panel of anesthesiologists and CRNAs to call upon in urgent coverage situations.
Haroon W. Chaudhry MD
