27 Mar 2020

Anesthesia Providers in Health Administration

The field of anesthesiology offers many career options.1 An anesthesia provider can choose a degree or certification as a physician anesthesiologist, anesthesiologist assistant (AA), certified registered nurse anesthetist (CRNA), anesthesia technician (AT), certified anesthesia technician (Cer.A.T.) or certified anesthesia technologist (Cer.A.T.T.).1 Anesthesiology professionals may also pursue opportunities in research, academics or political activism.1 Additionally, anesthesia providers may become administrators or join a private practice, which involves learning about business and finance.2 In order to know more about their career possibilities and ways they can help their patients, anesthesia providers should be familiar with the business of medicine and ways to pursue health administration in anesthesiology. 

In today’s world, medicine is a business, despite controversy over whether or not it should be one.3 For-profit businesses are widespread in the medical field, and their aim extends beyond healing patients to providing high-quality goods and services at affordable prices.3 Even hospitals are complex organizations that must maintain a certain level of income to avoid shutting down.4 Hospital and health administration is complex, involving a balance of excellent and equitable patient care as well as income.5 Health administration organizations such as the American Hospital Association6 and Healthcare Financial Management Association7 exist to help clinicians and business leaders navigate health-related spending and health systems. Business and finance also affect clinicians on an individual level. Some payment strategies, such as pay for performance (P4P) models, use monetary incentives to encourage better practices, patient satisfaction and successful patient outcomes.8 Health care in the United States involves more than care for patients and their families; it also entails administration of large businesses and monetary transactions with patients, insurance companies and the government. 

In order to educate themselves about or even undertake a career in health administration, anesthesia providers can pursue courses, certificates or degree programs. According to Desai et al.’s paper on anesthesia providers in business administration, a single management course may be enough to give a physician knowledge for managing or leading an organization.9 A Master’s in Business Administration can allow an anesthesiology professional to integrate the cultures of the business world and medicine.9 Ljuboja et al. found significant variation in primary employment among physician-MBAs, with the most common sectors being clinical, investment banking/finance, hospital/provider administration, biotechnical/device/pharmaceutical or entrepreneurship.10 The authors also found that after completing their education, a majority of physician-MBAs moved their professional focus away from clinical work.10 This change in career may be especially prudent for anesthesia providers who move from a hospital to a less intense setting, such as an office, and have the opportunity to expand their role beyond a consultant clinician.11 A focus on business is also available at many points throughout the anesthesiology professional’s career. For example, the Harvard Medical School and Harvard Business School provide medical students with a joint MD/MBA program.12 Other institutions have business programs for clinicians who have already specialized in anesthesiology. This includes the anesthesiology residency combined with the Professional MBA (pMBA) degree at Tulane University,12 the Anesthesia Administration Fellowship at Emory University13 or the Fellowship in the Management of Perioperative Services at Stanford University.14 As Pearl and Fogel emphasize, today’s new physicians (and other medical providers) may need business school skills to thrive in the medical field.15 

Anesthesia providers can take a variety of career paths, including those in business and finance. Given the monetary exchange and administrative complexities that come with contemporary medicine, medical workers would benefit from learning more about the business of medicine. Future research should investigate the differences between joint MD/MBA programs and business education for residents or attending clinicians. Additionally, schools may want to consider a business school rotation for medical students to equip them for a potential career in health administration.15 

1.American Society of Anesthesiologists. ​Types of Careers in Anesthesia. Anesthesia as a Career 2020; https://www.asahq.org/education-and-career/career-resources/anesthesia-as-a-career/types-of-careers-in-anesthesia

2.Weiss MS, Gross WL. Anesthesia Outside the Operating Room. Anesthesiology Clinics. 2017;35(4):xvii–xix. 

3.Matthews M, Jr. Medicine as a business. The Mount Sinai Journal of Medicine. 2004;71(4):225–230. 

4.Pearl R. Why Major Hospitals Are Losing Money By The Millions. Forbes. Web: Forbes Media LLC; November 7, 2017. 

5.Sharma DK, Goyal RC. Hospital Administration And Human Resource Management (Fifth Edition). Prentice-Hall Of India Pvt. Limited; 2010. 

6.American Hospital Association. AHA.org. 2020; https://www.aha.org/

7.Healthcare Financial Management Association. Power Over Uncertainty. HFMA.org 2020; https://www.hfma.org/

8.Massachusetts Medical Society. What Is Pay for Performance in Healthcare? NEJM Catalyst. March 1, 2018. 

9.Desai AM, Trillo RA, Jr., Macario A. Should I get a Master of Business Administration? The anesthesiologist with education training: Training options and professional opportunities. Current Opinion in Anaesthesiology. 2009;22(2):191–198. 

10.Ljuboja D, Powers BW, Robbins B, Huckman R, Yeshwant K, Jain SH. When doctors go to business school: Career choices of physician-MBAs. The American Journal of Managed Care. 2016;22(6):e196–e198. 

11.Koch ME, Giannuzzi R, Goldstein RC. Office Anesthesiology: An Overview. Anesthesiology Clinics of North America. 1999;17(2):395–405. 

12.Krupat E, Dienstag JL, Kester WC, Finkelstein SN. Medical Students Who Pursue a Joint MD/MBA Degree: Who Are They and Where Are They Heading? Evaluation & the Health Professions. 2016;40(2):203–218. 

13.Emory School of Medicine. Anesthesia Administration Fellowship. Anesthesiology Fellowships 2018; https://med.emory.edu/departments/anesthesiology/education/fellowships/anesthesia-administration.html

14.Stanford Medicine. Fellowship in the Management of Perioperative Services. Fellowships 2020; https://med.stanford.edu/anesthesia/education/fellowships/fellowship-management.html

15.Pearl RM, Fogel AL. New Physicians Will Need Business School Skills. NEJM Catalyst. August 7, 2017.