The Crisis of Rural Health Care
Rural Hospitals Are Disappearing: As a family medicine-trained doctor working in a rural emergency room, I know the toll that rural health care closures take—physically, emotionally, and on entire communities. I drive 90 minutes to work every day because if I don’t, no one will. The nearest hospital in our county is gone, the OB/GYN unit shut down long ago, and specialists are few and far between. And the result? Sicker patients, late diagnoses, chronic conditions unmanaged, and too many preventable deaths.
The crisis in rural health care is not just theoretical. Since 2010, over 140 rural hospitals have closed, with more than 600 at risk. The cost of running these hospitals has risen sharply, but reimbursement rates from government and private insurers remain inadequate. Yet, the demand for services continues to grow. Over 75% of rural counties in the United States are designated health professional shortage areas.
The Myth of Volunteerism
The policy solutions proposed to address this crisis are inadequate and misguided. Some think tanks are suggesting replacing trained, credentialed physicians with volunteers. Yes, you read that right—volunteers. The Project 2025 proposal, which advocates for such an approach, is unrealistic and dangerous. Volunteers cannot replace the skills, training, and expertise that are essential for saving lives in rural ERs and maternity units.
If we continue down this path, the lives of rural Americans—many of whom voted for the very leaders now cutting their care—will be in jeopardy.
The Fall of Maternal Care
Rural maternal health care is in dire straits. More than half of U.S. counties no longer have an OB/GYN, and between 2011 and 2021, more than 200 rural hospitals closed their labor and delivery units. Pregnant women in rural America are now forced to travel hours for care, or sometimes, they go without it altogether. Rural Hospitals Are Disappearing
For Black women, the situation is even more dire. They are three times more likely to die from pregnancy-related causes than white women. This is not just a public health failure—it is an ethical crisis. As someone who has lived through high-risk pregnancies myself, I understand the importance of timely, informed care. But most women in rural areas don’t have the medical training I did to advocate for themselves.
The Human Impact
In my ER, I see the human toll of this crisis every day. Women hemorrhage after childbirth, having received no prenatal care. Babies are born in cars because the nearest hospital is hours away. I see untreated mental health crises, hypertension left unmanaged, and missed cancer diagnoses—all because care is either unavailable, too far, or too late.
This is more than just clinical work. It’s a human rights issue. When people are forced to forgo basic care, they suffer in ways that are preventable. The lack of resources in rural areas isn’t just an inconvenience—it’s a death sentence for too many people who could have been saved if only they had access to timely, appropriate care.
The Policy Failure
And yet, we continue to hear about the defunding of rural health care. Programs like the Teaching Health Center GME program, which trains primary care doctors in underserved areas, are at risk of losing funding. Meanwhile, proposals like volunteerism are being entertained as solutions to replace doctors, nurses, and essential health professionals. Rural Hospitals Are Disappearing
This approach is not only misguided; it is immoral. You cannot staff an emergency room with goodwill or deliver babies with prayers alone. Rural Americans deserve better, and that better must include:
- Loan repayment programs to incentivize doctors to practice in rural areas.
- Expanded residency slots in rural hospitals.
- Fair reimbursement for rural providers who are underpaid and overworked.
- Better pay for nurses and medical technicians, who are the backbone of rural health care.
We need policies that don’t just promise hope but deliver real, tangible change.
By Pamela Buchanan, MD
Physician, Advocate, and Thought Leader
The Path Forward: A Call to Action
At Stanford Physician Advocate, we believe that rural health care deserves real investment—investment in the people, the resources, and the infrastructure that can keep these communities alive. The physicians and health care providers in rural America are the backbone of the health system, often without recognition or adequate support.
We need your help to demand better for rural patients. Speak up for rural communities. Advocate for legislation that treats rural lives as valuable as urban lives. Support loan forgiveness programs, push for residency slots in underserved areas, and work to ensure that policies are designed to help—not hurt—rural Americans.
Read More from StanfordPhysicianAdvocate.org
- How Vaccine Hesitancy is Reviving Deadly Childhood Diseases
- How a Coaching Culture Reduces Physician Burnout
- Hidden Crisis in Health Care: How Corporate Greed is Undermining Patient Care
- Transforming Health Care Leadership: Prioritizing Care for Providers and Patients
- The Financial Pressures Reshaping Physician Priorities
Join the Movement
Rural health care is a matter of life and death. We can’t afford to lose more hospitals, more doctors, or more lives. Stand with us and advocate for policies that put rural America first. Together, we can change the course of health care in this country.
Learn more about how you can make a difference.