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December 15, 2025
3 min read
Key takeaways:
- Practicing family physicians in rural areas declined from 11,847 in 2017 to 10,544 in 2023.
- Some good news: Women family physicians represented 49.3% of all family physicians in 2023, up from 44% in 2017.
The number of practicing rural family physicians has declined in the United States in recent years, especially in certain regions of the country, according to a study published in Annals of Family Medicine.
Colleen T. Fogarty, MD, MSc, a professor and chair of the department of family medicine at the University of Rochester, said the decrease in rural physicians is not surprising — but the magnitude of the reduction is.
Data derived from: Fogarty CT, et al. Ann Fam Med. 2025;doi:10.1370/afm.240549.
“I had to look several times at the data and say, ‘Is this really what we think we have?’” she told Healio.
Healio recently reported that rural areas still have 15% fewer primary care providers per capita, although rural physicians often provide more comprehensive care vs. their urban peers.
In the current study, Fogarty and colleagues at the Robert Graham Center used the AMA Physician Masterfile for each year from 2017 to 2023 to determine the number of practicing family physicians aged 65 years or younger who were not in training or hospitalists.
The number of practicing family physicians ranged from 78,070 to 79,464 yearly across the U.S.
The researchers reported the number of practicing family physicians in rural areas significantly decreased from 11,847 in 2017 to 10,544 in 2023, for a nationwide net loss of 11%.
During the study period, the West lost the fewest practicing family physicians in rural areas on a percentage basis (3.2%) whereas the Northeast lost the most (15.3%).
Primary Care Collaborative President and CEO Ann Greiner, MCP, told Healio the decrease is “unfortunate and troubling.”
Greiner, who was not involved with the study, suggested the COVID-19 pandemic, hospital closures, administrative burden and underinvestment in primary care are among the contributors behind the findings.
“We talk a lot about the value of primary care, but we’re not adequately valuing it in terms of financial support,” she said.
Fogarty and colleagues pointed out there was an encouraging growth in practicing women family physicians. Specifically, they represented 49.3% of practicing family physicians in 2023, up from 44% in 2017 (P < .001).
“If you look at many residency programs, they’re dominated by women,” Fogarty told Healio. “So, I think that it’s reflecting that there are more women in the field, that there are more in rural areas.”
The researchers added that in rural areas, the percentage of practicing women family physicians significantly increased from 35.5% in 2017 to 41.8% in 2023.
“It’s not sufficient to meet the needs of the community, but it’s exciting that there is an increase,” Greiner said. “Having more women physicians in the community is a plus, because a lot of women like to go to a woman physician, particularly to deliver their children and to take care of the entire family.”
There was also a statistically significant increase in practicing family physicians in urban areas from 2017 to 2023, rising from 49.4% to 51.9%.
The researchers explained that the annual percentages lost may seem small but that “losing even 0.5% of the family physician workforce, as occurred in the West from 2021 to 2022, represents the loss of 11 of these clinicians.”
“Assuming these family physicians all work full-time (our analysis is not that granular), based on a panel size of 1,500 per full-time equivalent to 3,500 per full-time equivalent, this represents a potential loss of primary care access for 16,500 to 38,500 persons,” they wrote. “The implications of the loss go beyond numerical calculations and represent economic, social, and interpersonal losses for communities so affected.”
Ultimately, “I think it’s important each region recognize some of the differences [in these trends],” Fogarty said. “I think solutions need to be local and national.”
For more information:
Colleen T. Fogarty, MD, MSc, can be reached at primarycare@healio.com.
Ann Greiner, MCP, can be reached through Tod Didier, MA, communications director at PCC, at tdidier@thepcc.org.
Sources/Disclosures
Source:
Fogarty CT, et al. Ann Fam Med. 2025;doi:10.1370/afm.240549.
Reference:
Disclosures:
The University of Rochester Academic Leave Support Fund supported this study. The authors report no relevant financial disclosures. Healio could not confirm Greiner’s relevant financial disclosures at the time of publication.
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