Impacts of this supply-demand mismatch are felt daily in our GI practices as we strive to expand access in our clinics and endoscopy suites, particularly in rural and urban underserved communities. In gastroenterology, increased demand for care has been driven by a perfect storm of population growth, increased patient awareness of GI health, and rising incidence of digestive diseases.
Between 2019 and 2034, the U.S. population is expected to grow by 10.6%, while the population aged 65 and older expands by over 42%. Recent increases in the CRC screening–eligible population also have contributed to unprecedented demand for GI care. Furthermore, care delivery has become more complex and time-consuming with the evolution of personalized medicine and high prevalence of comorbid conditions. At the same time, we are faced with a dwindling supply of gastroenterology providers. In 2021, there were 15,678 practicing gastroenterologists in the U.S., over half of whom were 55 years or older. This translates to 1 gastroenterologist per 20,830 people captured in the U.S. Census.
Dr. Megan A. Adams
Addressing this striking supply-demand mismatch in GI requires a multi-pronged approach that addresses its complex drivers. First and foremost, we must expand the number of GI fellowship training slots to boost our pipeline. There are approximately 1,840 GI fellows currently in training, a third of whom enter the workforce each year. While the number of GI fellowship slots in the GI fellowship match has slowly increased over time (from 525 available slots across 199 programs in 2019 to 657 slots across 230 programs in 2023), this incremental growth is dwarfed by overall need. Continued advocacy for increased funding to support expansion of training slots is necessary to further move the needle – such lobbying recently led to the addition of 1,000 new Medicare-supported graduate medical education positions across specialties over a 5-year period starting in 2020, illustrating that change is possible. At the same time, we must address the factors that are causing gastroenterologists to leave the workforce prematurely through early retirement or part-time work by investing in innovative solutions to address burnout, reduce administrative burdens, enhance the efficiency of care delivery, and maintain financial viability. By investing in our physician workforce and its sustainability, we can ensure that our profession is better prepared to meet the needs of our growing and increasingly complex patient population now and in the future.
We hope you enjoy the November issue of GI & Hepatology News and have a wonderful Thanksgiving.
Megan A. Adams, MD, JD, MSc
Editor-in-Chief
