A new study from the University of Rochester Medical Center has found an alarming 11 percent decline over seven years in the number of family physicians who serve in rural communities nationwide.

The study, which examined the rural physician decline from 2017 to 2023,  was published in the November/December 2025 issue of the Annals of Family Medicine. 

While the shortage of family physicians nationwide has been a well-known problem for many years, the lead author of the study, Dr. Colleen T. Fogarty, chair of the Department of Family Medicine at the university, said she was astonished by the significant loss found through her study. “The speed at which this has happened is remarkable and terrible,” she said. 

According to this research, the problem varies regionally, with the northeastern US facing a more severe problem than the west. In addition, the loss of doctors tends to reduce the stability of the workforce that is still there. Wherever a rural shortage occurs, it can cause multiple issues for the remaining doctors whose workload may increase, along with their vulnerability to overwork and burnout, which can then lead to more rural departures.

There are a few other causes of the drop in the numbers of rural physicians, as explained in a November 24, University of Rochester article written by Barbara Ficarra. One is tied to a decline in the number of medical school students who choose a family medicine specialty.

Fogarty also cites “current uncertainty around visa requirements for residents and practicing physicians” as adding another concern about the medical workforce.

As a management and policy issue, state and local governments can help to improve the situation for rural doctors. “Healthy boundaries on work life are important,” said Fogarty. “We need to get male and female family physicians the support they need so they are not working around the clock.”

Beyond the need to ensure balance in working conditions, increases to compensation packages can help with both recruitment and retention. Medical schools also can be encouraged to focus on the recruitment of candidates from rural areas or to establish tracks for rural residency training. Fogarty, herself, is currently leading a program like this at the University of Rochester School of Medicine & Dentistry Department of Family Medicine.

In the program, which is based on a national model, residents first work for a year in a city (in order to experience larger patient loads and “high acuity care”) and then continue for the next two years of their residency in a rural community, while also working with local specialists. 

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