Why These CRNAs Refused to Work with 3 Large Anesthesia Groups
Large anesthesia groups like USAP, TeamHealth, and Envision have long dominated the industry, offering employment opportunities to CRNAs nationwide. But how do CRNAs really feel about working for these organizations? We saw a motivated, interested CRNA match with a client — as soon as she realized what Group she would be working for, she rejected the match.
More than how CRNAs feel about working for these organizations, we wanted to know how CRNAs feel about not working for them. To find out, we asked CRNAs themselves, gathering both quantitative and qualitative responses about their experiences and what they’ve heard from colleagues. The results reveal significant concerns about pay, working conditions, and job security.
In this article, we’ll dive into the key findings, analyze CRNA sentiment, and explore better alternatives for anesthesia professionals.
Have you ever turned down a role from any large group? We’re expanding this to include other major groups and you can tell us about your experience here.
Data Overview
We surveyed 140 CRNAs across the U.S. to understand their perspectives when they have turned down opportunities with 3 large anesthesia groups: USAP, Team Health and Envision. The survey included:
- Refusal rates: How many CRNAs actively avoid working for which groups?
- Reasons for avoidance: Common concerns such as compensation, workplace treatment, and scheduling reliability.
- Personal experiences: Some CRNAs who actually worked with these groups also shared their stories.
- Word-of-mouth influence: How often do CRNAs hear warnings about these groups from peers?
Key Findings and Trends
1. Refusal Rates for Large Anesthesia Groups
- 55.7% of CRNAs refused to work for USAP.
- 41.4% avoided Envision.
- 29.3% stayed away from TeamHealth.
- CRNAs were given the option to select one or more of the groups. Other groups, like NAPA and AmSurg, were written in, but this initial survey focused on the 3 groups mentioned above.
2. Common Reasons for Avoidance
CRNAs identified the following major concerns and themes:
- Low Pay (25%): Many respondents cited inadequate compensation or undesirable compensation packages as a deal-breaker.
- Anti-CRNA Lobbying (30%): Some large groups have reputations for policies that undermine CRNA autonomy —ultimately, this was the most salient issue for CRNAs.
- Mistreated by MDs (16%): Reports of CRNAs being undervalued, bullied or disrespected by physician anesthesiologists.
- Poor Working Conditions (10%): Reports of overwork and high-stress environments.
- Market Monopolies, Takeovers, Anti-competition (9%): Last-minute cancellations or bait-and-switch tactics were a common complaint.
- Unreliable Recruiting, Scheduling or Contracting (8%): Last-minute cancellations or bait-and-switch tactics were a common complaint.
3. Negative Word-of-Mouth is Widespread
- 106 respondents said they frequently hear negative feedback about these groups.
- Only 7 respondents had never heard negative reports.
- This suggests that CRNAs rely heavily on peer recommendations when choosing where to work.
4. High Incidence of Negative Experiences
Among CRNAs who had worked for these groups:
- 79 reported a negative experience.
- Common complaints included unfair termination, pay disputes, unreliable scheduling, and excessive workloads.
Sentiment Analysis: Overwhelmingly Negative
While a handful of CRNAs had neutral or positive experiences, the overwhelming sentiment toward these large anesthesia groups was negative. For the avoidance of doubt, our expectation was that the responses to this survey would be negative as CRNAs were asked to only take this survey if they had refused to work for any of these groups. CRNAs expressed frustration with compensation, lack of respect, and instability in their jobs.
What CRNAs Are Saying
“They canceled my contract last minute after I had already moved for the job.”
“I was promised a certain pay rate, only for them to change it after I started.”
"They lobby against CRNAs—why would I work for a group that doesn't respect my profession?”
"They treat CRNAs like we’re disposable. I’ve seen too many colleagues burned by these groups.”
“I refuse to work for a group that prioritizes profits over patient safety and provider well-being.”
“I took a job with one of these companies once—never again. The pay was lower than promised, and they kept changing my schedule at the last minute.”
“Every CRNA I know warns against them. If so many people have bad experiences, why take the risk?”
“Underpaid, undervalued, a number not a person.”
Actionable Insights for CRNAs and Employers
For CRNAs:
- Negotiate confidently: Advocate for fair pay and clear contract terms before signing.
- Research thoroughly: Seek insights from peers and review employer reputations before committing.
- Explore alternative options: Many smaller groups and independent practices offer competitive conditions and greater flexibility.
For Anesthesia Groups:
- Improve pay transparency: Competitive and consistent rates will attract better talent.
- Respect CRNA autonomy: Publicly address concerns about lobbying and workplace treatment.
- Enhance scheduling reliability: Avoid last-minute cancellations that disrupt CRNA careers.
- Assess internal operations and reputation: Understand how policies and workplace culture impact recruitment success in order to attract and retain top talent.
How Lokum App Helps CRNAs Find Better Opportunities
Lokum App was built to address these exact concerns. Here’s how we make job finding easier and more transparent for CRNAs:
1. Connecting CRNAs with Better Jobs
- No bait-and-switch: Lokum’s customer success team works with organizations to ensure offers are accurate and transparent.
- Transparent pay, market insights: We help CRNAs find positions that align with their expectations through our matchmaking engine.
- More options, less hassle: CRNAs can explore locum tenens and full-time roles knowing what types or organizations or employers they are interacting with (direct vs agency), and access resources to help guide them along the way.
2. Providing Market Insights
- Real-time pay data: Lokum collects and shares pay trends so CRNAs know what they should be earning according to industry benchmarks and reports from colleagues.
- Insight-driven career decisions: With Lokum, CRNAs tap into the network of knowledge their colleagues to make informed choices about where to work.
3. Helping Employers Improve Their Offers
- Sentiment analysis: Lokum provides data on how CRNAs perceive job opportunities.
- Better recruitment strategies: Employers can adjust offers based on CRNA feedback, improving hiring success rates.
Final Thoughts: The Future of CRNA Staffing
The CRNA workforce is speaking loud and clear and our survey confirms what many CRNAs already know about the patterns that drive talent away : They expect better pay, respect, trust, and stability. If anesthesia groups want to attract and retain top talent, they need to address these concerns head-on. For CRNAs looking for better opportunities, platforms like Lokum App provide the transparency and tools needed to make informed career decisions.
Want to see what better opportunities are out there? Want to connect with engaged CRNAs who are looking for the right fit? Join Lokum App today to be in the know.