Oct 5, 2026 · 14 min · 7 segments
Rural communities across the United States are facing a sustained decline in access to primary care. Since 2017, the number of family physicians practicing in rural areas has dropped by more than 10%…
Colleen FogartyGuestJ. Carlisle LarsenHostI wanna take a look at how we fill in those gaps when a family physician leaves one of these areas.
There are programs and structures in place to bring physicians in, including international medical graduates who serve in these communities a lot of the time.
Uh, but recent, you know, immigration and visa changes, uh, could make that more challenging.
As you think about this more broadly, you know, as both a physician and as the lead author of the study, um, what are your thoughts on how those gaps can be filled, um, you know, given the current policy landscape?
So internationally trained physicians have long been part of the US workforce in really many, many areas and including specialties not only in family medicine or primary care.
And at the same time, th- um, the previous, uh, waiver programs for certain types of visa holders would require the physician to do service in a medically underserved community.
Now, not every medically underserved community is rural, but many are, and so those physicians that are internationally trained may wind up in a rural community, and in the best of circumstances, they become an integral part of that community, you know, providing medical care, but also being a, you know, a neighbor, a community member, and so forth.
Um, y- you're right that the, the current uncertainty around visa requirements and the different mechanisms is challenging.
I'm not an expert at every visa status, but the H-1B that you hear about on the news is for, um, highly trained, highly skilled workers, and that sometimes can include physicians.
So places, maybe f- a small community hospital that wants to hire a family physician who requires an H-1B visa, they're not gonna have $100,000 to spare in the same way a large tech company that's, you know, highly profitable does.
So that visa situation could really affect rural health in ways that may not be obvious when you just think about the H-1B visa itself.
I wanna take a look at how we fill in those gaps when a family physician leaves one of these areas.
There are programs and structures in place to bring physicians in, including international medical graduates who serve in these communities a lot of the time.
Uh, but recent, you know, immigration and visa changes, uh, could make that more challenging.
As you think about this more broadly, you know, as both a physician and as the lead author of the study, um, what are your thoughts on how those gaps can be filled, um, you know, given the current policy landscape?
So internationally trained physicians have long been part of the US workforce in really many, many areas and including specialties not only in family medicine or primary care.
And at the same time, th- um, the previous, uh, waiver programs for certain types of visa holders would require the physician to do service in a medically underserved community.
Now, not every medically underserved community is rural, but many are, and so those physicians that are internationally trained may wind up in a rural community, and in the best of circumstances, they become an integral part of that community, you know, providing medical care, but also being a, you know, a neighbor, a community member, and so forth.
Um, y- you're right that the, the current uncertainty around visa requirements and the different mechanisms is challenging.
I'm not an expert at every visa status, but the H-1B that you hear about on the news is for, um, highly trained, highly skilled workers, and that sometimes can include physicians.
So places, maybe f- a small community hospital that wants to hire a family physician who requires an H-1B visa, they're not gonna have $100,000 to spare in the same way a large tech company that's, you know, highly profitable does.
So that visa situation could really affect rural health in ways that may not be obvious when you just think about the H-1B visa itself.
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