ISN’T IT TIME? A Call for an Anesthesia Industry Network Dedicated to Objective Standards, Benchmarks and a Common Business Framework 

ABSTRACT 

The anesthesia industry is navigating one of the most consequential periods in its history. A workforce crisis of historic proportions, a rapid and disruptive surge in non-OR anesthesia (NORA), unsustainable financial pressures on hospitals and anesthesia groups alike, and a near-total absence of objective, shared benchmarks have created conditions that demand a coordinated industry response. Yet the field lacks a single network, body or forum specifically dedicated dedicated to advancing the business, economic and operational performance of anesthesia as a specialty. This article argues the time has arrived—perhaps long past arrived—for the anesthesia community and its hospital/ health system partners to create such a network: a professionally governed, data-informed organization committed to producing the objective standards, benchmarks, vocabulary and shared intelligence the industry urgently needs. 

1. A SPECIALTY AT A CROSSROADS 

Ask any hospital CFO, anesthesia group medical director or health system administrator what keeps them up at night, and the answer increasingly centers on the economics of anesthesia. It is not on surgical volume and not on nursing shortages—though those issues are real—but rather on anesthesia: its cost, its availability and the growing difficulty of negotiating an equitable arrangement that works for everyone at the table. 

This is not a local phenomenon. Across the country, in community hospitals and academic medical centers, in freestanding ambulatory surgery centers and large integrated health systems, the same pressures are converging simultaneously. The workforce pipeline has not kept pace with demand. The sites requiring anesthesia have multiplied far faster than the providers available to serve them. Reimbursement has been compressed by federal policy. And the financial support that hospitals provide to anesthesia groups—the subsidy, stipend or deficit payment that makes many programs operationally viable— has risen from an average of $2–4 million annually to levels approaching or exceeding $12 million, a dramatic shift that has occurred in less than two years. 

The data are sobering. Before COVID-19, approximately 35% of facilities reported anesthesia staffing shortages. Within two years of the pandemic’s onset, that figure had more than doubled to 78%.¹ Fifteen percent of the active ASA physician workforce has retired since COVID.² Of those who remain, more than 57% are age 55 or older.3 Replacing each departing physician requires between 1.4 and 1.7 full-time equivalents—not because of incompetence, but because of the permanent generational shift in how younger providers balance professional and personal life.⁴ Simultaneously, non-OR anesthesia cases have grown from roughly 20% to more than 35% of all anesthesia volume and are projected to exceed 50% of cases in acute care hospitals before 2030.⁵ 

“The anesthesia subsidy that averaged $2–4 million a few years ago is now approaching or exceeding $12 million in many markets—yet both sides of the negotiating table lack the objective benchmarks to evaluate these arrangements fairly.” 

Despite these pressures, the anesthesia industry (including pain management services) operates without the shared institutional infrastructure that some other complex, high-stakes specialties take for granted. There is no dedicated network for exchanging economic intelligence. There are no consensus-driven, specialty-specific benchmarks for compensation, subsidy levels or productivity. There is no forum in which hospitals, groups, academic centers, ambulatory providers and clinicians can come together as peers to define what “fair” looks like. Without these things, every negotiation begins from scratch, every contract is contested based on anecdote rather than evidence and every stakeholder is disadvantaged by the absence of a shared framework. 

Isn’t it time for the anesthesia community to build the infrastructure it has long lacked? 

2. THE WORKFORCE CRISIS: SCALE, SCOPE AN DURATION 

Any serious conversation about the anesthesia industry must begin with workforce, because workforce is the governing constraint on every other variable. You cannot negotiate a reasonable subsidy without understanding what it truly costs to staff a program. You cannot design a NORA strategy without knowing where your providers are being deployed and how efficiently. You cannot plan without an honest accounting of the supply and demand imbalance that will define the next decade. 

The supply side of the equation has been structurally disrupted in ways that will take years to repair. Training pipelines were interrupted during the pandemic. A generation of anesthesiologists who might have worked several more years elected to retire rather than endure the operational chaos of pandemic-era practice. The conversion of CRNA programs to doctoral-level education temporarily reduced the graduation pipeline. The remaining workforce is aging out at a rate that incoming classes of new providers simply cannot match. While anesthesia is not the great driver of economic sustainability, it is the enabler. These collective supply constraints will be catastrophic to the “have nots” in the industry and force already bleak decision making into worse long-term choices. The demand side has grown in parallel. 

An aging U.S. population with an increasing burden of chronic illness requires more procedures.⁶ Hospitals continue to expand service offerings, often without the strategic discipline to evaluate whether the anesthesia resources required are actually available or affordable.⁷ NORA cases, which are structurally less efficient than OR cases—requiring the same provider mobilization and documentation burden for lower per-case revenue—now represent a major and growing share of total workload.⁸ The locum tenens market, which in some markets has become the de facto solution instead of existing to bridge supply gaps, carries premium labor rates that compound the financial pressure on both sides of the table. 

What is perhaps most striking about this crisis is how unevenly it is understood. Clinicians and administrators within the specialty have a granular, lived sense of the pressure. Hospital executives at the system level—particularly those who built their careers before the current environment emerged—are often operating from outdated mental  models. The executive whose instinct is to say “just hire more CRNAs” or “we didn’t pay subsidies at my last hospital” is not acting in bad faith; they are simply operating without current, objective, shared data. 

3. NORA: THE FASTESTGROWING CHALLENGE NOBODY PL ANNED FOR 

Non-OR anesthesia deserves particular attention, not only because of its growth rate, but because it represents a category of operational complexity most facilities are genuinely unprepared to manage. Unlike the operating room—where decades of infrastructure, governance, scheduling systems and leadership structures have been developed—NORA has expanded organically, procedure by procedure, department by department, without a corresponding investment in management capability. 

The consequences are predictable and documented. NORA cases are distributed throughout the hospital in physically distributed locations where anesthesia providers are infrequent visitors rather than integrated members of a care team. Scheduling is often paper-based or informal. Data capture in the EMR is incomplete, which means that when NORA volume is excluded from OR utilization metrics—as it typically is—performance reports overstate efficiency and mask the true cost burden of the anesthesia service line.⁹ Clinically, the risks are real: patients undergoing NORA procedures have higher rates of severe adverse events than those in the OR, and in a substantial proportion of documented claims, the care was deemed preventable.¹⁰ 

For OR managers, the operational impact is direct and daily. Every anesthesia provider pulled toward a NORA location is unavailable for surgical cases. Delays, cancellations and OR closures attributed to anesthesia shortages frequently have unmanaged NORA demand as a contributing or primary cause. However, as the data connecting NORA activity to OR performance is typically absent, the causal relationship remains invisible to administrators making resource allocation decisions. 

Managing NORA well requires data systems, leadership structures, scheduling infrastructure and staffing models specifically designed for non-OR settings. Purpose-built anesthesia information platforms—such as Medaxion’s Anesthesia Manager—can provide the real-time visibility previously unavailable, capturing case volume, location, acuity and staffing deployment across both OR and NORA settings in ways that hospital EMRs cannot.¹¹ But data systems alone cannot ensure effective management and governance of optimized scheduling. What the industry needs are shared standards for how NORA should be led, staffed, measured and reported. No such standards currently exist in any widely accepted form. 

“NORA cases now represent more than 35% of all anesthesia volume—yet most facilities have no organized NORA leadership, no acuity-adjusted staffing model, and no data infrastructure accurate enough to manage it effectively.” 

4. THE FINANCIAL RECKONING: NEGOTIATING WITHOUT A MAP 

At the center of the current anesthesia crisis is a financial negotiation that has grown vastly more consequential without a corresponding development of the tools, benchmarks or frameworks needed to conduct it well. The subsidy negotiation—in which an anesthesia group asks a hospital for financial support to close the gap between clinical revenue and the true cost of providing contracted services—has become one of the highest-stakes conversations in healthcare operations. 

The numbers are no longer marginal. Across many markets, organizations that were paying $2–4 million annually are now receiving ask amounts of $10, $12 or $15 million.¹² These increases are not arbitrary. They reflect the convergence of compressed commercial reimbursement from the No Surprises Act, rising anesthesia labor costs in a constrained market, the structural inefficiency of NORA and the true cost of providing on-call coverage that prior generations largely absorbed without compensation. The ask is real. The need is genuine.¹³ 

The problem is not the ask itself. The problem is the absence of any shared, objective framework for evaluating said requests. Hospital executives are asked to approve expenditures of this magnitude without access to industry-wide benchmarks for what constitutes a reasonable subsidy, an appropriate compensation level or a fair staffing ratio for their facility type and case mix. Anesthesia groups present their own financial data, which is accurate but inevitably framed in their interest. Both sides may hire consultants who add genuine expertise, but who bring their own client relationships and perspectives to the analysis. The result can be pennywise financial decisions that create compounding, long-term business issues for the very delivery of care. 

The industry does not have consistent, accessible objective data sources that are unbiased, absent agendas and free from partisan groups advocating a particular point of view. National compensation surveys exist, but they are generalized, they lag the market by a year or more, and they are not calibrated to the specific variables—facility type, payer mix, NORA load, coverage model, call burden—that drive the actual cost of a given program. In their absence, negotiations are conducted based on what each side believes, what each has heard happened elsewhere, and what each can will to fruition. The survival of the fittest in negotiations does not mean wellness for collective stakeholders. 

The results are well-documented: programs where the hospital holds leverage produce outcomes that undercompensate anesthesia and generate the workforce instability that makes programs unsustainable. Programs where anesthesia holds leverage produce subsidy levels straining hospital budgets and inviting adversarial responses—RFP, insourcing, corporate replacement—that typically disrupt clinical operations far more than they reduce costs.¹⁴ Neither outcome serves patients, institutions or the specialty. 

5. THE VOCABULARY PROBLEM: AN INDUSTRY WITHOUT A COMMON LANGUAGE 

Before there can be shared benchmarks, there must be shared definitions. The anesthesia industry, for all its clinical sophistication, has not yet achieved consensus on the business vocabulary that underpins every negotiation, every contract and every performance conversation. 

Consider the word “subsidy” or more appropriately “stipend.” In common usage, subsidy carries a connotation of largesse—a gift from the hospital to a group that cannot support itself. An anesthesia stipend—the financial support required to close the gap between an anesthesia group’s net clinical revenue and the verifiable cost of providing contracted services at fair market staffing and compensation levels. Either use stipend or define “anesthesia subsidy”—the reciprocal service delivery obligation—is materially different from the informal usage, and the difference matters enormously at the negotiating table. 

As well, consider “fair market value” in the context of physician and advanced practice provider (APP) compensation. Most participants treat fair market value (FMV) as if it were a single number (e.g., the median) derivable from published survey data. It is not. Fair market value for anesthesia compensation requires contextual analysis adjusted for the employment model, coverage model, call burden, NORA load, payer mix and regional supply/demand dynamics. An FMV determination that does not account for these variables is not defensible; and, in a regulatory context, an indefensible FMV determination carries, at best, meaningful legal risk and, at worse, unintended behavior and consequences. 

The same applies to productivity measurement. Is a provider who generates fewer billable time units because they carry a disproportionate share of call obligations, NORA coverage and medical direction responsibilities less productive than a peer working exclusively in the efficient OR? Any honest answer requires a composite metric accounting for all dimensions of contribution and no such standard metric exists in common use. The absence of agreed vocabulary enables bad outcomes, because it allows each party to define key terms in whatever way supports their position. 

6. WHAT EXISTS TODAY—AND WHAT IS MISSING 

The anesthesia field is not without professional infrastructure. The American Society of Anesthesiologists provides clinical guidance, advocacy and educational programming of significant dept and quality. The AANA serves nurse anesthetists with similar breadth. Specialty-specific quality improvement networks—including the Anesthesia Quality Institute and the Michigan Anesthesiology Quality Collaborative—have made meaningful contributions to patient safety and outcomes measurement.

What these organizations do not do—and arguably should not be expected to do—is address the business, economic and operational dimensions of anesthesia practice with the depth and specificity the current environment requires. Their missions are rightly focused on clinical quality, patient safety and professional advocacy. A CFO evaluating whether a $12 million subsidy request is reasonable, an anesthesia medical director building a defensible compensation analysis or a hospital administrator designing a NORA staffing model—none of these stakeholders can go to an existing body, extract the necessary data or better yet operate an application that can produce an unbiased management report. 

National consulting firms, specialist attorneys and individual advisors fill some of the gap and many do so with genuine expertise. But consulting relationships are bilateral by definition—they produce intelligence for paying clients, not public goods for the field. The anesthesia industry needs something qualitatively different: a shared platform where benchmarks and standards are produced collectively through a rigorous and transparent process, and made available to the whole community. 

“The clinical quality infrastructure of anesthesia is well-developed. The business and economic infrastructure—the benchmarks, vocabulary, standards and shared intelligence that every stakeholder needs—simply does not yet exist.” 

7. A NETWORK BUILT FOR THIS MOMENT 

What the anesthesia industry needs is a dedicated network—an anesthesia management network—specifically designed to address the business, economic and operational dimensions of practice. Not a lobbying organization, but the data could help in the activities of lobbying. Not a clinical quality body, but acknowledgement and inclusion of clinical data where appropriate. Not a consulting firm, but the community of consultants that wish to support organizations with accurate, unbiased data and in-depth services. Vendors of anesthesia services that have professional experience and expertise would be welcome. In summary: a professionally governed, membership-based and inclusive network dedicated to producing the shared intelligence and frameworks that the industry currently lacks. 

The design of such a network matters as much as its existence. Several principles principles should govern it: 

Independence and Objectivity Above All 

• The network’s value depends entirely on the credibility of its outputs. Hospitals, anesthesia groups, vendors, consultants and clinicians all have legitimate interests in anesthesia economics—and all those interests deserve representation. The governance structure should reflect that balance, and the processes by which benchmarks and standards are developed should be transparent enough to withstand scrutiny from every member constituency. 

Anesthesia Group Management Applications Available to Network Members 

• Many organizations are swimming in too much industry data and drowning in its complexity. The network should support and operate management applications that can source these networks or other databases for reporting purposes. In some cases, could operate real-time management tools such as APP shift optimization to member organizations: (a) anesthesia groups and their client facilities and (b) organizations that employ anesthesia providers—with real time dashboards. The application should be robust enough to assist with understanding both economic drivers and to correlate those to clinical events. 

Grounded in Real Data 

• The network’s outputs must be grounded in data and direct information, not indirect survey data alone. The field needs access to transactional-level case data reflecting actual operational patterns across diverse facility types, geographic markets and payer environments. Purpose-built anesthesia information platforms—such as Medaxion’s Anesthesia Manager—which aggregate millions of case records across hundreds of facilities, represent exactly the kind of data infrastructure that rigorous benchmarking requires, provided appropriate governance and data-use agreements are in place.¹⁵ The network should establish clear methodological standards for how data is analyzed and reported, allowing for stakeholders to acknowledge that “in God we trust, all others bring data.” 

Broad and Balanced Representation 

• The network should encompass the full range of stakeholders whose decisions shape anesthesia economics: hospital and health system executives, ASC administrators, anesthesia group leaders, independent consultants, legal and compliance professionals, finance representatives and clinicians. Anesthesia economics is a multi-party problem that can only be addressed through multi-party participation. A body representing only one constituency will produce outputs that only one constituency trusts. 

Clinical Integrity Through a Medical Advisor 

• Anesthesiology is a medical specialty practiced by physicians and advanced practice clinicians, subject to professional and regulatory standards that have direct implications for business decisions. The network should include a medical advisor—a licensed physician of standing in the anesthesia community—whose role is to provide clinical and scientific oversight, approve any research activities and maintain the evidence-based integrity of the network’s published work. 

Complementary to Existing Infrastructure 

• The network should be designed explicitly to complement the existing professional and quality infrastructure of anesthesia—not to compete with or duplicate it. The ASA (AQI and various committees), AANA, and similar bodies do important work that the business network should support. However, the network’s specific mandate—produce business, economic and operational standards utilizing direct access to millions of anesthesia records—would be sufficiently distinct that a well-designed and educationally focused organization could fill the gap and complement the work of existing institutions. 

8. WHAT A NETWORK SHOULD PRODUCE 

A network of this kind, properly constituted and resourced, should be capable of producing outputs across several interconnected dimensions. Taken together, these outputs would give every stakeholder in the industry access to a shared framework for making and defending decisions …. for the first time. 

• Compensation benchmarks and commentary: Contextualized analyses accounting for employment model, coverage requirements, call burden, NORA load and local market conditions—with the methodological commentary needed to apply benchmarks and appropriate productivity metrics defensibly in specific situations, not use overly generalized, outdated and statistically flawed survey medians. 

• Subsidy, stipend and deficit standards: Consensus definitions of what constitutes a fair and reasonable stipend (subsidy) or department budget deficit, grounded in a shared understanding of how anesthesia program costs are calculated and benchmarked against comparable facilities nationwide. 

• Staffing and coverage model frameworks: Evidence-based frameworks based on historical and future data for how anesthesia programs should be staffed across OR and NORA settings, calibrated to different facility types, case mixes and service requirements. Fill an existing need for studies on the amount and type of call (e.g., beeper vs in-house) that anesthesia practitioners typically provide and/or should provide.¹⁶ 

• NORA management standards: Leadership structures, scheduling approaches, data capture standards and acuity-adjusted staffing models specifically designed for non-OR anesthesia settings—none of which currently exist in widely accepted form. 

• Operational performance benchmarks: OR utilization, case throughput, flip room efficiency and turnaround standards calculated using NORA-adjusted methodology that prevents distortion of performance data when NORA volume is excluded. 

• Common industry vocabulary: Agreed definitions for the key business and operational terms—subsidy, fair market value, productivity, coverage model, medical direction and others—that underpin every negotiation and contract in the field. 

• Knowledge sharing and education: Regular forums, published case studies and structured programming through which members exchange practical intelligence on workforce planning, NORA governance, contract strategy and operational leadership—grounded in real data rather than anecdote. 

• Research and peer-reviewed publications: Studies utilizing real-world clinical and operational data, overseen by a medical advisor, that advance the field’s collective understanding of the economic and operational dynamics shaping anesthesia practice. 

None of these outputs are currently produced by any existing body in a form that is broadly accessible, and grounded in the kind of multi-facility, multi-market data that would make them credible across constituency lines. The gap is real, the need is urgent and its costs are borne every day by every stakeholder in industry. 

9. THE COST OF CONTINUED INACTION 

The costs of operating without shared benchmarks and standards are not abstract. They are paid in the specific currency of disruption: contracts that collapse because neither party can agree on what “fair” looks like; RFP processes launched in frustration that produce institutional upheaval without the savings anticipated; insourcing initiatives undertaken without the data infrastructure or operational expertise to succeed; locum tenens costs that compound because programs cannot recruit permanently into environments where compensation norms are actively contested. 

The publicly documented cases of anesthesia program breakdowns across the country—facilities that have lost their entire anesthesia teams, OR throughput that is permanently thwarted due to lack of enabling anesthesia availability, systems that have spent tens of millions of dollars in crisis response, communities whose patients have faced access disruptions for months—share a common characteristic: they reached the point of crisis before any party had the data, the vocabulary or the framework to intervene  constructively.^{17 18} 

The anesthesia industry is at an inflection point. The workforce will not replenish itself on the old timeline. NORA will not stop growing. Subsidies will not return to 2019 levels. The No Surprises Act will not be repealed. These are the structural conditions within which the field will operate for the foreseeable future. The question is not whether those conditions demand a more sophisticated institutional response—they clearly do. The question is whether the industry will build that response proactively or wait until the next wave of program failures makes the cost of inaction undeniable. 

10. A CALL TO THE INDUSTRY 

The creation of an anesthesia management network is not a complex proposition. It does not require legislation, regulatory approval or resolution of any fundamental disagreement about how anesthesia should be practiced. It requires only that the stakeholders who have the most to gain from shared intelligence—and the most to lose from its continued absence—recognize that collective action is in their common interest. 

Hospital executives who are tired of negotiating without access to objective benchmarks that would allow them to evaluate what they are being asked to pay—they have every reason to participate. Anesthesia group leaders who are tired of being viewed with suspicion when they present data that supports their own position, and who would benefit from the credibility that comes with an independent, consensus-driven standard—they have every reason to participate. Clinicians who believe that anesthesiology’s value as a medical specialty is systematically underrepresented in the business frameworks that govern their contracts and compensation—they have every reason to participate. ASC administrators, independent consultants, legal and compliance professionals and industry vendors who serve this field and understand that its dysfunction is ultimately their problem too—they all have reason to participate. 

A network of this kind could be membership-based and self-sustaining, with broad fees calibrated to ensure academic medical centers, training programs, individual clinicians and organizations providing substantive data contributions can participate regardless of institutional resources. The goal is not exclusivity; it is breadth of representation and depth of shared commitment to the health of the specialty. 

The network this article describes is not a utopian vision. It is a pragmatic response to well-documented problems that have grown severe enough to demand a structural solution. The analytical tools exist. The data infrastructure is emerging. The expertise is distributed throughout the field. What has been missing is the organizing vehicle—a network with a clear mandate, credible governance and the commitment to produce outputs that serve the whole community rather than any single constituency within it. 

The anesthesia industry has navigated remarkable transformations before; the development of the anesthesia care team model, the expansion of ambulatory surgery, the integration of digital information systems into perioperative care. In each case, the specialty’s ability to adapt was strengthened by the development of shared frameworks that gave every stakeholder a common reference point. The current moment calls for exactly that kind of collective intelligence—applied not to clinical technique but to the business, economic and operational realities that will determine whether anesthesia programs across the country remain viable, equitable and sustainable for the patients who depend on them. 

“The time to build shared infrastructure is before the crisis forces it. The anesthesia industry has the expertise, the data and the collective interest to act. The only thing missing is the decision to begin.” 

Isn’t it time? 

About This Paper 

This position paper was prepared to advance industry dialogue about the need for a dedicated anesthesia business and economic network. It draws on published peer-reviewed research, industry conference presentations and operational white papers from across the anesthesia field. It does not represent the official position of any professional society, health system or commercial entity. References are provided as footnotes throughout the text. This paper is intended as a contribution to a conversation the industry needs to have—and to the decision to begin having it in an organized, constructive and data-driven way. 

Sources 

¹Abouleish AE, Pomerantz P, Peterson MD, et al. Closing the Chasm: Understanding and Addressing the Anesthesia Workforce Supply and Demand Imbalance. Anesthesiology. 2024;141(2):238 249. doi:10.1097/ALN.0000000000005052. Source for pre- and post-pandemic staffing shortage rates (35% rising to 78%); physician workforce demographics; supply-demand dynamics. 

²Johnson R, Scott SJ, Semo JJ. Requesting Compensation for Undercompensated Services: Three Industry Perspectives. ADVANCE Annual Meeting Presentation. January 31, 2025. Source for: 15% ASA workforce retirement since COVID; 57%+ physicians age 55+; 1.4–1.7 FTE replacement ratio; generational workforce expectations; subsidy escalation to $12M; facility crisis case examples. 

³Ibid. (Johnson, Scott & Semo, ADVANCE 2025). 

⁴Ibid. (Johnson, Scott & Semo, ADVANCE 2025). 

⁵Medaxion. 5 Ways to Limit NORA Impact on OR Coverage. OR Manager White Paper, 2024–2025. Source for NORA growth from ~20% to 35%+; projection to exceed 50% in acute care by 2030; NORA operational and safety characteristics; data capture gaps in EMRs; impact on OR utilization reporting. 

⁶Ibid. (Johnson, Scott & Semo, ADVANCE 2025). 

⁷Ibid. (Johnson, Scott & Semo, ADVANCE 2025). 

⁸Ibid. (Medaxion OR Manager White Paper). For NORA scheduling characteristics, absence of centralized leadership, anesthesia utilization inefficiency in non-OR settings, and resource allocation implications of simultaneous OR and NORA demand. 

⁹Ibid. (Medaxion OR Manager White Paper). 

¹⁰Ibid. (Medaxion OR Manager White Paper). 

¹¹Ibid. (Medaxion OR Manager White Paper). 

¹²Ibid. (Johnson, Scott & Semo, ADVANCE 2025). 

¹³Johnson, Scott & Semo, ADVANCE 2025 (op. cit.). For the No Surprises Act’s effect on commercial reimbursement compression; rising labor cost data; and the operational and legal dynamics of subsidy negotiations under financial pressure. 

¹⁴Trinity Health Advisors. Anesthesia Service Line Insourcing. Operational overview, 2024–2025. Source for context on hospital insourcing decisions, data-driven governance during employment model transitions, and the operational management challenges that accompany adversarial program changes. 

¹⁵Ibid. (Medaxion OR Manager White Paper). 

¹⁶Johnson R. How Much Call is Too Much? Communiqué (Anesthesia Business Consultants). Spring 2018. Available at: https://www.anesthesiallc.com/news-events/99-communique/past-issues/spring-2018/1114-how-much-call-is-too-much. Source for call burden data by facility type; beeper vs. in-house call patterns; relationship between call obligations and anesthesia provider compensation and staffing models. 

¹⁷Ibid. (Johnson, Scott & Semo, ADVANCE 2025). 

¹⁸Ibid. (Trinity Health Advisors, 2024–2025). 

Robert Johnson, RCPT, MBA, is a seasoned healthcare executive with deep expertise in hospital operations, hospital-based physician services and anesthesia business development. His career began at Johns Hopkins, where he advanced from anesthesia technician and perfusionist to administrator for the Department of Anesthesia and Critical Care Medicine.  He subsequently held senior leadership roles across both academic and for-profit healthcare, including Johns Hopkins, Baylor College of Medicine, Duke University Hospital, and UPMC. Early in his career, he co-founded and helped launch with Michael DeBakey, MD, The Health Channel, a pioneering satellite-delivered medical education service. Mr. Johnson has led business development and integration efforts for several national anesthesia organizations, including Anesthesia Partners, Premier Anesthesia, and Sheridan (now Envision). He served as corporate vice president of hospital-based physician services at HCA, where he directed contracting and employment operations across its 180-hospital system with a concentrated focus on anesthesia services. Prior to joining Medaxion, Johnson provided strategic advisory services to anesthesia groups, hospitals and health systems, including HCA, Bon Secours Mercy, Universal Health Services, Piedmont, Ardent, Advocate and others. At Medaxion, he contributes expert guidance to the development of enterprise-wide anesthesia management tools for national anesthesia groups and health systems and is leading the creation of the anesthesia management network: an industry-wide information and benchmarking resource. He can be reached at bob.johnson@medaxion.com.