Physician-first: Building rural health care from the frontlines
Among the many challenges facing rural health care, attracting enough physicians is one of the hardest to solve – and the difficulty is growing. While about one in five Americans live, work, and play in rural areas, only about 9 percent of physicians practice there, and the numbers are even lower for specialists. [1]
“Rural communities are increasingly burdened by a persistent and growing shortage of both general physicians and specialized surgeons,” says Daniel Siegel, MBA, CEO at Synergy Health Partners. These factors threaten patient health and economic stability as executives, administrators, and policymakers work to address this growing problem.
For rural health care leaders, the strategic value of physicians is becoming increasingly apparent. With the present difficulty in recruiting, retaining physicians is key, not only to strengthening the workforce but also to increasing access to care in the community.
The untapped value of physicians in rural systems
Physicians remain the backbone of the health care industry. Each may generate revenue of between $250,000 and $3.8 million annually, depending on their specialty. Even the loss of one physician can significantly impact an organization’s bottom line. [2,3]
Perhaps more importantly, the loss is not simply financial. Physicians represent continuity, leadership, and trust not only to the health care team but also to their patients, with whom they establish relationships over the course of repeat visits. In rural communities, physicians may also engage in meaningful activities outside the clinic, further solidifying their place within the local patient population.
4 imperatives for rural health leaders
Outdated models often treat physicians as staffing units rather than strategic leaders. Research from the American Association of Physician Leaders finds that physician-led hospitals generally outperform other hospitals, and effective physician leaders can help promote better well-being in the physicians they supervise. “Top-performing organizations recognize the need for more physician leaders,” it concludes. [4]
For organizations looking to strengthen their physician workforce, here are four key imperatives to keep in mind:
1. Invest in physicians as economic engines
Physicians aren’t just employees; they’re the economic engines behind successful health care systems. Health care is typically one of the largest employer groups in rural communities, and the economic impact of a physician extends outward to the community. [5]
Physician retention and engagement are essential to protecting revenue and sustaining performance — but so is bridging the gaps. The strategic use of locum tenens transforms what was once seen as a cost center into a revenue-generating, burnout-preventing lever that supports continuity, expands access, and builds long-term system resilience.
2. Build flexible, rural-centric staffing models
Implement the CHG “order of utilization” staffing model, which is based on best practices for cost-effectiveness and allows for continuity of care based on fluctuating needs. Strategically deploying full-time staff, float pools, telehealth providers, and locums creates efficiencies via cost-effective labor sources.
Hybrid and job-sharing models can also attract talent and benefit the employer. Recent research in BMJ Open shows that community-based, hybrid models of in-person and virtual care may reduce the burden on emergency and hospital services in rural, remote, and underserved regions. [6]
3. Embrace technology that works with physicians
CHG Healthcare’s 2025 Physician Sentiment Survey found that most physicians said AI and digital technologies could benefit administrative work (84 percent), patient care (67 percent), diagnostics (79 percent), and business performance (77 percent). They also identified a big gap in how technology is currently being used and the potential benefits. [7]
Survey findings suggest the best practice is to collaborate with and involve physicians in selecting and customizing the technology they will use.
4. Make physician engagement a business strategy
“The future of workforce strategy is focused on the kind of environment where physicians can thrive, innovate, and lead,” says Leslie Snavely, president and CEO of CHG Healthcare. This emphasis on physician enablement rather than deployment marks a decisive shift in how forward-thinking systems are redefining success.
Physician engagement strategies matter because physicians know their jobs best, and they have ideas about how to do things better. When their input is ignored, it can lead to frustration. That’s why it’s smart to develop governance models that value physician input.
How rural systems can become destination employers
Improving the rural physician value proposition may be easier in a rural health care system, with many physicians finding that they enjoy working in rural communities. [8]
“No one made me practice in a rural community for 20 years. I did that by choice because it’s some of the most rewarding medicine that there is,” says Dr. Sarah Chouinard, chief medical officer of Main Street Health. “You become a pillar in the community and have to know what you’re doing because access to specialty care is often limited.”
The idea of belonging to a culture in which physicians integrate into a smaller team has many benefits. A less-populated community has broad appeal for those who want a slower pace of life. A rural physician is more likely to feel heard, realize greater autonomy in decision-making, and find that new ideas and suggestions receive a warmer welcome.
Why it matters now: A call to action
The future of rural health isn’t built from the top down; it’s built from the physician out.
Instead of wondering how a rural health system will fare in the future, those making empowered decisions about rural health care know its survival depends on recruiting, retaining, and empowering physicians now. That’s no small task given that the projected physician shortage for 2036 is 86,000 doctors. [9]
As part of a sound health care workforce strategy, it only makes sense to empower physicians. That’s economically smart, culturally vital, and operationally urgent. Forward-thinking C-suite leaders and others can lead the way with bold, physician-first strategies that really work.
We invite you to learn how a focus on physicians can benefit your health care workforce.
NRHA adapted the above piece from CHG Healthcare, a trusted NRHA partner, for publication within the Association’s Rural Health Voices blog.
 | Melinda Giese has over 30 years of expertise as senior vice president of enterprise client solutions at CHG Healthcare. She has spent her career partnering with clients on strategic and innovative strategies that stabilize and grow their business. With experience representing payors, providers, health care organizations, and government entities, she is able to see health care from every angle. |