Utah’s rural communities are facing a growing healthcare crisis. There are too few primary care physicians to meet the needs of too many patients. If the current trajectory holds, health leaders warn the situation will only get worse.
“We’re at a critical tipping point,” said Dr. Michelle G. Hofmann, associate clinical professor of pediatrics at the University of Utah. “We are not producing enough physicians to replace those retiring. The number of graduating students hasn’t changed, and fewer and fewer are choosing primary care.”
That shortage is especially severe outside the Wasatch Front, where access is already limited. In many rural counties, patients have to travel hours to receive basic care, assuming they can find a provider at all.
According to Kasey DeLynn Shakespear, executive director of the Rural Health Association of Utah, it’s not just one factor driving the shortage. It’s a mix of systemic, financial and cultural challenges.
“It’s not any cheaper to live in rural than it is in urban Utah these days,” Shakespear said. “And it’s very different living in those small communities. It can be hard to get folks who’ve never lived rural to commit to staying long-term.”
Practicing medicine in a rural town is not the same as working in Salt Lake City or Ogden. In remote clinics, primary care physicians are often the first and only point of contact for all types of care.
“You’re expected to know a little bit about every specialty. Cardiology, pediatrics, obstetrics and oncology,” Shakespear said. “You’re the front line, and in many places, the only line.”
This “jack-of-all-trades,” as Shakespear referred to it, expectation appeals to some, but for many young physicians, it’s a deterrent.
Utah ranks in the bottom third of U.S. states for active patient care physicians per capita. As of 2024, the state has fewer than 85 primary care physicians per 100,000 people, according to the Association of American Medical Colleges.
“Even students passionate about primary care are choosing other specialties,” Hofmann said. “There’s a huge financial disincentive when you’re graduating with hundreds of thousands of dollars in debt.”
A Broken Pipeline
Even as more students apply to medical school, Utah’s residency programs haven’t kept pace, especially in rural settings.
“One of the biggest predictors of where a physician ends up practicing is where they complete their residency,” said Shakespear. “We get students interested in rural health, but they match into residencies up north or out of state. Then they don’t come back.”
Utah currently lacks true rural residency programs. Instead, students may complete short “rotation” stints in rural communities, not enough, Shakespear argues, to encourage lasting commitment.
The state is working to fix that.
One major step is that the U is partnering with Utah Tech University to open a Southern Utah Regional Medical Campus in St. George. The new campus aims to train physicians specifically for underserved communities and includes an accelerated M.D. program designed for rural service.
“Physicians are more likely to practice where they train,” Hofmann said. “Expanding education beyond the Wasatch Front is key to retention.”
The program, expected to launch in the coming years, seeks $10.6 million in ongoing legislative funding. Ten students per year will enroll, with Intermountain Health supporting clinical training and plans for new rural residencies in Southern Utah.
Solutions and Community Support
Loan repayment and visa programs, like the J-1 visa, which brings in international physicians to rural areas, are already in use. But both Hofmann and Shakespear agree that those strategies alone aren’t enough.
“Recruitment and retention depend on more than salary,” Shakespear said. “You also need external support from the community: things like child care, strong schools, spousal employment opportunities. That can make or break whether someone stays.”
Telehealth has also helped, particularly by expanding access to specialists. But insurance limitations still restrict its use.
“When Telehealth isn’t covered by insurance, it really restricts its reach,” Shakespear said.
When there aren’t enough providers, patients pay the price through longer wait times, missed preventative care and worse outcomes.
“Primary care doctors don’t just treat strep throat,” Hofmann said. “They manage chronic illness, provide mental health care and build long-term relationships. That relationship can be life-saving.”
As the state races to find solutions, healthcare leaders say it’s not just about numbers, it’s about equity.
“Everyone deserves access to quality health care, regardless of their ZIP code,” Hofmann said. “But that won’t happen unless we change how we train, support and value our primary care workforce, especially in rural Utah.”
k.keith@dailyutahchronicle.com
The post Utah’s Rural Primary Care Crisis Demands Urgent Action first appeared on The Daily Utah Chronicle.