Rural Gastroenterologist Supply Within the United States: A Workforce Review from 2014 to 2025

A significant portion of the US population lives in rural areas, and prior literature has highlighted rural disparities in access and mortality.

We sought to (1) determine trends in the proportion of gastroenterologists practicing in rural areas and (2) identify characteristics associated with rural practice.

We selected all physicians reporting a specialty of Gastroenterology from annual versions of the Physician Compare Database from 2014 to 2025. We calculated the number and percentage of gastroenterologists practicing in a rural area annually. Lastly, we constructed a multivariable logistic regression model to determine physician/practice factors associated with rural practice.

The percentage of rural gastroenterologists remained stable over the time period (2014: 7.3% vs. 2025: 7.7%; p = 0.84). Hepatology (aOR 0.62; 95% CI 0.41-0.93), female sex (aOR 0.64; 95% CI 0.54-0.76), academic affiliation (aOR 0.50; 95% CI 0.42-0.60), small practice size (1-9; aOR 0.57; 95% CI 0.45-0.71), and large practice size (≥ 100; aOR 0.82; 95% CI 0.71-0.96) were associated with decreased odds of rural practice. Conversely, later career (≥ 25 years of practice; aOR 1.53; 95% CI 1.29-1.82) and the Midwest (aOR 1.69; 95% CI 1.45-1.97) were associated with increased odds of rural practice.

Given late career stage was found to be predictive of rural practice, monitoring of trends is important to ensure patients treated by retiring gastroenterologists are covered by other qualified gastroenterologists. Furthermore, with an increasing proportion of women in gastroenterology, understanding and addressing their unique barriers to rural practice will help maintain the rural workforce.