Defining a Shortfall in the Anesthesiologist Workforce by Geography in the United States: Projections to 2037.

BACKGROUND: There is a paucity of contemporary research on the supply and demand of the anesthesiologist workforce in the United States. This study analyzed US federal government projections on the supply and demand of the anesthesiologist and certified registered nurse anesthetist (CRNA) workforces across the US. METHODS: This was a microsimulation of anesthesiologists and CRNAs in the United States using data from the Health Workforce Simulation Model. Supply was synonymous with the number of full-time equivalent (FTE) personnel at a given time point, while demand was defined as the projected number of FTE personnel needed. Workforce adequacy was defined as the ratio of supply over demand. A shortfall was determined when demand exceeded supply and surplus was determined when supply exceeded demand. RESULTS: From 2025 to 2037, the number of anesthesiologists was projected to decline from 53,840 to 52,310 FTEs (-2.8%). Over the same period, demand was projected to increase from 56,680 to 60,760 FTEs (+7.2%). As a result, the anesthesiologist shortfall was projected to worsen from supply meeting 95.0% of demand to 86.1%. In contrast, the number of CRNAs was projected to increase from 62,180 to 74,680 FTEs (+20.1%) while demand was projected to increase from 60,890 to 65,300 FTEs (+7.2%). Accordingly, the CRNA workforce was projected to have a surplus of 14.4% by 2037. In 2037, nonmetropolitan areas were projected to have greater anesthesiologist workforce shortfalls (supply meeting 52.7% demand) than metropolitan areas (supply meeting 84.1% demand). By 2037, the South was projected to have the greatest anesthesiologist workforce shortfall (supply meeting 71.1% demand) while the Northeast was projected to have a surplus (107%). In 2037, the states with the greatest anesthesiologist workforce shortfalls were projected to be Idaho (supply meeting 27.5% demand), New Mexico (47.2%), and Rhode Island (52.4%). By 2037, anesthesiology was projected to rank eight of 20 specialties for largest physician workforce shortfall. CONCLUSIONS: National workforce shortages are anticipated for anesthesiologists and are greatest in nonmetropolitan areas, the South, and certain states. Future strategies are needed to increase the supply of anesthesiologists in areas with identified deficiencies.