No Doctors in Rural Emergency Rooms

March 16, 2026

In rural areas, around 90% of emergency departments increasingly operate with few or no physicians amid a nationwide shortage of doctors. One in thirteen emergency departments in the United States lacks 24/7 attending physician coverage.

A Boston hospital study found that in 15 states, including those with substantial rural populations such as New Mexico, Nevada, and West Virginia, rural hospitals had no emergency departments.

In one stark example, Dahl Memorial, an emergency department in Ekalaka, Montana, hasn’t had a physician on staff in at least 30 years. This hospital’s head, Darrell Messersmith, said he would hire one if a doctor lived in the area. Messersmith also noted that other rural hospitals may have physicians who are either permanent staff members who leave after a few years or contract workers who fly in for a few weeks at a time.

Due to a shortage of competent doctors, these rural hospitals often rely on physician assistants and nurse practitioners to fill the gap. If a patient is in a critical condition that medical practitioners cannot handle, they transfer the patient by plane to a regularly staffed emergency room at a distant site. Such cases occur when these rural emergency departments encounter more complex cases, such as emergency childbirth and severe trauma. In certain situations, it was recorded that because of the medical staff’s lack of training, knowledge, and experience, the patients were misdiagnosed, leading to their death.

The physicians and their associations point out that some hospitals are just trying to save money by not employing them. For example, in Vermont, the state’s hospitals cut physicians from their emergency rooms to “improve” the state’s “troubled” health care system.

Therefore, the lack of healthcare funding for low-income individuals is the primary reason for the shortage of doctors in rural emergency rooms.

In large cities like Los Angeles, conditions may also be dire, even if for different reasons. Because emergency rooms are money-losing or non-profitable departments, big hospitals, even those of wealthy universities like the University of Southern California (USC) in Los Angeles, don’t have emergency departments. Instead, the Los Angeles County Hospital, located adjacent to the USC medical department, is tasked with handling emergency cases. The county picks up the costs of this emergency department. By contrast, in the wealthy areas of Los Angeles, the affluent receive proper medical care when they need it, including emergency care.

Capitalist society, with its sole focus on profit, condemns the working class and low-income people to poor medical care and eventual preventable death.