Gastroenterology is being squeezed from both sides. On one side, staffing shortages are worsening. By 2025, the U.S. will face a deficit of more than 1,600 full-time gastroenterologists. Half of today’s GIs are already over 55. Meanwhile, private practices are drowning in rising labor costs—92% saw year-over-year expense hikes in 2024 alone.
On the other side, the traditional business model is breaking down. Colonoscopy reimbursements have declined 40–50% in real dollar terms over the past 25 years. Practices tied to fee-for-service payments are watching margins erode while expenses climb. The old playbook will not carry us through.
Now zoom out. Globally, nearly $1 billion a day is being invested in AI. By 2030, that figure will climb to $3.3 billion a day. This is not a passing wave. Once digitization begins—whether liquid biopsy, AI-driven diagnostics, robotics, or self-driving cars—there is no turning back. Exponential technologies only move in one direction: forward.
For GI, this is both a crisis and an opportunity. Crisis, because those who cling to legacy models will fall into what I often call the valley of death—confusion, resistance, burnout, leadership paralysis. Opportunity, because AI offers the chance to leapfrog gastroenterology into a trillion-dollar future. Beyond polyp detection, AI can automate workflows, power decentralized virtual care, advance microbiome science, and create entirely new patient-facing platforms.
The key is to use AI in a practical way—as a co-strategist for your career, your practice, and your business. Not just tinkering with prompts, but building AI agents, training GPTs in your voice, and creating strategic assets that position you as a leader in this new landscape.
That’s why I created Strategic AI Mastery Live. On Friday, Oct 24th, 12noon MT to 6.30pm MT in Phoenix (before ACG), we’re gathering physician leaders and innovators for an exclusive hands-on session. Together, we’ll map out how to implement AI now—without waiting for permission—and how to guide our field through this transformation.