To the Editor:
I read with great interest Afonso et al.’s1 article on burnout rates and risk factors among anesthesiologists. I am very concerned that the entry of private equity firms and the resultant need to compete with these firms have increased the focus on profit (= revenue – costs).2
Private equity firms are not organized for long-term consistent growth but are, by definition, looking for short-term growth. These short-term goals may allow for leadership to tolerate staffing shortages, resulting in longer work hours and high productivity pressures as well as failing to support the local anesthesiologist in the clinical setting. All these are high-risk factors identified by Afonso et al.1 for burnout and burnout syndrome. But from a short-term perspective, clinician burnout is a long-term issue!
Unfortunately, this issue for anesthesiologists is not new but has been accelerated by the entry of private equity firms as well as national anesthesiology staffing companies. Many hospital administrators are also under short-term financial incentives and are looking to reduce costs in any possible way. The willingness of some national staffing companies to provide anesthesia care in less costly ways has led to similar situations of staffing shortages and productivity pressures.
As one may have noted, none of these short-term goals has included maintaining, let alone improving, quality of care. It is impossible to study quality of care and patient safety in rigorous scientific methods when short-term plans lead to a change in clinician composition, removal of physician-led care,3 a lack of local support, and staff attrition; therefore, we are left with anecdotal evidence.
But a lack of scientific evidence4 is not a reason to ignore the impact of short-term financial goals on our patients and our clinicians.
Competing Interests
The author declares no competing interests.