If you leave the operating room remembering one name, it’s usually your surgeon’s. But there’s another physician by your side from the moment you’re wheeled in until you’re safely on the other side: the anesthesiologist. Ours is often called the “silent profession” because, when we do our jobs well, you barely notice us at all.
During National Physicians Week — observed from March 25-31 — it’s worth recognizing what happens in operating rooms all over the country and why the nation’s growing need for anesthesia care demands attention.
Start with scale. In the United States, nearly 40 million anesthetics are administered each year across hospitals, ambulatory centers and offices. Over a lifetime, Americans undergo an average of 9.2 invasive procedures, including inpatient operations, outpatient surgeries and non‑OR interventions like colonoscopies and pain injections. As Americans age and live longer, surgical demand is rising.
What, exactly, do anesthesiologists do during your procedure? Beyond “putting you to sleep,” we orchestrate the body’s physiology minute by minute. We control your airway and ventilation; determine the amount of anesthesia you receive so you feel no pain; manage blood pressure, heart rate and oxygen flow; replace fluids and blood; maintain temperature; and respond immediately to any instability, whether from surgical stimulation, blood loss or an unexpected reaction. That vigilance relies on continuous monitoring and rapid adjustments with drugs, fluids and ventilator settings.
Much of the important work we do comes before and after an operation. Before surgery, we assess risk, optimize medications and plan an anesthetic tailored to your medical conditions and surgical needs. After surgery we manage pain, nausea and any early complications. We work hand‑in‑hand with surgeons and the broader team to safeguard you across that entire arc.
Demand for these skills is expanding. Elective orthopedics is a prime example: national registry and projection studies anticipate sustained growth in hip and knee replacements well into the 2030s and 2040s as arthritis, longevity and expectations for mobility rise.
Here’s the challenge: while demand climbs, the anesthesia workforce is under strain. Facilities experiencing staffing shortages jumped from 35 percent in early 2020 to 78 percent in late 2022 as procedures rebounded after the pandemic. Anesthesiology is among the top five healthcare specialties with the biggest shortages. But unlike the other four — ophthalmology, pathology, radiology and urology — anesthesia is required for almost every surgery.
The same is true in Washington, where I practice, which is experiencing a shortage of physicians, including anesthesiologists, especially across the eastern portion of the state.
Causes include an aging workforce approaching retirement, limited residency positions and burnout from heavy caseloads and schedule intensity. Several industry and academic assessments forecast thousands of anesthesiologist vacancies over the next decade.
Many anesthesiologists are in their mid‑50s or beyond, accelerating retirements. Training more physicians takes time. The result is a growing mismatch: more patients needing anesthesia, fewer clinicians to deliver it and higher stress on those still in practice.
The stress is real. Our work happens where risk is concentrated in seconds. A sudden drop in blood pressure, a difficult airway, a hidden heart issue — these are ours to detect and correct in real time. Burnout follows when long days, night calls and relentless vigilance compound.
And yet, despite the pressure, this profession is profoundly rewarding. I meet every patient on one of the most anxious days of their life. I can listen, explain, tailor a plan, and then stand watch so they can wake up safer and more comfortable than they feared. The technology keeps improving; safety has advanced dramatically over decades; and the partnerships with surgeons, nurses, and techs are among the best in medicine. For many of us, the quiet trust from patients and colleagues is what keeps the work worth doing.