Gastroenterologist compensation 2023: Slight salary dip, still lucrative

Gastroenterologists are among the higher earning medical specialties due to their specialized skills, focus on procedures, and demand. Despite a modest drop in annual pay, the field remains lucrative, especially in regions lacking GI specialists. Yet, like their peers, they face burnout, debt, staff shortages, administrative overload, and pay gaps.

The state of gastroenterologist compensation

Nearly 16,000 gastroenterologists practice in the US,[1] specializing in digestive tract issues of the esophagus, stomach, intestines, and colon.

In general, gastroenterology salaries vary by subspecialty, with more years of training and board certification yielding higher salaries—thus, hepatologists earn more than general gastroenterologists.

Per MGMA (based on 2022 data), national median compensation for gastroenterologists came in at $556,675, with a year-over-year decrease of 0.84% from 2021-2022—while hepatologists saw an increase of 6.43% during the same period.[2]

Student loan burden

Many factors influence a gastroenterologist's compensation, including subspecialization, location, scarcity, and work environment, but the need to pay off student debt is especially significant.

Like cardiologists and hematologist-oncologists, gastroenterologists go through extensive schooling, which is why they are highly compensated for their role.

For specialists like gastroenterologists, that number is a lot higher—it's safe to say that these GI specialists amass a daunting amount of student loan debt.

After medical school, new doctors who aspire to specialize in gastroenterology start a 3-year internal medicine or pediatric residency program, which hardly pays enough to offset the debt they’ve accumulated. Upon graduation, physicians complete an additional 3-year gastroenterology fellowship, meaning they must complete approximately 10 years of training before commanding their terminal salaries. 

Highest and lowest paying states for GI specialists

Gastroenterologists' salaries range widely, from $1,186,871 in Nebraska to $323,049 in Indiana, per MGMA. This is likely due to differences in supply and demand for these specialists, and underscores how scarcity affects compensation across the nation. State taxes and cost of living also affect take-home pay.

Facility and ownership

Where a gastroenterologist decides to work, whether in an academic medical center or private practice, plays a major role in their salary. In general, gastroenterologists who work in single-specialty private practice earn the most, due to the potential for equity and volume-related bonuses, compared with those who work in multi-specialty practices. 

Gastroenterology salaries are also lower in hospital-owned or other majority-owned practices relative to physician-owned practices.

Employed and self-employed gastroenterologists earn similar salaries—$405,000 vs $408,000—according to Becker's.[4] However, this information does not include bonuses or benefits, so greater differences between the salaries of self-employed and hospital-employed GI doctors may exist. 

Experience and tenure

Gastroenterologists with more experience and seniority earn more money, as evidenced by a linear relationship between years of experience and salary, per MGMA data. 

Challenges

Like other specialties, burnout remains a major issue in the field of gastroenterology. Factors that contribute to burnout include:

• Long hours

• Inadequate staffing

• Administrative burdens 

• Workplace violence

• High stress and general unhappiness in the workplace 

• Lower reimbursement rates

• Racial, ethnic, and gender pay gaps

Lower insurance reimbursement rates and work environments that do not support work-life balance are known contributors to career dissatisfaction. Under-representation and a sustained racial, ethnic, and gender pay gap exacerbate dissatisfaction, ultimately underscoring the need for research that supports culturally competent care, equitable compensation, and better work-life balance. 

Inadequate representation of minorities

The field of gastroenterology continues to struggle with inadequate representation of racial and ethnic minorities. According to 2022 US census data, nearly one-third of all Americans identified as Black/African-American (13.6%) or Latino/Hispanic (19.1%).[5]

Women are also under-represented in gastroenterology, particularly in leadership roles, which can lead to lower salaries.[7]

Parting thoughts

Despite the high salaries that gastroenterologists command, they are vulnerable to salary decreases, high debt, and burnout.

Reducing student loan burden is one way to maximize income. Achieving seniority and gaining experience also translates to more pay. Other factors that impact compensation include the geographical region and size of the area in which one works.

Of note, under-representation based on gender or ethnicity impacts quality of healthcare, research, patient compliance to treatment, and compensation, but more research needs to be done to elucidate the magnitude of the impact of under-representation and pay gaps throughout the field.

Sources

1. Physician Specialty Data Report. AAMC, AMA Physician Masterfile. December 31, 2021.

2. Medical Group Management Association (MGMA) DataDive. 2021-2023 data. 

3. Budd K. 7 ways to reduce medical school debt. AAMCNews. October 14, 2020.

4. Newitt P. Do self-employed or employed gastroenterologists earn more? Becker’s GI & Endoscopy. May 14, 2021.

5. United States Census Bureau. Quick Facts. United States. 2022.

6. Cryer B, Rivera-Nieves J, Nuquay C. AGA promotes workforce diversity in academic gastroenterology: The FORWARD program. GI & Hepatology News. Oct 3, 2019

7. Jamorabo DS, Chen R, Gurm H, et al. Women remain underrepresented in leadership positions in academic gastroenterology throughout the United States. Ann Gastroenterol. 2021;34(3):316–322.