‘No easy solutions’: Labor shortage requires multipronged approach to recruit, retain GIs
This month’s Healio Gastroenterology Exclusive highlights a problem that we as physicians “feel” either directly or indirectly nearly every day — labor shortages.
This is not only a concern among gastroenterologists but also among advanced practice providers (APPs), certified registered nurse anesthetists (CRNAs) and endoscopy technicians.
The most recent estimate shows that we will be short by more than 1,300 gastroenterologists 12 years from now. Without an expansion of postgraduate training spots, it seems that this shortage may only worsen. By one estimate, more than half of GI providers in the U.S. are aged 55 years or older — impending retirements over the next 10 years will put pressure on the GI workforce.
At the same time, the demographic wave of “peak Medicare” and the reduction in colorectal cancer screening age to 45 years ensure that demand for our services will remain high.
Several leaders in the field are weighing in on the topic, including Amy S. Oxentenko, MD, FACP, AGAF, FACG, our current ACG president, who wonders if we should focus on ways to entice retiring GIs to stay in the workforce longer. I know that my own division at Mayo Clinic welcomes back retired GIs with open arms to work supplementally to assist with colonoscopies.
President Oxentenko also suggests that we examine the possibility of training within GI fellowships on the administration of propofol. In addition, she also reminds us that the shortage is not restricted to physicians — it also involves APPs, CRNAs, technicians and the like.
Samir A. Shah, MD, FACG, the 2021-’22 ACG president, notes that regional differences in salaries can impact recruitment to areas with historically lower compensation and that this is exacerbated by the higher student loan debt loads that our trainees “graduate” with. These factors can magnify the need to join “mega-groups” funded by private equity.
Shah also notes that retention of older physicians might be hampered if they are also asked to pitch in on the call schedule.
Finally, Daniel J. Pambianco, MD, FACG, FASGE, FAPCR, who served as ACG president from 2022 to 2023, shares the perspective of the private practitioner and notes that the pressures on small private practices have resulted in many joining private equity. Pambianco laments the trend of younger physicians accepting locum tenens positions, rather than joining practices with an aim to become partner.
There are no easy solutions here. It will take a multipronged effort to recruit the best to gastroenterology, to retain them and to perhaps incentivize the oldest of us to delay retirement. Division leaders and group heads will need to be flexible in order to promote retention. Please drop us a line with your suggestions.
- For more information:
- Edward V. Loftus Jr., MD, is the Maxine and Jack Zarrow Family Professor of Gastroenterology at the Mayo Clinic and chief medical editor of Healio Gastroenterology. He can be reached at loftus.edward@mayo.edu.
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