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We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Key takeaways: Rural areas in the U.S. face GI care deserts, despite what appears to be an adequate workforce. Anesthesia support and APP recruitment, training and retention are needed to strengthen GI care. The maldistribution of physicians, growing demand for anesthesia support and challenges related to integration of advanced practice providers are critical issues facing the field of gastroenterology, according to a report from ACG. The organization\u2019s Workforce of the Future Task Force, convened by past ACG President Amy S. Oxentenko, MD, MACP, MACG, AGAF, outlined strategies to address these challenges and strengthen the gastroenterology workforce.
Data derived from Oxentenko AS, et al. Am J Gastroenterol. 2026;doi:10.14309\/ajg.0000000000004106.
Oxentenko, vice dean of practice and chief patient experience officer for all Mayo Clinic sites, emphasized that the three areas covered by the report are \u201cintimately linked.\u201d Amy S. Oxentenko \u201cGastroenterologists will have increasingly more procedures to do for screening, surveillance and diagnostic purposes,\u201d she told Healio. \u201cIn order to perform those procedures, we need the availability of anesthetizing resources at the ready. \u201cAs gastroenterologists spend more time in endoscopy, it will lead to increased dependency on our trusted advanced practice provider colleagues to manage the outpatient established practice, with disease complexity on the rise,\u201d Oxentenko added. Healio spoke with Oxentenko about these challenges, actions required, and how healthcare systems and practitioners can help. Healio: What are the most important \u2018take home\u2019 messages from this report for gastroenterologists? Oxentenko: While there are many concerns about a shortage of gastroenterologists across the country, the real issue is a maldistribution of gastroenterologists, with many urban areas adequately populated with GI specialists, yet GI healthcare deserts in rural communities. This highlights that simply training more gastroenterologists will not solve this issue, as that has been tried and does not seem to have the sticking power for the areas most in need. We need to find solutions to bring care to rural areas and other pockets where there is a paucity of GI care through various hub-and-spoke models, connecting local care teams to larger centers that can help guide care when needed. We also need a solution to bring endoscopic resources to those areas when needed, rather than expecting patients to travel far distances when they have a positive stool- or blood-based colorectal cancer screening test. The anesthetizing concerns will not be solved by asking anesthesia to train more anesthesiologists or certified registered nurse anesthetists, which both have their own critical shortages. Due to patient-, procedure- and practice-related factors, the need and demand for propofol level of sedation has increased, so the dependency on anesthesia has grown in parallel. However, that demand outstrips the supply. At the same time, we seem to be exposing our GI fellow graduates to fewer opportunities to be comfortable and competent in administering conscious sedation, a current GI training requirement. This leads to an increased dependency on anesthesia and may have even more impact on rural areas to recruit GI clinicians if they need to be well-versed in self-administration of conscious sedation for that practice. We need to either reinforce our current training requirements and ensure we maintain a skill set of our own in conscious sedation or look for ways to expand training in propofol-administered sedation by endoscopy care teams. We need to lessen our dependence on a specialty that has its own workforce challenges, otherwise we will impede our progress to offer GI care to more people. Advanced practice providers (APPs) are often the ones caring for complex, established patients in the practice, often with little GI-specific training and with variable levels of oversight and support. That needs to change. APPs are a growing and incredibly valuable part of our GI care teams, and we need to work to recruit, train and retain them in ways that support their professional growth. Creating new educational programming to ensure they have the curricula needed to establish a strong foundation in GI care, developing mentoring programs to ensure clinical and professional support, and ensuring career growth opportunities are all essential. Healio: The report identifies geographic distribution as a major workforce challenge, and concludes mitigating the issue will require federal and state action. Which policies and incentives have the strongest promise for addressing this issue, and how can clinicians advocate for them? Oxentenko: Support national legislation that could increase training capacity and retention in underserved areas. People may be more likely to work in areas they train or grow up in, so working to push those, including SPARC, the Specialty Providers Advancing Rural Care Act. We also need to push for sustained CMS and commercial support of telehealth coverage, especially for rural areas. By reducing the burden of carrying multiple state licenses to provide care remotely, clinicians may be more likely to engage in telehealth across state lines where it is most needed. Expanding loan repayment programs for GI clinicians working in underserved areas will be important and advocating for expanded J-1 waiver eligibility are other means that should be pursued. Healio: What impact could anesthesia workforce constraints have on colorectal cancer screening and surveillance capacity over the next decade? Oxentenko: With the expansion of stool- and blood-based colorectal cancer screening tests, the goal is to screen more patients, including those in rural or underserved areas. However, that means there will be positive tests that require timely colonoscopy follow-up. If we do not have GI endoscopic care readily available or the appropriate level of sedation needed for a given patient, that could delay endoscopic follow-up and lead to more advanced-stage findings when the colonoscopy is ultimately completed. 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