Merritt Hawkins, the physician placement firm, has released its 2014 list of doctors in highest demand in the community. For the seventh year in a row, to no one's surprise, family medicine and other primary care fields were requested over all others. Most of the jobs in the top ten belonged to PCP's or physician extenders like PA's and NP's. It's not until the bottom half of this top twenty list do you start seeing need for specialty fields like surgery or cardiology.
I was a little surprised that anesthesiologists were not on this list of sought after doctors. It wasn't that long ago that the ASA loudly proclaimed the U.S. has a shortfall of several thousand anesthesiologists and that this situation will only get worse through the rest of the decade. If anesthesiologists are supposedly in such shortage, how come we don't see that reflected in the jobs marketplace?
In the early years of the last decade, radiology and anesthesiology were frequently the highest requested physicians in the Merritt Hawkins surveys. But starting in 2005, M-H already started noticing a downturn in demand for these two ROAD fields. In its report that year, anesthesiology had dropped to the tenth spot. The company wrote in the report, "anesthesiology is one of the few medical specialties where a significant amount of care can be provided by non-physicians, and in many cases health care organizations are recruiting certified registered nurse anesthetists (CRNA's) in lieu of anesthesiologists."
The picture continued to grow more bleak as the decade progressed. In the 2009 survey, anesthesiology placement had dropped to 19th place, with CRNA just slightly higher at 18th. Then in Merritt Hawkins's 2012 report, the bottom finally fell out of the specialty. That year M-H stated that, "for the first time since Merritt Hawkins began compiling data for this Review, anesthesiology was not among its top 20 most requested search assignments." It has not made a reappearance in the top twenty list since. In this year's report, M-H theorized that, "Inhibiting demand for anesthesiologists is the use of certified nurse anesthetists (CRNAs), who now administer 65% of all anesthetics nationwide, according to the American Association of Nurse Anesthetists (AANA) and are particularly prevalent in smaller, rural communities."
So who are you going to believe, the ASA with its interest in self promotion, or a third party company who is reading the pulse of the jobs market on a daily basis? If you peruse the job listings in the anesthesiology jobs site GasWork, you can see that many states have few posts available. And the anesthesiologists that are requested are for very specific subspecialties like cardiac or OB anesthesia or for part time locums positions.
Are we in another downturn in the anesthesia market like the mid 1990's? Back then you couldn't give away anesthesia residency spots. No smart medical student wanted to go into a dead end residency with such a poor job prospect like anesthesiology. But soon the cycle turned and anesthesiologists experienced a boom in demand as a dearth of new anesthesia graduates were unable to fill all the job openings available. Has the bubble already popped in anesthesiology? Only time will tell.