Supply, Distribution, and Access to Cardiologists, Neurologists, Oncologists, and Pulmonologists in the Rural and Urban U.S.

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08/2025

The purpose of this study was to analyze changes in the supply and distribution of specialist physicians in the rural U.S. overall and among rural population demographic groups. The study focused on specialists—cardiologists, neurologists, oncologists, and pulmonologists—that treat the conditions associated with four of the top causes of rural mortality. Additionally, researchers report perspectives of rural health system leaders on how specialty care is accessed by and delivered to rural patients with these conditions.

Key Findings:

• In 2022, the supply per 100,000 population of four types of specialist physicians was far lower in rural than urban areas: cardiologists (2.6 rural vs. 7.3 urban), neurologists (1.1 rural vs. 4.1 urban), oncologists (2.2 rural vs. 6.6 urban), and pulmonologists (0.9 rural vs. 1.4 urban).
• Four of the leading causes of rural mortality are heart disease, cancer, stroke, and chronic lower respiratory disease. From 2012 to 2022, the rural supply per capita of specialist physicians who treat three out of four of these diseases decreased; cardiologists (-5.8%), pulmonologists (-41.4%), and neurologists (-16.8%), while the rural supply of oncologists increased 19.9%.
• Supply per capita disparities for these specialists were more pronounced in small and isolated small rural areas than in large rural areas.
• Eighteen rural health system leaders interviewed for this study described five methods used to provide specialty care in rural areas. In order of frequency mentioned, solutions included: specialists visiting on an intermittent basis, referrals to care in larger towns or cities, community-based specialists, use of telehealth, and management in primary care with specialist support.

WWAMI Rural Health Research Center

Signe Burchim, David Evans, Nathan Maris, Lisa Garberson, Samantha Pollack, Holly Andrilla, Janessa Graves, Gina Keppel, Davis Patterson

Cancer, Chronic diseases and conditions, Healthcare access, Physicians, Workforce