By Pat Raia, The Daily Yonder
March 11, 2025

Four years ago, family practitioner Dr. Jeff Chappell retired from his post as medical director of the Wayne Community Health Center in Bicknell, Utah. He was excited to undertake a new medical mission, through the Church of Jesus Christ of Latter-day Saints, to South America where he served as area medical director for Peru, Colombia, Bolivia and Venezuela.

But when he returned to Utah, then 63-year-old Chappell was not ready to swap his medical career for the life of a retiree.

“I was 61 when we accepted the mission and I thought, ‘Well, if we’re going to do it, this is the time to do it,’” he recalled. “But when we returned, I found out that I was not ready to fully retire.”

Instead Chappell, now age 65, came out of retirement to accept a part time position on the staff of the Kazan Health Center located in the rural community of Escalante, Utah.

“I wouldn’t want to work in a busy ER, but working a couple of days a week works for me,” he says. “Besides, there is a nurse [at the clinic] who is pursuing a PA designation and my being here gives her more hours to do that – also I think the patients are happy to have me here.”

In its March 2024 report, the Association of Medical Colleges predicted that the U.S. is likely to face a shortage of as many as 86,000 physicians by 2036, compounding the dearth of medical services that is already hitting rural communities hardest.

In response, some retired physicians like Chappell are coming out of full time retirement to mitigate the shortage.

Even so, the current shortfall remains critical, says Dr. Nancy Babbitt who is a director for the Wayne County Utah Health Centers, and the Torrey Utah representative to the Robert Graham Center Steering Committee, which provides advice on policy issues facing primary care providers.

According to Babbitt, rural health care centers are particularly vulnerable to problems connected to medical services shortages because those networks can cover communities that are located miles apart, and are likely to serve patients that are older, perhaps requiring more specialized care than urban counterparts.

“For example, our Wayne County Health Centers cover 7,600-square miles, and we are one to two hours’ drive from an emergency room and three hours away from a tertiary hospital [a hospital that provides specialists],” she says. “And a high percentage of rural residents are older and maybe sicker.”

For Dr. Douglas DeLong, 73, those rural realities have been facts of life throughout his medical career.

“I have never practiced in any area where there is more than one traffic light,” he says. “When I was in Ladysmith, Wisconsin, I might be the only doctor in the [Rusk] county on duty at the hospital that night – I saw it all.”

These days, DeLong practices in Cooperstown, New York, population around 1,853. He tried full time retirement but returned on a limited schedule.

“I retired from full time practice when I was 70 years old, but about a year ago, I unretired,” he explains. “Now I work two or three days a week partly to provide access for patients and because I really enjoy being around these bright young people – but most of them are on their way somewhere else.”

That’s a switch from the time when DeLong was beginning his practice and made a conscious decision to practice medicine in a rural setting.

“I wanted to be a family physician because I didn’t know there was anything else,” he recalls. Also, I grew up in rural settings in Pennsylvania and Washington state – it was a lifestyle choice for me – today though, [rural practice] is a tougher sell.”

That’s because there are economic and other personal factors pressing young physicians to either establish their practices in urban settings, or to forgo family practice altogether for specialty medicine.

“These days, young physicians are racking up educational debt in excess of a couple thousand dollars and that’s on their minds, too and they’re wondering ‘how do I lay these mega debts’?” DeLong points out. “Also your wife has to be happy – something that’s not easy if she is an urban planner for instance.”

At the same time, Babbitt believes that young doctors are not even aware that rural family practice is a career option. So she’s heading to Washington D.C. to tell medical students at Georgetown University that rural practice is a possibility and what it means to establish such a practice.

“Of course there are larger issues facing rural medical providers ranging from state funding resources to insurance costs, but many of them have never even considered it because it’s not something that ‘s even considered by [medical] residents,” she says.

She also plans to tell them that while rural practice is challenging, doctors must be prepared to treat patients for everything from broken bones to heart conditions, and that hours are long, there are perks too.

“You are part of a community – you know the people who come into your clinic and you create long term connections,” she says. “I just got a graduation invitation from a kid that I delivered years ago, and I get wedding invitations all the time – you can’t put a price tag on that.”

While Babbitt makes the case for rural medicine to a new generation of doctors, Chappell says he’s happy that his age and experience allow him to do what he does best and help his community, too.

“You don’t have to run after an IRA, we don’t have the debts we had when we were young and I don’t have to work the massive number of hours, and can do what I enjoy,” he says. “Life is good.”

This article first appeared on The Daily Yonder and is republished here under a Creative Commons license.