Increasing compensation is the most common way organizations address retention and recruitment challenges in anesthesia. While this approach may provide short-term results, it often leads to a cycle of escalating labor costs as competitors attempt to outpace the market. However, research¹,² indicates that employees leave jobs for at least three primary reasons, suggesting that compensation alone is insufficient to improve retention. Additional data³ highlights the need to optimize several key categories to enhance retention and recruitment in anesthesia. These categories, ranked by importance according to anesthesia providers, are as follows:
- Working Conditions
- Negative or hostile work culture in surgery and/or anesthesia
- Work-life interference (e.g., call schedules, night shifts)
- Burnout due to lack of resources (e.g., understaffing, insufficient support personnel)
- Difficulty using paid time off or personal days
- Poor safety or quality of the work environment
- Practice environment challenges (e.g., scope of practice, collaboration with other anesthesia provider types, opportunities to perform anesthesia-related skills, supervision of residents, differences between academic and private practice settings)
- Leadership
- Inadequate clinical leadership (e.g., lack of respect, collaboration, communication, or support for staff)
- Ineffective administrative leadership (e.g., tolerance of chronic staffing shortages, inability to resolve departmental issues, or lack of support)
- Compensation
- Competitive salary relative to the local market
- Comprehensive benefits (e.g., vacation time, overtime pay, minimum hourly guarantees)
- Fair compensation for differentials (e.g., night shifts, weekends, holidays, specialty teams)
What stands out from this list is that compensation ranks last among the reasons participants cited for quitting. Regardless of pay, anesthesia jobs with deficiencies in working conditions or leadership are likely to experience above-average turnover.
While compensation remains an essential component of recruitment and retention, it is only one aspect of maintaining a healthy anesthesia department. Notably, compensation is often the last factor influencing an anesthesia provider’s decision to leave. Addressing challenges in the work environment and leadership may be difficult, but the investment pays off through better retention, stronger recruitment, reduced turnover costs, and enhanced patient care delivered by experienced professionals who align with organizational values.
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