Young adults in the U.S. have been moving to rural communities with less than 20,000 residents at the highest rate in almost 100 years.
There's just one problem. Once they move to the country they might find they have difficulty finding a healthcare provider.
A team, led by researchers at the University of Rochester, recently found that the proportion of family physicians practicing in rural areas has decreased by about 11 percent nationwide between 2017 and 2023.The Northeast lost about 15 percent of its rural family physicians, while the West lost about three percent.
The study's lead author, Colleen Fogarty, called loss of rural practitioners alarming and the speed with which it has happened, remarkable. Fewer medical school graduates in the U.S. are choosing family medicine in general, she told TheDoctor. At the same time, the percentage of students from rural areas enrolling in medical school is lower than the percentage of people living in rural areas.
The physicians most likely to choose to practice in rural area are those who grew up there. When family physicians are deciding where to practice, they tend to consider where they are from, where their partner is from, and if the area has work opportunities and good schools.
One bit of good news is that even as the number of family physicians practicing in rural areas has dropped, the percentage of women going into family medicine has risen to become almost equal to the percentage of men. In 2017, women represented 44 percent of family physicians in the U.S., and by 2023 they represented 49 percent. In rural areas, the percent family physicians who were women grew from 36 percent to almost 42 percent in 2023.
This increase in women, however, presents a challenge to recruiting family physicians to practice in rural areas. Since many female physicians are also mothers, the rural communities they work in must offer working mothers the resources they need — like childcare — to allow healthy boundaries between work and family life. Said Fogarty, “We need to get family physicians the support they need so they are not working around the clock, then diagnosing a medical issue in the checkout line at the grocery store.”Family physicians may have anywhere from 1,500 to 3,000 patients in their practice. They provide adult and pediatric care and may provide emergency and maternity care. Burnout is not uncommon.
Family physicians may have anywhere from 1,500 to 3,000 patients in their practice. They provide adult and pediatric care and may provide emergency and maternity care. Burnout is not uncommon.
If a rural physician leaves to practice elsewhere, it can place a significant burden on already overworked colleagues or force residents to travel long distances to get care. Advanced practice providers, such as nurse practitioners, can help relieve rural physicians' workload. Fogarty, chair of the family medicine department at the University of Rochester, said the department has a grant to train nurse practitioners in a rural setting.
A rural family medicine training program at the University of Rochester is also in the works. Residents in family medicine will spend the first year of the three-year program in a city with large hospitals with high patient volume. Then they will spend the second and third years in a rural community, seeing patients and getting to know them over time while learning how the practice there works. “It's an initiative that we hope will make a difference,” Fogarty said.
The study is published in the Annals of Family Medicine.
