The medical infrastructure is scarce in rural America. Generally clinics instead of hospitals, overburdened doctors, lack of nurses, lack of supplies.
Maybe medical personnel from cities that are trending downward can fill the void
The reason for the shortage of medical help in rural areas is unregulated or improperly regulated capitalism.
It's not profitable to be in rural areas.
It's the same reason why high speed Internet isn't available in the rural areas or what's available isn't very good.
It's the same reason why the rural areas have to use satellites instead of cable.
The reason why rural areas don't have medical staff is that they come out of school with such high burden of debt from student loans they can't afford to go to work in the rural areas. They can't support themselves on the very low wages plus the high payments of the student loan.
Which it all comes back to unregulated or improperly regulated capitalism.
Capitalism will destroy itself if it's not properly regulated.