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The solitary, satchel-carrying rural doctor is etched into our enduring fantasy about small-town Arizona. But such physicians are fading away. The doctors are gone, but the towns – and the medically underserved people who live in them – remain.  

A few years ago, Dr. Molly Anderson – the only physician serving the verdant Southern Arizona village of Patagonia – was called for jury duty. As she sat in the small-town courtroom, each potential juror was asked if they knew anyone involved in the case. Anderson recalls looking around and thinking, “Well, the defendant is a patient. The victim is a patient. The witnesses are patients. The detective is a patient. And I can’t say this because of privacy laws.”

Fortunately, she didn’t need to breach confidentiality. One after the other, they all admitted to knowing her. The “everybody knows your name” phenomenon is one of the side effects of practicing in a one-doc town – a bucolic lifestyle immortalized in shows like Northern Exposure and Dr. Quinn, Medicine Woman.

But the solo family physician on the frontier is fast going the way of fiction. In 1983, 40 percent of the nation’s doctors practiced alone, according to the American Medical Association. By 2018, that number had fallen to less than 15 percent, underscoring a troubling fact: Arizona suffers from a huge shortage of primary care physicians (PCPs). To meet its needs, the state currently requires an extra 563 PCPs, plus an additional 1,941 by 2030, according to the Health Resources and Services Administration.

The scarcity is felt most acutely in rural areas, which struggle to recruit and retain physicians and are hemorrhaging hospitals and health clinics. According to an informal PHOENIX magazine study of Arizona Medical Board licenses and medical clinics statewide, only about a half-dozen true one-doctor towns remain. Most Arizona towns of 1,000 residents or less have no dedicated local physician – they’re zero-doctor towns.

That’s certainly a loss for people living in these “medical deserts” scattered around the state. And it may also be a loss for clinicians. Because some family docs in remote Arizona towns like Patagonia, Seligman and Safford say small-town medicine epitomizes the kind of personalized, caring experience that both doctors and patients desire. Unfortunately, that too is disappearing. But some country docs in Arizona are trying to keep the tradition alive.

It wasn’t blind fate that conspired to make Dr. Michael Druschel the lone physician serving the Route 66 outpost of Seligman. He grew up in a small town in Pennsylvania and has always gravitated to blink-and-you-miss-’em burgs. That’s not unusual. A rural background is the strongest predictor that a doctor will choose to practice in a rural location, according to the American Academy of Family Physicians.

A year and a half ago, Druschel moved to Flagstaff, where his wife and two daughters can enjoy urban amenities and he can pursue his passions for skiing, biking and running. Three days a week, he works at the North Country HealthCare clinic in Williams. And once a week, he puts on a podcast or audiobook and drives a little over an hour to the smaller clinic in Seligman (population: 776).

The couple moved to Sonoita, and a few years later, Anderson began working at the Mariposa Community Health Center in Patagonia. “By the time I’d been here two weeks, it seemed like everybody in town knew who I was,” she says. “And I had no clue who they were.” Inspired by these awkward encounters, she wrote a limerick called “Small Town Doc”: “In the best of all worlds, I suppose/ I should have recognized you by your woes./ But if you’re from Patagonia/ it’s more likely I’da known ya/ had you presented yourself without clothes.”

Despite having a population of about 772, Patagonia provides a varied clientele at Anderson’s clinic. The area is home to a quirky assortment of residents that seems ripe for a TV medical drama: vintners, artisans, birdwatchers, foodie retirees, low-income long-timers, Mexican American mining and ranching families, and cowboys. “Boy, they are a stoic group,” Anderson says of the wranglers. One man came to her with an achy arm after he’d endured a fractured humerus for two weeks while he finished his roundup.

Anderson says she enjoys rural medicine because she can form close, enduring bonds with her patients, plus generations of their families. “It’s nice to be able to sit and talk with people and their families and actually know something about their home situation,” she says, sitting in the clinic where she’s worked part-time for 25 years. “You run into people at the store and at restaurants all the time, and it just makes you feel more responsible for them.”

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Anderson says she enjoys rural medicine because she can form close, enduring bonds with her patients, plus generations of their families. “It’s nice to be able to sit and talk with people and their families and actually know something about their home situation,” she says, sitting in the clinic where she’s worked part-time for 25 years. “You run into people at the store and at restaurants all the time, and it just makes you feel more responsible for them.”

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