{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/anesthesiologists/",
  "methodology": "https://cookedindex.com/methodology",
  "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.",
  "scored_at": "2026-08-11",
  "model": "claude-opus-5",
  "occupation": {
    "title": "Anesthesiologists",
    "soc_code": "29-1211",
    "category": "Healthcare",
    "us_employment": 38760,
    "median_annual_wage": 391490
  },
  "verdict": "SAFE",
  "risk_resistance": 89,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 17,
    "embodiment": 19,
    "liability_shield": 20,
    "trust_premium": 14,
    "judgment_accountability": 19
  },
  "reasoning": {
    "task_resistance": "At 17 rather than 20, the genuinely digitisable slice is real — ASA physical status scoring from chart data, pre-op checklists, and automated anesthesia record charting are already shipping — but airway rescue on a Mallampati IV patient, awake fiberoptic intubation, and hand-titrating pressors through a hemorrhage are not tasks a model can do, and closed-loop propofol systems like McSleepy still require a physician at the head of the bed.",
    "embodiment": "A 19 reflects that nearly every minute is physical and in an uncontrolled field: laryngoscopy in a patient whose neck won't extend, ultrasound-guided internal jugular access, loss-of-resistance for an epidural in a laboring patient who is moving, plus trauma bays, OB suites, and out-of-OR sedation in radiology where the equipment and lighting are whatever you find.",
    "liability_shield": "20 is the ceiling because you hold an unrestricted state medical licence and ABA board certification, sign the anesthesia record yourself, and wrongful-death and anoxic-brain-injury claims name you personally — this is the specialty that rebuilt its own malpractice profile through the ASA Closed Claims Project precisely because the physician, not the device, is the defendant.",
    "trust_premium": "14 rather than 18 because the pre-op consent conversation and the promise that you will not let the patient wake up mid-case carry real weight, but most patients meet you twenty minutes before induction, never see you again, and cannot name you afterward — the durable relationship is with the surgeon who requests you for their difficult cases.",
    "judgment_accountability": "19 because the calls are yours alone and made in seconds: cancel the case for an unexplained troponin, convert to general when the block fails at incision, declare a can't-intubate-can't-ventilate emergency and cut the neck, decide whether a hypotensive patient on a MAOI gets ephedrine or phenylephrine — no protocol resolves these and there is no time to consult upward."
  },
  "rationale": "The core work is physical and unforgiving: intubating airways, placing central lines and epidurals, titrating agents minute-by-minute against a bleeding, hypotensive, unpredictable patient. Closed-loop sedation algorithms and monitoring alarms already exist and will keep improving, but a licensed physician must be present and personally liable for induction, crisis rescue, and extubation. The automatable slice is documentation, pre-op risk stratification from chart data, and dosing suggestions — real efficiency gains, not job replacement.",
  "outlook": "Automated monitoring and dosing assistants will absorb documentation and routine titration, and care-team staffing models will keep pressuring physician-to-case ratios, but the procedural and crisis-accountability core stays human through the 2030s.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "trust_premium",
        "change": "Continued growth of patient-selected 'physician-only anesthesia care' — explicit MD/DO presence guarantees marketed by hospitals and demanded in surgical consent conversations, plus ASA's ongoing campaign against opt-out of physician supervision for CRNAs. If state opt-out rollbacks (as ASA has pushed in several state legislatures) succeed, buyer-side preference for a physician anesthesiologist becomes contractually locked rather than merely preferred.",
        "plausibility": "plausible",
        "would_add": 3
      },
      {
        "dimension": "task_resistance",
        "change": "Task-mix shift as closed-loop TIVA/TCI systems and automated documentation (Epic Anesthesia, autocharting) absorb the routine ASA I-II maintenance tier, leaving the day dominated by high-acuity cases: cardiac, obstetric hemorrhage, difficult airway, pediatric, and pre-op optimization of ambiguous multi-morbid patients. Also chronic pain and critical care sidelines expand the judgment tier.",
        "plausibility": "already happening",
        "would_add": 2
      }
    ],
    "ceiling_note": "At 89/100 with liability_shield and embodiment effectively saturated, only trust_premium has real headroom, and that headroom is contested by the CRNA scope-of-practice fight rather than by AI. The realistic risk direction for this occupation is scope substitution by mid-level clinicians augmented by decision support, not model capability."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2019,
        "emp": 31010,
        "wage": 239200
      },
      {
        "y": 2020,
        "emp": 28590,
        "wage": 239200
      },
      {
        "y": 2021,
        "emp": 31130,
        "wage": 239200
      },
      {
        "y": 2022,
        "emp": 37430,
        "wage": 239200
      },
      {
        "y": 2023,
        "emp": 33470,
        "wage": 239200
      },
      {
        "y": 2024,
        "emp": 41890,
        "wage": 239200
      },
      {
        "y": 2025,
        "emp": 38760,
        "wage": 391490
      }
    ],
    "from": 2019,
    "to": 2025,
    "change_pct": 25,
    "comparable_from": 2019,
    "spans_soc_revision": false
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}