As Health Needs in Rural Communities Grow, Access to Physicians Declines

December 05, 2025

Despite an ever-increasing demand, fewer family doctors are practicing in U.S. rural areas, according to research published in The Annals of Family Medicine.

In the northeast, the number of rural physicians has declined 15.3 percent from 2017–2023 (from 1,259 to 1,066). This amount far exceeds the 11 percent nationwide decline in rural family physicians over the same period.

In recognition of the problem, efforts have been made to develop the rural workforce; however, the study shows the continuing loss of physicians has outpaced gains and the trend contributes to existing disparities rural communities’ experience.

Here are a few key takeaways:

Customized solutions:  Addressing the rural physician shortage will require a varied approach tailored to each region. Experts recommend medical pathway programs as one option.

Addressing disparities:  Family physicians have proven to be the key to reducing health disparities in rural communities. They provide needed preventative care and reduce mortality, the report said.

Access to care challenges:  Maternity and emergency care often falls to family physicians in rural communities, where more family physicians care for children than pediatricians.

Help wanted:  More female doctors are gravitating toward rural communities, where there have historically been a greater number of male doctors. The proportion of female rural family physicians increased from 35.5 percent in 2017 to 41.8 percent in 2023. The study suggests communities pursue ways to recruit and retain women, including recruiting candidates with rural backgrounds, developing rural family medicine residencies, and increasing remuneration.

Bridging the gap:  Nurse practitioners and physician assistants could help in providing essential care in rural communities; however, not all states allow these positions full practice authority and their scope of practice may not include critical services such as maternity, emergency, and other services. In Pennsylvania, nurse practitioners require a collaborative agreement with a licensed physician.

Read the report online. 

Growing Pennsylvania’s health care workforce is among HAP’s top priorities. Learn more about HAP’s workforce advocacy online.