• Posted November 26, 2025

Family Doctor Shortages in Rural America Are Getting Worse

The shortage of primary care physicians in rural America was already bad in 2017.

Now, new data finds the situation has only gotten worse in the years since.

Between 2017 and 2023, the number of family physicians dropped by another 11% in the rural U.S., according to researchers at the University of Rochester in New York.

“The data reflect what we already experience and know about physician shortages, but the year-over-year numbers for rural areas were astonishing to me. The speed at which this has happened is remarkable and terrible,” said study lead author Dr. Colleen Fogarty. She's a professor and chair of the Department of Family Medicine at the university.

In terms of U.S. demographics, the timing couldn't be worse: Opportunities for remote work mean that more young Americans are moving from cities to more affordable rural areas than ever before.

Unfortunately, they may find it tough to find a family doctor for themselves and their children after they move.

According to Fogarty's team, the average family physician cares for between 1,500 and 3,500 patients. So when even one doctor leaves a rural community, the result can be devastating.

The study, published recently in the Annals of Family Medicine, found that shortages were worse in some U.S. areas compared to others. The Northeast has been hardest hit, losing 193 primary care physicians (15.3%) between 2017 and 2023. That's compared to the West, which lost 67 such doctors (3.2%).

Overall, rural America's reserve of family physicians fell from 11,847 in 2017 to 10,544 by 2023, a decline of 11%, the research team reported.

What's driving the trend?

“Fewer U.S. medical students are choosing family medicine as a specialty, and medical students from rural areas remain underrepresented compared with their non-rural peers," Fogarty explained in a university news release.

Because of their heavy caseloads, rural physicians are also more prone to burnout. In rural communities, especially, they often find themselves responsible for emergency care and maternity care, including cesarean deliveries, as well as pediatric care, the team noted.

The current political climate around immigration isn't helping, Fogarty noted.

"Over the years, international students choosing family medicine have offset the shortage, as they have become valuable and integral members of their rural communities," she said. "But current uncertainty around visa requirements for residents and practicing physicians adds another layer of concern about the family medicine workforce."

The one silver lining from the new study: A rise in the percentage of women working as family physicians in rural areas. In 2017, 35.5% of these doctors were women; by 2023 that had risen to 41.8%.

But Fogarty worries overworked female doctors may face special burdens.

“Does the rural community have what working mothers need? Healthy boundaries on work life are important; we need to get male and female family physicians the support they need so they are not working around the clock and diagnosing a medical issue while they’re at the cash register at the grocery store,” she said.

What's the solution to easing these shortages? According to Fogarty's team, improved compensation will be key to recruiting and keeping rural doctors.

In the meantime, Fogarty is leading a team that is creating a "rural residency training track" at her university's medical school. As part of the program, training physicians are first sent to busy city hospitals but spend the last two years of their training in a rural setting.

“It’s an important initiative that we hope will make a difference,” said Fogarty. 

More information

There's more on the U.S. rural doctor shortage at the Commonwealth Fund.

SOURCE: University of Rochester, news release, Nov. 24, 2025