In the 20s & 30s, that how Mom & Dad’s families did it, with a neighborhood doc. When they both went into US Army in early 40s in WWII - she as RN Lt and he in D-Day and Battle of The Bulge - they had real medical care. But civilians back home still used local docs and paid in-kind, or what they could. Barter plus a little cash worked. But we sure didn’t have the medical system overhead we do today.
My grandfather was a "country doctor". His "territory" was a small town in Oklahoma and the surrounding farms.
Initially, he served them from a horse and buggy -- forded a flooding river once to deliver a child.
That's what he did, he delivered babies, he cared for their childhood afflictions, he set their bones and mended their wounds, he saw their parents into old age and comforted them in their last hours.
He was compensated by eggs, fresh garden vegetables, live chickens, a cured ham, an occasional side of beef and, every now and then, some cash.
He was proud of his profession. And never complained about his lot.