Gastroenterology in 2025 was not shaped by a single breakthrough or defining moment. It was shaped by pressure—rising demand, constrained capacity, shifting economics, and a growing gap between how the system was designed to work and how it actually functions in practice.
Across screening, endoscopy, ownership models, site of care, innovation, and workforce sustainability, the specialty spent the year reassessing what still scales, what no longer does, and which assumptions quietly broke along the way.
The clearest signal of that reassessment comes from the articles GI leaders returned to most often.
The screening model began to fracture under its own success
Colorectal cancer screening dominated attention in 2025, but not because of incremental improvements in colonoscopy technique. What GI leaders gravitated toward instead were stories about scale—specifically, what happens when demand outpaces the system built to serve it.
Most-read articles reflecting this pressure:
- Colonoscopy Capacity Crisis: Time to Embrace Noninvasive Tests?
- Evaluating benefit-to-burden ratios of colorectal cancer screening strategies
- Insurers are mailing people unsolicited Cologuard tests, and it’s a terrible idea
That’s why blood-based and liquid biopsy tests repeatedly surfaced among the most-read items. Freenome’s move toward the public markets via a SPAC transaction, with approximately $330 million in gross proceeds, mattered less for its financial engineering and more for what it signaled: noninvasive screening was no longer experimental capital—it was institutional capital.
Most-read liquid biopsy and blood-based screening stories:
- Liquid Biopsy Firm Freenome Finds a Way to the Public Markets via $330M SPAC Merger
- Shield CRC Blood Test Demonstrates Adherence of 95% in New Study of 20,000 Patients
- Goodbye colonoscopy? Simple stool test detects 90% of colorectal cancers
That signal became impossible to ignore when Abbott announced its acquisition of Exact Sciences in a deal valued at roughly $23 billion—one of the largest bets ever placed on cancer screening and precision diagnostics. This was not a niche acquisition. It was a declaration that screening itself had become a platform business.
Major screening announcements GI leaders closely followed:
- Abbott bets on cancer screening with $23 billion Exact Sciences deal
- Exact Sciences Launches the Cologuard™ Plus Test
- Exact Sciences Announces Medicare Coverage for Oncodetect™ MRD Test
Within that ecosystem, Exact Sciences’ exclusive licensing agreement with Freenome for blood-based colorectal cancer screening tests further clarified the direction of travel. Incumbents weren’t hedging against disruption. They were absorbing it.
Most-read partnership and licensing coverage:
- Exact Sciences Announces Exclusive License with Freenome for Blood-Based CRC Screening Tests
- Exact Sciences Announces Expiration of HSR Waiting Period for Freenome License
The subtext of these reads is important: GI leaders were not asking whether colonoscopy would disappear. They were asking whether it could continue to serve as the sole bottleneck in a system facing rising incidence, earlier screening ages, and mounting capacity pressure.
Endoscopy was repositioned, not replaced
If noninvasive screening expanded the top of the funnel, endoscopy in 2025 was being reshaped to defend its role further downstream. Not as a volume gateway—but as a higher-value intervention layer.
What resonated most were not incremental scope upgrades, but signals that endoscopy itself was becoming more capable, more complex, and more central to advanced GI intervention. Robotics, in particular, marked an inflection point. EndoQuest’s report of the world’s first fully robotic procedure performed by a gastroenterologist using an endoluminal surgical system was not just a technical milestone—it suggested that increasingly sophisticated procedures could remain within GI-led workflows rather than migrating outward to surgery.
Most-read endoscopy and procedural evolution stories:
- World’s First Fully Robotic Procedure by a Gastroenterologist
- Virtual biopsy: tiny robot wobbles its way through the gut
Taken together, these reads suggest that GI leaders were trying to understand how endoscopy evolves after it stops being the default screening gateway and becomes a differentiated, high-value intervention layer in a more diversified screening ecosystem.
Artificial intelligence became the operating layer of GI
Artificial intelligence did not rise to prominence in gastroenterology in 2025 because of novelty. It rose because the system became constrained. As staffing pressures mounted, clinical complexity increased, and capacity tightened, AI shifted from optional enhancement to potential stabilizer.
What GI leaders gravitated toward were not grand claims of automation, but narrowly defined use cases—decision support for surveillance intervals, guideline adherence, diagnostic reasoning, and cognitive load reduction. Studies examining ChatGPT-assisted colonoscopy surveillance, GI-specific foundation models, and applied AI governance resonated because they addressed real bottlenecks rather than speculative futures.
Importantly, professional societies adopted a restrained tone, stopping short of blanket endorsements and emphasizing validation, accountability, and clinical oversight. That caution mattered. It signaled a specialty intent on integrating intelligence carefully, not outsourcing judgment.
In this framing, AI became the operating layer of GI—supporting decisions, absorbing variability, and extending capacity without replacing clinicians.
Most-read artificial intelligence coverage:
- Best of Artificial Intelligence in GI Endoscopy– Miller School of Medicine Gastroenterologists Study Use of ChatGPT for Surveillance Colonoscopy Intervals
- GutGPT: A multidimensional knowledge-enhanced large language model for gastrointestinal medicine
- AI in Colonoscopy: Saving Lives or Stirring Controversy?
- The Role of Industry to Grow Clinical Artificial Intelligence Applications in Gastroenterology and Endoscopy
- Olympus launches Olysense AI-powered colorectal polyp detection platform
Ownership stopped being abstract once prices, turnover, and leverage became visible
Private equity has been part of gastroenterology for years. What changed in 2025 was not its presence, but the availability of data that made its effects harder to dismiss.
That’s why articles examining PE’s impact on colonoscopy pricing, physician turnover, and quality metrics consistently ranked among the most-read. Once studies showed that prices rose significantly following PE acquisition while quality metrics remained flat, the conversation shifted from theory to consequence.
Most-read private equity impact studies:
- Colonoscopy Costs Rise When Private Equity Acquires GI Practices, but Quality Does Not
- Private equity groups significantly raise colonoscopy prices
- Increases in Physician Professional Fees in Private Equity–Owned GI Practices
This is also why content on physician autonomy, independence, and alternative ownership models surged. The profession was no longer debating whether consolidation would continue. It was grappling with whether physicians would retain meaningful agency inside consolidated systems—or whether autonomy would quietly erode through compensation structures, productivity expectations, and governance changes.
Most-read autonomy and consolidation perspectives:
- Physicians taking back medicine: The rising toll of private equity in health care
- Another View on Private Equity in GI
- How to protect physician autonomy as GI consolidates
- Private-equity-backed U.S. Digestive Health, the Philly region’s largest private GI group, has been sold to UnitedHealth unit
2025 was the year GI began auditing consolidation not as an event, but as an operating condition.
Physician pay stopped feeling reassuring once pressure became personal
Gastroenterology remains one of the highest-paid specialties in medicine. But in 2025, that statistic stopped functioning as reassurance.
What GI leaders gravitated toward were not celebratory compensation rankings, but analyses that unpacked how pay was actually changing beneath the surface—after inflation, after rising overhead, and after productivity expectations were recalibrated. Articles examining relative declines, shrinking margins, and widening gaps between effort and compensation consistently ranked among the most-read.
The attention wasn’t driven by surprise. It was driven by recognition. Many gastroenterologists felt that while headline compensation figures remained strong, the experience of practice felt increasingly compressed—more volume, more complexity, more administrative friction, without a corresponding sense of control or reward.
Most-read compensation and pay context:
- GI Ranks Just Out of Top 10 for MD Pay
- Why gastroenterologists feel underpaid—even as a top-paid specialty
- 10 numbers on plummeting GI pay
- Medscape Gastroenterologist Compensation Report 2025
Taken together, these reads suggest that pay was no longer being evaluated in isolation. It was being weighed against autonomy, sustainability, and long-term professional satisfaction.
Site of care became an economic survival question
The attention paid to office-based endoscopy, ambulatory surgery centers, and anesthesia models reflects a deeper recalibration. GI leaders were no longer optimizing for efficiency; they were optimizing for resilience.
Articles interpreting proposed Medicare payment boosts for office-based endoscopy, dissecting ASC cost advantages, and examining the rapid rise of monitored anesthesia care (MAC) resonated because they addressed a central fear: that traditional delivery models may no longer sustain margins, access, and workforce stability at the same time.
Most-read site-of-care and anesthesia coverage:
- Office-Based Endoscopy Model Offers Way Forward for Outpatient GI
- Interpreting proposed 2026 physician payment boost for office-based endoscopy
- ASCs cut GI costs in half: Study
- The rise of MAC in GI procedures
Innovation migrated from the margins into the operating core
Another underappreciated signal in the 2025 reading list is how often GI leaders engaged with stories about incubators, research networks, and platform partnerships.
The American Gastroenterological Association’s collaboration with MATTER to launch a GI-focused incubator was widely read not because it was novel, but because it formalized something that had been fragmented: a structured pathway for GI innovation.
At the same time, Iterative Health’s partnership with One GI reframed clinical research from an academic adjunct into a practice-embedded growth strategy. Research was no longer optional upside—it was core infrastructure.
Most-read innovation infrastructure stories:
GLP-1s forced workflow questions GI could not defer
GLP-1 receptor agonists entered the GI conversation in 2025 not as a pharmaceutical trend, but as a workflow disruptor.
As adoption accelerated, articles examining their downstream impact—particularly on colonoscopy preparation quality, scheduling reliability, and procedural efficiency—rose quickly in readership. The interest reflected a practical concern: medications prescribed outside the GI clinic were now reshaping what happened inside it.
At the same time, obesity management began to intersect more directly with gastroenterology, raising questions about how GI practices would integrate—or deliberately not integrate—these patients into already constrained care pathways.
Most-read GLP-1 and obesity-related coverage:
- How soaring GLP-1 use is reshaping GI
- GLP-1 receptor agonists negatively impact colonoscopy bowel preparation
These reads point to a specialty adapting not to a single drug class, but to a broader shift in how chronic metabolic disease enters GI workflows.
Burnout emerged as a system constraint, not a personal failure
Perhaps the most telling theme of all was the sustained attention to burnout, turnover costs, and physician dissatisfaction—even in a specialty that remains among the highest paid.
By 2025, burnout content was no longer framed as wellness discourse. It was framed as capacity risk. Articles quantifying the economic cost of gastroenterologist turnover and documenting widespread dissatisfaction resonated because they pointed to a fragile human substrate beneath an increasingly complex system.
Most-read workforce and burnout coverage:
- Striving for Balance: Medscape Gastroenterologist Mental Health & Well-Being Report 2025
- The high cost of gastroenterologist turnover
- Why gastroenterologists feel underpaid—even as a top-paid specialty
GI leaders weren’t reading these pieces to empathize. They were reading them to understand how long the system could continue demanding more without replacing what it consumes.
Policy volatility became an operating assumption
Reimbursement pressure has long been part of gastroenterology. What changed in 2025 was the tone of engagement.
Rather than reacting to isolated policy updates, GI leaders increasingly consumed content that treated regulatory and payer volatility as a persistent condition. Articles analyzing proposed Medicare fee schedule changes, reimbursement cuts, and payer-driven utilization controls drew sustained attention because they addressed planning uncertainty—not just financial impact.
Most-read policy and reimbursement coverage:
- Significant impacts to GI in Medicare Physician Fee Schedule Proposed Rule
- 5 policy changes that could bite GI pay
- AGA joins push against UnitedHealthcare’s CRNA reimbursement cut
The shift here was subtle but important. Policy was no longer viewed as episodic disruption. It was being absorbed into long-term strategic thinking about site of care, staffing, and service mix.