A Workforce at a Crossroads: Rural Gastroenterology Supply in the United States

Despite the significant gastrointestinal (GI) disease burden in rural America, prior research has highlighted persistent disparities in access to care for GI diseases for patients in non-metropolitan regions. In the study by Cwalina et al. [5], the authors analyze gastroenterologist data from the Physician Compare Database collected from 2014 to 2025, finding that while the absolute number of rural gastroenterologists increased, the proportion practicing rurally remained stable at approximately 7.7%. Late career stage and the Midwest region were associated with increased odds of rural practice, whereas female sex, hepatology subspecialization, academic affiliation, and both small and large practice sizes were associated with decreased odds. These findings reveal a workforce that has grown numerically, but has not kept sufficient pace with the access needs of rural patients, thereby highlighting two intersecting vulnerabilities: an aging rural GI workforce and a rising proportion of women in gastroenterology who face structural barriers to rural practice. This commentary contextualizes these findings, calling for proactive, patient-centered strategies to sustain rural gastroenterology care.