Rural Gastroenterologist Supply Within the United States: A Workforce Review from 2014 to 2025
Thomas B Cwalina1,2,3, Sanya Goswami4, Justin T Kupec4
1Division of General Internal Medicine, Department of Medicine, West Virginia University, Morgantown, WV, USA. thomas.cwalina@hsc.wvu.edu.
Digestive Diseases and Sciences
|March 17, 2026
Summary
The proportion of rural gastroenterologists remained stable, but later-career physicians and those in the Midwest were more likely to practice rurally. Understanding these factors is key to ensuring continued rural access to gastroenterology care.
Area of Science:
- Gastroenterology Workforce Analysis
- Rural Health Disparities
- Physician Practice Patterns
Background:
- Rural populations face significant healthcare access challenges and higher mortality rates.
- Prior research indicates disparities in healthcare access and outcomes for rural residents.
- Gastroenterology services are crucial for managing digestive diseases prevalent in diverse populations.
Purpose of the Study:
- To analyze trends in the proportion of gastroenterologists practicing in rural areas from 2014 to 2025.
- To identify physician and practice characteristics associated with rural gastroenterologist practice.
- To inform strategies for maintaining adequate gastroenterology workforce distribution in rural settings.
Main Methods:
- Utilized the Physician Compare Database from 2014-2025, focusing on Gastroenterology specialists.
- Calculated annual percentages of rural-practicing gastroenterologists.
- Employed multivariable logistic regression to identify factors associated with rural practice.
Main Results:
- The percentage of rural gastroenterologists remained stable (7.3% in 2014 to 7.7% in 2025).
- Factors decreasing rural practice odds included Hepatology subspecialty, female sex, academic affiliation, and small/large practice sizes.
- Factors increasing rural practice odds included later career stage (≥25 years) and practice location in the Midwest.
Conclusions:
- Later career stage is a significant predictor of rural gastroenterologist practice.
- Monitoring workforce trends is essential to ensure continuity of care as experienced physicians retire.
- Addressing barriers for women in gastroenterology is crucial for sustaining the rural workforce.
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