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Lack of anesthetists affects surgical centers, increases rescheduling, and exposes a challenge that goes beyond the number of trained doctors, involving the distribution of specialists, schedule organization, and inequality of access between SUS and the private sector.
The lack of professionals in crucial roles in surgical centers still limits the capacity of Brazilian hospitals, even in a scenario of growth in the number of trained and registered doctors in the country.
According to the Medical Demography 2025, launched on April 30, 2025, 8% of surgeries are canceled due to lack of staff, mainly due to the absence of anesthetists in hospital schedules.
This data reveals a bottleneck little perceived outside the hospital environment, but capable of interrupting an operation even when the room, surgeon, equipment, and patient are already prepared for the procedure.
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In the surgical center, the presence of the anesthetist is not limited to the administration of medication for sedation or pain control, as it involves clinical evaluation, patient monitoring, and verification of safety conditions.
The guidelines of the Federal Council of Medicine require that the anesthetist doctor evaluate the patient beforehand, accompany the procedure, and verify the safety of the surgical environment and the post-anesthetic recovery room.
When this professional is not available, the failure is no longer just a scheduling problem and directly affects the hospital’s ability to transform structure into care.
Even after completing preparation and waiting stages, the patient may return to the queue if the necessary team is not complete at the scheduled time for surgery.
More doctors, but unequal distribution
The Medical Demography 2025 shows an important contradiction in the health sector, as the country increases the overall number of doctors while maintaining a shortage of specialists in strategic areas.
In December 2024, Brazil had 353,287 specialist doctors, equivalent to 59.1% of the total registered doctors, in addition to 244,141 generalists without a specialist title.
Although the number of professionals has increased, the shortage does not automatically disappear in services that depend on specific training, continuous presence, and complete teams to function regularly.
The research itself points out that specialists remain unevenly distributed across the national territory, with a significant concentration in the Southeast region and relevant differences between Federation units.
This imbalance helps explain why the opening of medical courses alone does not solve the difficulty hospitals face in maintaining full schedules in high-demand areas.
In specialties related to surgeries, diagnostics, and continuous hospital care, factors such as professional retention, available infrastructure, and the organization of work ties also weigh in.
Lack of anesthetists stalls the surgical center
In hospital routine, anesthesiology occupies a central position because it involves risk assessment, clinical monitoring, and response to incidents during procedures of varying complexity levels.
Besides medical practice, the CFM provides for minimum safety conditions, such as patient monitoring, equipment, materials, and mandatory drugs for anesthetic practice.
Thus, the anesthetist accompanies a stage that cannot be replaced by improvisation, as decisions made during the procedure can directly interfere with patient safety.
The role requires permanent vigilance, real-time decision-making, and integration with surgeons, nursing, anesthetic recovery, and other areas involved in hospital care.
For those awaiting surgery, the absence of this link becomes concrete when the procedure is suspended, rescheduled, or pushed again to an already pressured queue.
A rescheduling can extend the waiting time, reorganize family routine, affect work, and prolong pain, physical limitations, or uncertainties related to treatment.
On the hospital management side, cancellation also has an impact because it wastes schedules, leaves rooms idle, requires team rearrangement, and increases pressure on high-demand services.
SUS and private sector have unequal access to surgeries
The inequality between the Unified Health System and the private network also appears in the procedures analyzed by Medical Demography 2025, especially in frequent surgeries in the country.
The survey compared appendectomy, cholecystectomy, and abdominal wall hernia repairs, procedures used to measure access differences between SUS users and health plan beneficiaries.
In appendectomy, pointed out as the most common emergency surgery, the rate among plan beneficiaries was 100 per 100,000 inhabitants, above the 74.45 per 100,000 recorded in the SUS.
Even so, the public system accounted for 70% of the total volume of these procedures in 2023, highlighting the importance of the SUS in performing surgeries on a national scale.
The difference was repeated in gallbladder removal, with a rate of 312.38 surgeries per 100,000 inhabitants in the private sector and 196.81 per 100,000 in the SUS.
Despite the lower proportional rate, the public network performed 66% of these interventions, reinforcing the weight of the public system in serving a large portion of the Brazilian population.
In abdominal wall hernia surgeries, the disparity was even greater, with 401.41 procedures per 100,000 inhabitants in the private network and 215.07 per 100,000 in the SUS.
Specialists do not reach all services in the same way
The concentration of professionals also appears in the surgeons’ affiliations, as 70% work simultaneously in both public and private sectors, according to the Ministry of Health.
Another 20% work only in the private network, while 10% work exclusively in the SUS, a setup that helps explain why the availability of specialists varies between services.
For the patient, the central issue is not only how many doctors exist in the country, but whether they are available in the city, in the network, and at the time the surgery needs to occur.
The training of specialists depends on medical residency or recognized certification, in addition to hospitals able to train professionals and absorb them after specialization.
According to Medical Demography 2025, 63.7% of specialty titles were obtained through residency, while 36.3% came through certification exams from societies linked to the Brazilian Medical Association.
After training, factors such as remuneration, workload, safety, infrastructure, working conditions, and the possibility of working in more than one affiliation influence where these professionals remain.
This set weighs especially in hospital specialties, which require continuous presence, coordinated teams, and infrastructure compatible with the complexity of the procedures performed.
In anesthesiology, the bottleneck becomes relevant because it directly interferes with the use of surgical rooms, recovery beds, and specialized care schedules.
A unit may have demand, equipment, and patients waiting, but cannot operate at full capacity when the necessary team to ensure the procedure’s safety is lacking.
Therefore, advances in medical training alone do not eliminate the scarcity in areas that make surgery go from planning to reaching the patient.
If Brazil is already increasing the number of doctors, what still prevents essential specialists from reaching hospitals when the patient needs them?
