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Gastroenterologists' average annual income rose from $501,000 in 2022 to $515,000 in 2023 — a bump of 2.8% and just slightly lower than the 3% average gain for US physicians as a whole, according to the recently released Medscape Gastroenterologist Compensation Report.

Their earnings last year put gastroenterologists in the top tier among the 29 specialties in the survey of 7000 physicians. The other leading earners remained orthopedists ($558,000), plastic surgeons ($536,000), cardiologists ($525,000), and urologists ($515,000).

Among gastroenterologists who see patients, 34% reported increased income from those visits over the prior year, while 20% reported a decline. A total of 67% said compensation from patient care was flat or declining, which could reflect financial pressures on private payers and recent cuts in Medicare reimbursement rates.

About 65% of gastroenterologists surveyed felt that US physicians generally are underpaid. But when asked about their own compensation, gastroenterologists had more temperate views; 56% of them said their pay did not match up with their job expectations.

Despite consistently being among the top tier of earners, gastroenterologists ranked low (vs other specialists) on the pay-happiness list, with just 44% happy with their pay.

Specialists who are most happy with their pay work in public health and preventive medicine, dermatology, psychiatry, oncology, and neurology (60% or more), while those who are the least happy with their income work in infectious disease, diabetes and endocrinology, ophthalmology, urology, and plastic surgery (39% or lower).

One third of gastroenterologists said they supplement their income with extra work, about the same share as in the prior report (32%) but somewhat lower than doctors overall.

While side gigs can further a passion project, most physicians surveyed pointed instead to the need or desire for more money as the reason they take on extra work.

Competition, Rewards, and Burdens

Competition from other practices doesn't appear to be a big concern for most gastroenterologists. Nearly two thirds (61%) said competing practices don't affect their income at all, much like physicians overall (64%), while 30% of gastroenterologists felt their income was somewhat affected and 9% said it was considerably affected by competition.

Nearly 7 in 10 gastroenterologists (69%) said they are eligible for an incentive bonus, a larger share than among physicians overall (58%).

The majority of practicing gastroenterologists said potential pay was not a factor (41%) or only a minor factor (37%) in selecting their specialty, while 20% said it was a leading factor and 3% said it was the main factor.

However, when posed a similar question to residents for a 2023 report, half of them said potential earnings were extremely or very influential in choosing their specialty, which indicates that recollections about the role of money can shift with the passage of time in a medical career.

What do gastroenterologists find most rewarding about their job?

Similar to prior reports, being good at what they do/finding answers and diagnoses tops the list (33%), followed by relationships with/gratitude from patients (32%), making the world a better place/helping others (22%), and making good money at a job they like (5%). Small percentages cited teaching (4%) and pride in being a doctor (2%).

Consistent with prior reports, the most challenging part of gastroenterology is having to follow so many rules and regulations (23%). Other challenges include dealing with Medicare and insurers/trouble getting fair reimbursement (20%), working long hours (13%), dealing with difficult patients (12%), working with electronic health records systems (11%), and worrying about being sued (10%).