ABSTRACT
Despite the growing complexity of anesthesia services and the evolving healthcare environment, the fundamentals of anesthesia group management remain essentially unchanged since the origin of anesthesia groups. While drugs, equipment, and techniques have changed, anesthesia group management remains an exercise in human resources management. Ÿe goals of this chapter are to review the history of American anesthesia practice, its traditions of autonomy, the factors shaping anesthesia practice, the differences between medical facility and anesthesia group cultures, and to present ideas of how anesthesia groups should address organizational issues to meet the changing times. Ÿe main take home points are that the (1) disparity between the autonomy-based culture of physician groups and the positional authority-based culture of healthcare facility administration leads to ongoing conflict, (2) the field of anesthesiology is influenced by the search for recognition as a legitimate and innovative medical specialty, (3) community anesthesia groups are primarily operated by locally owned entities, (4) legal and regulatory factors (including exclusive contracting) have shaped the operation of anesthesia departments, (5) clinical anesthesia skills do not equate to business leadership or management
Introduction ................................................................................................36-1 A Brief History of Anesthesia Practice ....................................................36-2 Cultural Differences betweenAnesthesia Groups and Facility Management ................................................................................................36-3 Evolution of Closed Staffs and Exclusive Contracts ..............................36-4 Physician Practice Management Companies ..........................................36-4 Autonomy as a CoreValue ........................................................................36-5 Urgency ofToday .......................................................................................36-6 Change and Transitions inAnesthesia Groups ......................................36-6 Macro-Level Transition Models ...............................................................36-6 Impact ofTransitions on People ...............................................................36-6 Aligning Culture and Strategy ..................................................................36-8 Leadership in anAnesthesia Group .........................................................36-9 At a Crossroads…Again ..........................................................................36-11 Conclusion ................................................................................................36-11 References ..................................................................................................36-12
skills, (6) human resource management is critical to an anesthesia group’s long-term success, (7) change impacts anesthesia groups on a organizational and personal level, and (8) leadership education and involvement in the medical community will play an important role in the continued autonomy of the anesthesia group.
