Rural Illinois Healthcare Providers Grapple with Worst of Physician Shortage

Shrihita Ganga, a fourth-year medical student at the Southern Illinois University (SIU) School of Medicine, has her sights set on practicing medicine in a rural area post-residency. In the face of a dire physician shortage in rural areas across Illinois and the nation, Ganga said she aspires to practice psychiatry to provide for what feels like a “forgotten population.”

“Us as physicians have a duty to serve all patients,” Ganga said.

Illinois’s rural regions are particularly impacted by physician shortages. The Cicero Institute projects that by 2030, Illinois will face a shortage of 6,203 physicians, including 1,063 in primary care. Illinois has 87 designated primary care health professional shortage areas (HPSAs), 58 of which are in rural or partially rural counties, according to the Health Resources and Services Administration (HRSA) database.

Rural areas across the country have, on average, fewer physicians than urban and semi-urban areas. While 20% of the nation’s population lives in rural areas, only 9% of physicians practice in those regions, the National Rural Health Association reports.

We have known for decades that we would hit a point at which we would not have enough physicians to address patient needs nationwide, but rural populations are more affected by the trend, said Dr. Jennifer Rose, a family medicine physician at a rural satellite clinic of Southern Illinois Healthcare (SIH) Family Medicine in Frankfurt County.

“We do tend to see that whatever larger trends of healthcare shortage or disparity or access concerns affect the U.S. population tend to more profoundly affect rural populations,” said Rose, who is also a professor at the SIU School of Medicine.

Damon Harbison, president of SSM Health Good Samaritan Hospital, SSM Health St. Mary’s Hospital, and SSM Health’s Rural Health Network of Illinois, said his hospitals definitely feel the impact of the provider shortage.

“More patients with fewer doctors is an equation that we’re seeing, and so you could get the longer wait times for appointments,” Harbison said.

An aging U.S. population was identified as one of the primary causes of the nationwide physician shortage, according to an American Association of Medical Colleges study. Between 2021 and 2036, the study projects that the number of Americans aged 65 and older will grow by 34.1%, and those aged 75 and older will grow by 54.7%.

Recruiting physicians to rural areas is a challenge, Harbison said, due to factors such as lifestyle, job opportunities for spouses or partners, and the many physicians who become accustomed to living in urban areas during medical school.

Greater patient complexity can also amplify the shortage's impact in rural areas because populations tend to be older than in metro areas, Harbison said.

“In these smaller towns, the population grows a lot less,” Harbison said. “And so what usually happens when we’re older? More health issues, right? And they get more complex.”

Federal loan-repayment programs administered by the National Health Service Corps aim to recruit young doctors to underserved rural areas. However, recent caps on federal student loan programs instituted by the One Big Beautiful Bill Act threaten the availability of federal loans, according to the Illinois State Medical Society.

Recent cuts to Medicaid further compound the issue. Underserved, often rural, hospitals directly receive Medicaid dollars, some of which are used for federal student loan repayment programs.

Rose said Medicaid cuts may cause rural hospitals to close, and at the very least, cut loan repayment programs.

“If [rural hospitals] are able to stay open, things like offering additional loan repayment or other incentives to bring specialty care to the region is probably one of the things that’s going to have to go just to keep the doors open to be able to provide any degree of critical care,” Rose said.

Beyond loan-repayment programs, various initiatives in rural Illinois aim to attract more young doctors to practice there.

The Lincoln Scholars program at SIU, which Rose directs and Ganga studies in, aims to attract more students to practice in rural areas and equip them with skills specific to caring for rural patients. The University of Illinois has a similar program called the Rural Medical Education Program.

Harbison said SSM Health works to reduce many administrative burdens and supports physicians with strong clinical teams, such as nurse practitioners, nurses, and staff, to alleviate some of the burden caused by the shortage. SSM Health has launched an initiative called “Project One” to increase efficiencies and address rural physician needs.

“When you are a physician, and there’s the shortage and, you know, they’re taking on more patients than they normally would like, we gotta figure out how to be more efficient,” Harbison said. “We want the best life for them.”

But the doctors want the best life for their patients as well. Ganga said she hopes to practice psychiatry to address mental health concerns, which are often overlooked in rural areas.

“Things like mental health are almost always pushed to the side,” Ganga said. “They’re never really recognized in those populations, and that’s not their fault, but it’s just because they never have access to it.”

Megan Fahrney is a graduate journalism student at Northwestern specializing in health and science reporting.