In July, the ASA Monitor conducted an email survey that polled readers on their top perceived challenges facing anesthesiology today. You shared your greatest concerns and offered some innovative solutions to those challenges.

This third installment of a four-part series dissecting the survey results focuses on payment and regulatory concerns. Patient care and health care regulations go hand in hand, so anesthesiologists must stay abreast of the latest guidelines and regulations while also making their voices heard to advocate for themselves and their patients. Our readers' main regulatory concerns included payment, The Joint Commission guidelines, and changing/conflicting regulations.

Payment concerns

Payment and reimbursement issues can be difficult to navigate, but it is crucial anesthesiologists receive compensation that coincides with the value of the services they provide.

“This is an issue that can be difficult to explain to regulators and elected officials,” said Sam Page, MD, FASA, Chair of ASA's Committee on Governmental Affairs and County Executive of St. Louis. “Anesthesiologists should be comfortable outlining their role in patient care and why it is important to be fairly compensated for the work that they do.

“Equitable compensation is crucial to ensure we can continue to provide our expertise and that anesthesia services are available to patients who need surgery,” he continued. “Anesthesiologists must learn how to navigate the regulatory side of health care.”

Resources are available to help anesthesiologists hone their skills for tasks outside the clinical setting. For example, anesthesiologists can join ASA Team 535 and contribute to efforts focused on building strong relationships with each member of Congress.


Regulatory Challenges in Anesthesia Practice

Regulatory Challenges in Anesthesia Practice
Regulatory Challenges in Anesthesia Practice

“This is a way to take a proactive approach when it comes to addressing regulatory issues, such as reimbursement,” Dr. Page said. “Not only will you stay current on the latest issues before Congress, but you will also learn how to be most effective in your communication.”

The Joint Commission guidelines

TJC and its guidelines can be a challenge for any practice. However, this is not something that can be avoided and, therefore, must be addressed head on.

“Anesthesiologists must be familiar with the guidelines. Anyone who works in a hospital knows that The Joint Commission visits can be frustrating,” advised Dr. Page. “It is important to work closely with your hospital leaders to make sure that you are up to date and understand what the expectations are, so that you can do the hard work to meet those expectations.

“On occasion, they may ask for something that does not seem reasonable,” he noted. “The ASA has representatives on The Joint Commission. When you have concerns you should voice them, so these representatives can advocate for you and our profession.”

Changing/conflicting regulations

Regulations change often and can sometimes conflict with one another, so it can be difficult to navigate them when making clinical decisions.

“Make the time to stay current on the latest updates,” Dr. Page said. “The ASA Monitor and ASA e-newsletters are an efficient way to remain apprised of the latest regulations. I know that we all receive a lot of emails, but our commitment to keeping our patient safe requires us to stay current on any changes.”

Resources for the Anesthesiologist

Whether you are looking for ways to stay current on the latest regulations or advocate for the profession, here are a few helpful tools:

  • ASA Team 535: Support the specialty by building relationships with members of Congress (

  • ASA Monitor: Stay informed on legislative and regulatory news (

  • ASA e-newsletters: The latest guidelines delivered straight to your inbox.

  • Grassroots Network: Take action and engage with your elected officials (

  • ASA Advocacy Modules: Learn how to get involved in advocacy efforts (