Open-heart surgeries at the Minneapolis VA Medical Center have plummeted from 314 a decade ago to just 88 last year, and the hospital is on track for fewer than 100 again this year, as an exodus of anesthesiologists has delayed operations and shrunk surgical capacity at one of the largest hospitals in the VA system. The facility could not schedule heart surgeries on 11 dates in August alone, and administrators have had to cancel other procedures entirely because no anesthesiologist was available.
The staffing collapse has been building for more than a year. As reported by the Minnesota Star Tribune, the hospital's anesthesiologist ranks fell from 11 down to essentially one physician with part-time help, and Dr. Vasudha Goel, who called the Minneapolis VA one of her favorite places to work, stopped providing anesthesia services there in 2025. Overall hospital staffing dropped 13% in a single year, sliding from 5,048 employees in 2024 to 4,380 in 2025, per the same account.
A Bylaws Vote Splits the Medical Community
In August 2025, medical staff voted to amend facility bylaws so Certified Registered Nurse Anesthetists could practice independently in lower-risk surgeries without physician supervision, a change the hospital says helps it meet patient demand. The move drew formal opposition from the American Society of Anesthesiologists and the Minnesota Society of Anesthesiologists, and roughly 200 anesthesiologists and other providers signed a letter opposing the switch, according to the Star Tribune's reporting.
The National Association of Veteran Affairs Physicians and Dentists went further, stating that the bylaws change violated VHA Directive 1220, which requires 24-hour physician anesthesiologist coverage at surgical facilities. The group alleged that anesthesiologist departures stemmed from management problems rather than a systemic labor shortage. The American Association of Nurse Anesthesiology countered by backing the Minneapolis VA's decision, pointing to national VA data showing a 38% increase in facilities facing severe physician anesthesiologist shortages, as noted in a statement from the American Association of Nurse Anesthesiology.
The federal government itself has wavered on the underlying policy question. When the VA established national full-practice authority rules for Advanced Practice Registered Nurses back in December 2016, it explicitly carved out CRNAs from systemwide independent practice, ruling at the time that anesthesia access problems nationally did not justify overriding physician oversight, according to the U.S. Department of Veterans Affairs. That left the anesthesia oversight question to individual facilities like Minneapolis to decide on their own.
Residents Pulled, Contractors Paid Premium Rates
The University of Minnesota ended its long-standing relationship with the Minneapolis VA last summer, halting the placement of anesthesiology residents at the hospital, the Star Tribune reports. Andrea Jones described the departures as a slow trickle or loss of talent providing direct care for veterans, per the same account. The hospital has since paid premium rates to a contractor for temporary anesthesia help and changed its contracts for perfusionists to keep operating rooms functioning.
Dr. James Rauschnot, who lives and runs an anesthesia practice in La Crosse, Wisconsin, now provides on-call coverage at the Minneapolis VA a few days each month, and must stay within one hour of the hospital during those on-call shifts, according to the Star Tribune's reporting. Policy changes at the VA have also included scheduling rules limiting anesthesiologists' ability to moonlight at other hospitals, a restriction the article notes as another friction point for recruitment.
A VA spokesperson said the hospital is actively recruiting anesthesiologists and other doctors and acknowledged that a nationwide shortage of anesthesiologists has created a challenge, per the Star Tribune. That national shortage is well documented: a June 2025 survey by the American Medical Association found that 40.6% of practicing anesthesiologists intended to leave their roles within two years, while industry data showed 59% of the workforce nationwide was 55 or older, according to Becker's ASC Review. Industry analyses cited in that report project a national shortage of 6,300 anesthesiologists by 2036.
Congressional Pressure and a Watchdog's Warning
The staffing crunch extends well beyond the operating room. A VA Office of Inspector General report found the Minneapolis VA led the entire Veterans Health Administration nationwide in nonclinical severe occupational staffing shortages, registering 52 distinct nonclinical position gaps, as reported by the Washington Examiner. The Minneapolis VA had the second-highest number of vacancies among veterans hospitals in 2025, per the Star Tribune's reporting.
In September 2025, U.S. Representative Kelly Morrison and Minnesota's Democratic congressional delegation sent a formal letter demanding answers from VA Secretary Doug Collins about 130 reported severe staffing shortages at the Minneapolis VA, including 78 clinical positions, according to the Office of U.S. Representative Kelly Morrison. Separately, a court order restored the VA health care workers union in August 2026, reversing the VA's 2025 dissolution of that union, per the Star Tribune's account.
The Minneapolis VA also has not hired a physicist to calibrate and monitor radiation therapy machines and has moved radiation therapy for cancer patients to other hospitals, the newspaper reports. Anesthesiologists reportedly quit the Minneapolis VA last year in a wave that has left the hospital struggling to keep pace with a patient population that includes veterans with deployment-related respiratory problems and higher rates of post-traumatic stress and substance use disorders.
Veterans Steered to Community Hospitals
Under the VA MISSION Act of 2018, enrolled veterans can access VA-funded private community health care if specialty surgical care cannot be scheduled at a VA facility within 28 days or requires a drive exceeding 60 minutes, according to the VA. The agency streamlined that community care access in May 2025 by removing secondary review requirements, giving veterans more flexibility to use federal health benefits for surgeries outside the VA system.
The tradeoffs of that shift are contested. A VA-funded review in 2023 found surgical quality was equivalent or better at federal veterans hospitals than community hospitals, while other findings from that same period indicated community hospitals provided cheaper and more efficient surgical care, a conflict the Star Tribune's reporting leaves unresolved. For its part, the VA Office of Inspector General found no significant concerns with surgical quality or patient safety at the Minneapolis facility in 2025, and the hospital maintains a five-star Medicare rating.
The Minneapolis VA Medical Center holds a Level 1a facility complexity rating, the highest classification in the Veterans Health Administration, designating it a regional tertiary referral center equipped for complex, high-risk surgical operations, according to a USAJobs posting. It treats roughly 100,000 patients annually and, per a VA statement, its surgeons performed 155 cardiothoracic surgeries in 2026 even as open-heart procedures specifically remain far below historical levels. The VA system overall has reported a decline in cardiac surgeries over the past decade, a trend the Minneapolis numbers reflect starkly.
Expansion Continues Even As Surgical Capacity Shrinks
Despite the surgical strain, the campus has continued to grow in other areas. In July 2026, the Minneapolis VA Health Care System opened a new 13,000-square-foot Women's Health Clinic to provide dedicated primary, specialty, and mental health care to roughly 10,000 enrolled female veterans, according to KARE 11. VA caregivers have continued to raise concerns about anesthesia staffing and surgical capacity at the medical center this month, underscoring that even as new services launch, the core surgical bottleneck remains unresolved for veterans awaiting operations in Minneapolis.
