NORTHFIELD — By expanding family medicine residency programs, hospitals can help address physician shortages by preparing doctors to work in the communities where they hope to eventually practice, and two Northfield residents are prime examples.
Doctors John Romano and Rachel Anderson, a husband-and-wife team of physicians who met as medical students at the University of Massachusetts Chan Medical School in Worcester in 2018, talked about their experience as some of the first graduates of the Greenfield Family Medicine Residency Program during a program sponsored by Neighbors at Home, a volunteer organization that provides an array of services to senior citizens.
In January 2022, Romano and Anderson joined the residency program, which is currently the only family medicine residency program in western Massachusetts. Designed to serve rural and underserved residents of Greenfield and surrounding towns, one of the goals of the program is to attract young doctors to the region, and Romano and Anderson have chosen to remain in the county, working at Baystate Family Medicine at 48 Sanderson St. in Greenfield. In addition to seeing patients, the two serve as faculty members at the Greenfield Family Medicine Residency Program, where they teach new groups of residents.
The program has grown since their time as residents. When they joined, Romano and Anderson were selected out of 1,000 applicants for four available spots.
“This year, we recruited six residents for the class program,” Romano told those gathered at Dickinson Memorial Library last week. “The program has done really well and is growing, which is great.”
For family medicine doctors, that growth is particularly important given the lengthy process of becoming a physician. Anderson said the path to becoming one includes four years of medical school, three years in residency and exams that run up to 15 hours.
During residency, Anderson explained that residents go through clinical rotations such as taking care of newborns and college athletes, and getting surgical experience.
Though residents have demanding schedules of up to 60 hours per week, Romano emphasized the training’s importance, saying that it helps residents develop decision-making and critical-thinking skills, and learn how to “communicate well with their patients that fits their priorities while being reasonably efficient for the healthcare system.”
The need for well-prepared, properly trained physicians is especially apparent in western Massachusetts, the doctors said. According to Anderson, Franklin County had approximately one primary care physician for every 1,500 residents in 2025.
While that number may sound feasible, the doctors have been seeing patients come from surrounding counties as well. Anderson noted that Greenfield Family Medicine is currently the only practice within the Baystate system accepting new primary care patients, resulting in new patients coming from Springfield and Pittsfield.
At the same time, longtime physicians are retiring without always having a replacement.
The doctors also identified the cost of health care as a major concern. According to figures from Baystate Franklin Medical Center’s 2025 Community Health Needs Assessment, four in 10 Franklin County residents reported that they or their families had an issue affording healthcare, while 29% reported that they or a family member had an unmet healthcare need because of the cost.
Attendee William McGee asked what assistance young doctors receive in finding housing that they can afford in Franklin County, given the sizable debts from medical school.
Anderson expressed that finding housing was hard when they first began their residency.
“When we were looking for our apartment in Greenfield, where we lived and first started residency, we had a couple hundred bucks in our bank account,” she said.
The couple eventually moved to Northfield, however, their student debt nearly prevented them from buying homes due to the debt-to-income ratio.
The problem highlights one of the challenges rural communities face when recruiting physicians: attracting doctors to rural areas that have lower wages while they carry the weight of student debt. Housing can be an additional concern for residents who enter their careers after years of medical school and substantial educational expenses, Anderson said.
The conversation then shifted from physician shortages and housing to another challenge: helping patients understand their own health. With 300 pages of medical information that physicians receive, the doctors expressed that it’s crucial for patients to be aware of and express their current pain and conditions.
Rather than simply providing information, doctors increasingly have to help and work with patients to make sense of the information they already have, Romano explained.
“Sometimes it’s decreasing fear around common medications, or a lot of medications that get a really bad rap on the internet are super safe and helpful in reality, and sometimes it’s just about having someone you trust to help demystify some of that and kind of walk you through,” he said.
Sometimes, Anderson sees that change as an opportunity as well.
“I think it’s great when patients come in with a lot of information,” she added. “We can walk through [the information] together.”
She recalled instances when patients brought her information she hadn’t previously seen, which sometimes led them to find and research the medical question together. With the help of technology, she said, it can also act as a tool for conversation to strengthen the relationship between doctors and patients.
That local connection and conversation is a part of what Romano and Anderson hope the Greenfield Family Medicine Residency Program can continue to achieve.