The Anesthesia specialty continues to change day after day. Nobody could have envisioned groups with hundreds or even thousands of providers working for a single entity, but that’s exactly what’s happening.

Mergers and acquisitions has become commonplace in Anesthesia and venture capital money continues to pour into the industry.  Are we witnessing the end of an era and the disappearance of the single hospital private anesthesia practice? And if so, how should providers prepare for the practice of the future?

One of the initial, and most notable, was the merger of anesthesia practices serving the Methodist Hospitals in Houston.  The anesthesia practice at Good Samaritan Hospital in Los Gatos, California, joined an entity called CEP America Anesthesia.  A number of practices in the Chicago area have come together to form Midwest Anesthesia Partners (MAP). 

Some predict that all anesthesia providers will inevitably work for some much larger entity in which they will be little more than salaried employees. Many believe that we will eventually see the end of the private anesthesia practice as anesthesiologists and CRNAs continue to become hospital employees. 

Today, two types of large anesthesia entities predominate: those that still function as anesthesia group practices and those that operate more as staffing companies. 

The second type of entity has a financial focus, such as Envision, NAPA, TeamHealth or Somnia. Physicians work for these entities because they know how hard they have to work and how much they will get paid. Employment is more like traditional employment with a private company. The difference is that, usually, a smaller pool of managers shares in the profits.

One thing we can say about today’s anesthesia providers is that they are more mobile than ever. High turnover can undermine a large staffing company’s credibility with its client hospitals. Years ago, things were much simpler. You worked hard in high school to get into a good college and be accepted by a reputable medical school. It took years of struggle to get a good hospital position, but once you were there, you were there until you retired.

Smaller private practices that are willing and able to provide a better service, custom-tailored to the customer’s specific needs, will always have the edge over large national entities that are bureaucratic and formula-driven.

Every practice that is considering selling out to a larger entity should ponder one question: what is its value proposition? Would the members rather control their own destiny or someone else’s? There will always be a place for the small, innovative practice that understands the importance of good customer service.