Statement on Fundamentals of a Safe and Healthy Workplace for Anesthesiologists

Developed by: Ad Hoc Committee on Anesthesiologists' Work Bill of Rights
Original Approval: October 18, 2023

Preamble: The American Society of Anesthesiologists (ASA) is dedicated to enabling its members in the delivery of high-quality and safe physician-led care models. As part of this commitment, the ASA aims to foster work environments that prioritize efficient diagnosis and treatment, to advocate for policies that emphasize overall health and well-being, and to ensure equitable workplace arrangements and fair compensation. With these objectives in mind, the ASA has developed the Statement on Fundamentals of a Safe and Healthy Workplace for Anesthesiologists to outline the workplace fundamentals that every anesthesiologist should expect.

Anesthesiologists should expect: 

Patient Care and Safety:

1. To practice physician-led anesthesia care. The ASA, WFSA, and WHO believe that wherever and whenever possible, anesthesia should be provided, led and overseen by an anesthesiologist.¹
2. To perform a pre-anesthesia assessment for every patient under their care.²
3. To report safety or quality concerns without fear of retaliation.³
4. To work with qualified anesthesia clinicians in a physician-led team-based model.⁴

Optimized Health:

5. Family leave.⁵
6. Access to health services, including mental health services.⁶
7. Reasonable accommodations, including lactation policies, that are necessary for a return to work.⁷
8. A policy that clearly outlines how burnout is recognized, reported, and addressed.⁸
9. Relief from fatigue.⁹
10. Peer and institutional support following adverse events. This may include relief from duty in some circumstances.¹⁰

 Work Environment:

11. Limitation of excessive noise and distractions in the workplace that compromise patient care.¹¹
12. For safety incidents, patient complaints, and professionalism complaints to be evaluated and addressed under a Just Culture process.¹²

Fair and Equitable Compensation:

13. Fair and equitable compensation based on comparable work is essential to ensure that anesthesiologists are paid appropriately. This includes considering factors such as board certification, experience, education, and the complexity of the work performed.¹³
14. Compensation and advancement to be determined by objective assessment and established criteria. Anesthesiologists should be evaluated based on their performance, skills, and contributions to the organization, rather than any personal characteristics. Employment decisions cannot be made because of race or color, gender, sexual orientation, pregnancy or parental status, religious belief or genetic information whether overtly stated or implied.¹⁴

The anesthesiologist should be able to advocate for all fundamentals listed without fear of retaliation or reprisal.

References/Links:

1: World Health Organization-World Federation of Societies of Anaesthesiologists (WHO-WFSA) International Standards for a Safe Practice of Anesthesia 

1: ASA Statement on Physician-Led Anesthesia Care

2: ASA Guidelines for the Ethical Practice of Anesthesiology

3: ASA Statement on Safety Culture 

4: ASA Statement on Students Involved in Anesthesia Care 

5: ASA Statement on Personal Leave

6,7: ASA Statement on Creating a Culture of Well-Being for Health Care Workers

7: ASA Statement on Lactation Among Anesthesia Clinicians

8: ASA Statement on Burnout 

9: ASA Statement on Fatigue

10: ASA Statement on Peer Support After Unexpected Outcomes – Treatment of the "Second Victim"

11: ASA Statement on Distractions 
 
12: ASA Statement on Safety Culture 

13, 14: ASA Statement on Compensation Equity Among Anesthesiologists