1. Compensation decline in real terms: Average gastroenterologist pay dropped from $512,000 in 2023 to $495,000 in 2024, reflecting a 3% nominal decline — and because inflation has pushed the equivalent of 2015’s $370,000 salary to around $502,930 today, the 2024 average actually represents a real-term pay cut. This contravenes expectations given rising costs and practice burdens, making it harder for GI practices to sustain independent models.
2. Only 37% of GIs feel fairly compensated: This reflects a persistent misalignment between reimbursement and workload intensity. The dissatisfaction is prompting worries about burnout, retention and the specialty’s migration toward hospital employment.
3. Imminent workforce shortage: The U.S. is projected to face a shortage of approximately 1,630 gastroenterologists by the end of 2025. At the same time, over 50% of practicing gastroenterologists are aged 55 or older. These dynamics risk longer wait times for patients, heavier workloads for existing providers and increased pressure on GI practices to restructure.
4. Reimbursement erosion and policy headwinds: The conversion factor for the physician fee schedule in 2025 was cut by 2.83% (to $32.35 from $33.29). Moreover, from 2007 to 2022, adjusted average reimbursement for GI procedures declined by 33%, and colonoscopy/biopsy payments dropped 38%.
With costs rising for staffing, equipment and compliance, this reimbursement squeeze threatens the economic viability of many GI practices.
5. Private-equity consolidation accelerating: Since 2021, the number of private-equity-backed GI groups has grown by about 28%. This rapid consolidation may reduce physician autonomy, alter practice economics and intensify competitive pressures — all contributing to anxiety among GI practitioners.
