A study tracking family physicians from 2017 to 2023 found a steady decline in rural clinicians and a nationwide net loss of 1,303 rural family physicians, or 11%. The researchers counted 11,847 rural family physicians in 2017 and 10,544 in 2023. Regionally, the West lost 67 rural family physicians (3.2%), while the Northeast lost 193 (15.3%).
Demographic shifts complicate the picture: people aged 25–44 are moving to rural areas at the highest rate in nearly a century, and since 2020 two-thirds of growth in this age group occurred in smaller cities and rural counties. Remote work and the attractions of country life are part of the movement, yet access to medical care has not kept pace with population changes.
- Adult primary care
- Emergency care
- Maternity care such as cesarean deliveries
- Pediatric care
Rural family physicians commonly provide a broad range of services, and that scope raises the risk of overwork and burnout, which can prompt relocation or early retirement. Fewer US medical students choose family medicine, and although international medical graduates have helped fill gaps, current visa uncertainty adds workforce concern. One improvement is a rising share of women: females were 44% of family physicians in 2017 and 49.3% in 2023, while in rural areas the share rose from 35.5% to 41.8% over the same period. Suggested responses include wider use of advanced practice providers, better compensation, targeted medical school recruitment and curricula for rural practice, and a rural residency training track being developed at the University of Rochester (one year of city rotations followed by two years in a rural continuity practice with local specialist rotations). The study identified outpatient family physicians using the AMA Physician Masterfile and appears in the Annals of Family Medicine.
Difficult words
- decline — a gradual decrease in number or amount
- rural — relating to the countryside, not to cities
- demographic — relating to population size and characteristics
- burnout — extreme physical and emotional exhaustion from work
- international medical graduates — doctors who completed medical education in another country
- visa uncertainty — unclear or unstable situation about work visas
- advanced practice providers — health professionals with advanced training who assist doctors
- continuity practice — ongoing care provided by the same clinician or team
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- What effects might the loss of rural family physicians have on local health services mentioned in the article (for example, emergency or maternity care)?
- Which of the suggested responses (advanced practice providers, better compensation, targeted recruitment, rural residency track) do you think would be most effective, and why?
- How could remote work and the movement of people aged 25–44 change healthcare needs in rural areas?
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