Doctor shortages are hurting rural patients. Let pharmacists help them heal

For many rural patients, getting treated for a sore throat or the flu is needlessly burdensome. It can mean missing work, driving hours, waiting days for an appointment, or ending up in urgent care for a problem that should have been handled quickly. That is what provider shortages look like in practice. Seventy-four million Americans live in areas with health care shortages, and by 2036 the United States could be short by as many as 86,000 physicians. Yet many states still prevent pharmacists, one of the most accessible health care professionals in these communities, from treating minor, protocol-driven conditions. That should change.

Many rural patients live far from a hospital, and even routine care can impose real costs. A parent seeking treatment for a child’s flu or strep throat may have to take an entire day off work just to get a basic prescription. Pharmacists, by contrast, are already located in many of the communities where physician access is limited. A nationwide analysis found that 88.9 percent of Americans live within five miles of a community pharmacy and 96.5 percent live within 10 miles. For minor conditions, a pharmacy visit can be faster, closer and less expensive than a trip to a doctor’s office, urgent care, or an emergency room.

Pharmacist care can also lower costs for both patients and public programs. When minor illnesses are pushed into urgent care centers, physician offices, or emergency rooms, patients face higher out-of-pocket costs, longer delays and more time spent seeking care.

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Medicare and Medicaid also end up paying more for care that could have been handled safely in a lower-cost setting. A 2024 Washington state study found that care for minor ailments in community pharmacies cost a median of $277.78 less than comparable care in primary care offices, urgent care centers, or emergency departments. Allowing pharmacists to test and treat routine conditions would not solve every cost problem in health care, but it would move simple care out of expensive settings and reserve doctors and hospitals for patients who actually need them.

States do not need to guess whether pharmacists can prescribe safely; there are already examples to learn from. Virginia allows pharmacists, under statewide protocols, to test and initiate treatment for COVID-19, urinary tract infections (UTIs), influenza and strep throat. Iowa protocols allow pharmacists to dispense antivirals or antibiotics for influenza and strep throat. These models show that pharmacist prescribing does not have to mean open-ended prescribing authority. It can be limited to defined conditions, objective tests, clear treatment rules and referral requirements.

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Pharmacists’ scope of practice does not need to be expanded dramatically to help patients. COVID-19, flu, strep throat, uncomplicated UTIs and other common conditions can often be handled through standardized protocols. In many cases, the patient could be tested, treated and receive the necessary medicine in the same pharmacy visit. The reform would simply allow pharmacists to resolve a limited set of minor conditions that can be handled safely onsite.

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This is not a substitute for doctors, and it should not be treated as one. Pharmacists should refer complex cases, red flag symptoms, recurring problems, high-risk patients, and young children when more in-depth medical care is needed. Letting pharmacists handle routine care would make it easier for patients to get basic treatment while freeing doctors to focus on more complicated cases.

As the health care system becomes more strained, states should regulate intelligently: protect patient safety without blocking access to routine care. Pharmacists should not be sidelined when they can safely handle minor, protocol-driven conditions. Modernizing scope-of-practice laws would give patients faster access to basic treatment, reduce unnecessary pressure on physicians, and lower the cost of care by keeping minor illnesses out of more expensive settings.