Fostering a strong workforce is crucial no matter the profession, but this is especially true for anesthesiology – a specialty that plays a key role in the health care system.
“In any profession where you're dealing with a stressful environment and the health of patients, paying attention to the workforce and its culture is vitally important,” noted ASA Immediate Past President Mary Dale Peterson, MD, FASA. “It improves the well-being of the physician, which in turn enhances patient safety and satisfaction.”
A healthy workforce includes understanding recruitment and retention trends and related challenges. There are a variety of issues that can arise when dealing with a workforce comprising individuals with unique needs and desires, but anesthesia practices can successfully navigate this with the right approach.
Embracing a flexible approach
Depending on the size and location of an anesthesia practice, specific workforce challenges can vary, but there are a few key issues that anesthesiologists across the country are contending with today.
This includes a mindset shift among millennial professionals. “There is a generational difference in how people view work,” said Michael Lewis, MD, FASA, Henry Ford Health System, Houston. Unlike previous cohorts, millennials place much more emphasis on finding a meaningful balance between their work and personal life.
Dr. Lewis clarified that this doesn't mean millennials are unwilling to work hard. Rather, he explained, they may view the world differently and have different priorities. With this in mind, Dr. Lewis' department created an overarching culture of work-life integration.
Easing the on-call burden and other staffing challenges related to this changing mindset requires thinking outside the box. For Patrick Giam, MD, FASA, Vice Speaker of the ASA House of Delegates, and a member of U.S. Anesthesia Partners, this involved creating a financial point system. “This allows us to create shifts that may not start at traditional times,” he explained. “By having a flexible compensation system, we can offer a shift structure that not only fits the needs of our practice, but also our staff.”
Dr. Lewis and his team created shifts that allow their staff to come in late and stay later. He noted that it seems to work well for staff who have commitments in the morning. Another benefit of this staffing strategy is the guarantee that staff will be able to leave on time since a new team will arrive at the top of the late shift.
Other options include taking advantage of the unique desires of each individual. Do you have anesthesiologists who want to work part-time? Are there those who are interested in night or weekend shifts? Opting – if possible – for flexibility over rigid models will help foster employee satisfaction, which is key to any practice's success.
Recruiting the right person
Effective recruitment is necessary for the ongoing growth of anesthesia practices and the profession; however, attracting the right person can prove difficult. That is why it is important to understand what you are looking for in a team member.
Recruitment requires a multi-step approach, which begins by identifying the specific needs of your practice, according to Dr. Giam. For example, the needs of an ambulatory surgery center may vary from the needs of a tertiary care hospital with trauma call. These various needs will influence the flexibility you can offer to prospective staff.
Secondly, what about the priorities of the individuals you are trying to recruit? The changing mindset among millennials will impact your efforts. Dr. Giam stressed the importance of investing the time to understand individual applicants.
“And, if you can meet their needs while serving the needs of your practice, you will have found a staff member who is a good fit,” he emphasized. “The recruitment process is much more intensive than a decade ago, and we must adjust accordingly.”
Creating a workgroup or committee to manage recruitment can be very helpful, advised Dr. Giam. This should include a staff member with strong people skills and a comprehensive understanding of the market. It is equally important to involve practice leadership.
A well-defined process will help you contend with current recruitment trends. Pediatric and cardiac subspecialties have been identified as difficult to recruit. Connecting with specialty societies can be a good way to reach out to these individuals, according to Dr. Giam, who recommended that you highlight your needs as well as what makes your practice appealing to these specialists.
Anecdotal evidence also suggests that it is becoming increasingly difficult to attract candidates to small, rural communities as well as high-cost, urban areas such as New York and San Francisco.
“Recruiting to rural areas is and will continue to be a challenge,” said Dr. Peterson. “Addressing this requires flexibility.” One potential solution, she noted, involves leveraging a larger group and its providers to help facilitate anesthesia care in these areas when necessary. “They may not be located there, but they are able to support the needs of nearby communities.”
When it comes to more expensive regions, providing pay that is commensurate is key, according to Dr. Peterson, who noted that it may be more difficult to fill these roles with a growing interest in the suburban lifestyle post-COVID. Offering an attractive workplace and benefits – such as on-site childcare – can also help address these roadblocks.
Focusing on retention efforts
Once you find the right person for your practice, it is important that you make the effort to keep them. Cultivating an environment that promotes employee retention is vital to the health and success of any practice.
“Retention is a huge part of workforce management because unsuccessful retention means you're going back to the drawing board again, which is difficult and expensive,” Dr. Giam said. “And so, in addition to the efforts you're expending on the front end, you must be equally focused on the throughput and retention process.”
This includes recognizing how the needs and priorities of individuals change as they progress through life – both professionally and personally. What a person values when they just begin their career will evolve over time, and practices must offer opportunities that align with the various career stages.
Incorporating policies for young families as well as offering support for personal or family health issues that may arise are ways to invest in your employees and keep them invested in your practice.
Dr. Giam stressed the importance of policies that allow staff to manage life events as they come up. He explained it would be unfortunate to lose employees because they weren't supported through a temporary challenging situation.
In addition to addressing the unique needs of your staff, practice leadership must also take a close look at culture.
“Whether or not a workplace aligns with their values will be a deciding factor for many, and we must recognize this – both at the individual practice level and as a profession,” concluded Dr. Peterson.
Catlin Nalley is a freelance medical writer with a degree in journalism from the University of Maryland. She has 10 years of experience covering a variety of medical specialties.