Rajiv Sharma, MD, said many gastroenterologists cross paths just once a year, leaving little room for the honest, ongoing conversation that could expose bad deals before physicians sign them.
Dr. Sharma, a gastroenterologist and president of Phoenix-based Mirage Health, told Becker’s that infrequent contact among GIs is one of the reasons the specialty stays exposed to predatory contract terms.
“In gastroenterology right now — the reason I think we’re getting screwed is because GIs don’t talk to each other enough,” Dr. Sharma said.
Gastroenterology’s workforce dynamics make that isolation especially costly. By 2036, the U.S. is projected to have a shortfall of around 630 GI physicians, according to the Department of Health and Human Services’ Health Resources and Services Administration, and more than half of practicing GIs are 55 or older, meaning much of the field’s institutional knowledge is on track to retire within the next two decades.
Additionally, more than two-thirds of U.S. counties don’t have a single practicing gastroenterologist, so physicians in the field are more likely to be spread thin across small, standalone practices than concentrated in large hospital-employed departments, leaving fewer natural venues for the peer comparisons Dr. Sharma said are missing.
That scarcity hasn’t translated into leverage at the negotiating table. Average gastroenterologist compensation fell 3% between 2023 and 2024, to $495,000, even as demand climbs. Meanwhile, about 1 in 10 U.S. gastroenterologists now practice within a private equity-backed group, and such platforms have grown roughly 28% since 2021, consolidating negotiating power on the employer side of a specialty where individual physicians, by Dr. Sharma’s account, rarely compare notes.
“Right now the contracts are built in this big nebula of liabilities, which physicians get exposed to, and every liability is planned in such a way that they can leverage it to not pay the physician,” Dr. Sharma said.
He pointed to per-wRVU rates as a clear example, saying he’s seen identical work paid anywhere from $36 to $95 per wRVU. Dr. Sharma said the gap persists partly because compensation structures are built around physicians not knowing what their peers or group leadership are actually paid.
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