As private equity-backed groups, hospitals and ASCs all bid for the same thin pipeline of gastroenterologists, recruiting one has become one of healthcare’s longest and most expensive physician searches.
Gastroenterology openings now sit unfilled for a median of 186 days, according to Medicus Healthcare Solutions’ analysis of the Association for Advancing Physician and Provider Recruitment’s 2025 benchmarking report, well above the 118-day median AAPPR found across all physician specialties. Fifty-nine percent of GI searches were still open when measured, and 57.6% of organizations surveyed had a GI search running at some point during the year, which points to hospitals, health systems and ASC-affiliated groups all fishing in the same small pond at once.
That wait carries a price before an offer is even made. Gastroenterology had the highest average signing bonus of the five most-requested specialties in search assignments completed between April 2023 and March 2024 — $46,040, ranging from $15,000 to $100,000 — per AMN Healthcare and Merritt Hawkins’ 2024 recruiting incentives review. Average starting salary climbed to $531,000, up 4.9% year over year, even as GI fell to the fifth-most-requested specialty overall — 69 completed searches, down from 99 the year before.
An empty seat costs money too. Locum tenens gastroenterologists bill $150 to $263 an hour, per Barton Associates’ 2026 rate guide, and AMN Healthcare has listed GI locum assignments paying up to $16,000 a week in high-need states like Texas and North Carolina.
The same small pool of physicians is being pulled from multiple directions at once. At least 15 private equity-backed GI management groups — including GI Alliance, Gastro Health, US Digestive Health and One GI — are actively acquiring practices and recruiting nationally, per a 2026 tracker from CT Acquisitions, on top of continued hospital and ASC hiring.
HRSA’s Health Workforce Simulation Model projects a national shortfall of about 630 full-time-equivalent gastroenterologists by 2036, but the pain isn’t even. Wyoming has the worst physician-to-demand adequacy in the country at 33%, followed by Nevada at 48% (a projected shortfall of 120 GIs) and Alaska and Montana at 50% each. Oklahoma sits at 54%, short an estimated 130 physicians.
Six months to fill a seat, a $46,000 bonus to land it and a locum bill running the whole time it’s open — that’s the baseline cost of hiring a gastroenterologist in 2026, and it climbs sharply in the handful of states already short well over 100 physicians.
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