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Looking Ahead to 2024 and Our Mission to Serve the Servants

December 22, 2023

As we reflect on 2023, we are first and foremost struck with a deep appreciation for the sacrifice and dedication of our clinical providers and their commitment to compassionate care for the patients, administrators, surgeons, proceduralists, and nursing teams whom they serve every day.

The formula is actually pretty simple. As an organization, Premier Anesthesia remains committed to serving these servants! We do that by keeping the focus where it belongs. We create tailored anesthesia solutions uniquely customized for each facility we partner with – and we help empower our clinicians to do what they do best!

In September, I was privileged to lead a panel discussion at the annual summit of Health Connect South – the largest gathering of healthcare providers, leaders, and influencers in the southeastern United States. The panel was on the State of Healthcare: Industry Leader’s Perspectives on Cost & Quality Transparency and had input from clinical leaders from ambulatory care and surgical teams as well as hospital administration. The trends in the industry are stark and require that we focus efforts where they belong.

The anesthesia market is turbulent, with private equity-backed groups and publicly traded companies beholden to the investors and shareholder interests driving their direction and decisions.


The results across the country are shocking:

  • Skyrocketing costs for administrators
  • Throttling of coverage, staffing, and services for patients in need
  • Filing of bankruptcies and even federal lawsuits for alleged anti-competitive trade practices
  • Creation of outrageous expectations of clinicians and unsustainable clinical rotations, which contribute to a record burnout and worsening of provider shortages
  • Scarcity of leadership, lack of customer service, poor practice-management fundamentals
  • Most importantly, a reduction in clinical quality


All of this is happening while insurance companies are seeing:

  • Record profits
  • Extraordinary executive compensation packages
  • Merger and acquisition activity decreasing competition
  • Increased leverage through lobbying efforts to change federal laws for provider billing laws

With over 10,000 baby boomers retiring every day, demand for services has never been higher, while reimbursement for anesthesia is steadily declining year-over-year. This results in very real cost-shifting and rising subsidies that must be passed along. Unfortunately, this has given many anesthesia groups a black eye and left clinical providers feeling like their long education journey and steep student debt load has only led them to a point in their professional career where they feel like a cog in an out-of-control corporate machine.

Premier Anesthesia stands in stark contrast to others in the industry – as one of the only remaining anesthesia groups with national reach, which does not accept any private equity investment or stockholder ownership. Fundamentally, we are committed to being a different kind of anesthesia group – and keeping the focus where it belongs. It’s in our DNA. We exist to serve the servants.

In 2024, our teams – both clinical and corporate – will remain laser-focused on our mission – led by our outstanding clinical providers – and the service orientation they have to the patients they treat and the administrative, surgical, and nursing partners they work alongside every day.

In the coming year, we aim to highlight why it matters to keep the focus where it belongs – through the delivery of exceptional and compassionate care that is patient-focused, efficient, and service-driven – with a transparent and cost-effective model of operations for hospitals and clinics throughout the country.

We will offer a home to those clinical providers who are the victims of corporate mismanagement, poor vision, and misplaced priorities. As part of the Premier Anesthesia team, no clinical provider will be worried about whether s/he will be paid because of a dark cloud of bankruptcy hanging over the group. No healthcare administrator will question whether the anesthesia group has the resources to continue providing services for the patients of the facility or whether they have engaged in shady trade practices. Those concerns are put to bed – so that patients have what they need at the bedside.

Through our unique model, Premier Anesthesia will seek to provide rewarding career opportunities for our clinical providers, bridge healthcare gaps, integrate innovative technology support, and continue to provide comprehensive, adaptable anesthesia solutions. Focused on the fundamentals of what really drives exceptional healthcare, we are poised to extend our long track record of success and make meaningful contributions to the ongoing transformation of healthcare – strengthening the bonds with our clinical leaders, ensuring improved patient outcomes, and creating real partnerships with our clients.


By Preston Smith, FACHE