2. Where Do Family Physicians Practice?

Commentary

American Board of Family Medicine (ABFM) Diplomates are found in all 50 states, U.S. territories, and even abroad. They are more evenly distributed across communities in the U.S. than any other physician discipline, but some variation in their concentration exists. Denominated by 2024 state-level population estimates from the U.S. Census Bureau, there are approximately 27 family physicians for every 100,000 persons in the United States. Alaska has the highest number of family physicians per capita at 60.7 per 100,000, while Connecticut and New Jersey have the lowest at 13.8-13.9 each.

Commentary

Family medicine serves all U.S. geographies, but are particularly depended on by rural populations. Using the Rural-Urban Commuting Area (RUCA) codes associated with family physicians’ reported practice address, we show that 17% of family physicians serve in rural locations, proportionally more than any other discipline. 

Connections and Context

Family medicine’s comprehensive scope of care makes it vital to maintaining healthcare access in rural communities, where family physicians represent a larger share of the workforce than any other specialty, meeting vital needs such as maternity care (Topmiller et al, 2025, Tong et al, 2023) and emergency medicine (Peterson et al, 2023). However, the rural physician workforce has been in decline, and absent funding and attention to ensure more trainees of rural background and more exposure to rural training (Russell et al, 2022), family medicine’s crucial contributions to rural healthcare access is at risk. Recent data from 2017 to 2023 shows a net loss of 11% nationwide over the 7 years studied (Fogarty et al, 2025). 

Commentary

While some family physicians work in hospitals, emergency rooms, urgent care, and administrative roles, most family physicians spend most of their time in outpatient continuity care (79.2%), building ongoing therapeutic relationships with patients of all ages and across a lifespan. See Chapter 3 for more details on practice sites. For the 20.8% that report spending most of their time outside of outpatient continuity care, the most commonly reported principal practice activities were urgent and emergency room care and hospital-based medicine. 

Connections and Context

Family physicians play vital roles in many settings - including emergency rooms, urgent care centers and hospitals (AAFP, 2025) - and across a wide range of clinical contexts, from sports medicine and sleep health to chronic pain management and care throughout the aging process through end of life (Ankuda et al, 2017). The vast majority of family physicians spend most of their time caring for patients in longitudinal, continuous relationships, a core feature of the discipline. Decades of research show that when patients have continuous relational care from the same clinician, they experience more satisfaction, better health outcomes, lower health care costs, and fewer hospitalizations (Bazemore et al, 2024). As the health system has directed increasing numbers of other primary care clinicians away from these vital continuous care roles, it will be important to track changes in these proportions in family medicine. 

Connections and Context

Family physicians are the foundation of continuous and relationship-driven care in the United States, serving across an array of clinical settings and domains in various proportions. A growing number of career choices in non-continuity settings offer family physicians flexibility and opportunities to practice the full breadth of family medicine across a career span (Carek et al, 2024).