Introduction. The staffing of the district internal-medicine service determines the accessibility of primary health care (PHC) for the adult population and the quality of dispensary follow-up. Aim. To assess the dynamics and territorial differentiation of the provision of the Russian Federation population with district therapists (DT) in 2021–2024 and to identify the main regional features of staffing indicators. Materials and methods. Data from federal statistical observation form No. 30 and statistical compilations of the Central Research Institute for Health Organization and Informatization of the Ministry of Health of the Russian Federation for 2021–2024 were used. The analysis was performed at three levels (Russian Federation, federal districts, 85 constituent entities) across seven staffing indicators; a counterfactual calculation was applied to separate the contribution of the real inflow of specialists from that of the change in the number of staff positions. Statistical processing used Microsoft Excel and Python. Results. Over the period, the provision of DT increased from 3.32 to 3.50 per 10,000 adults (+5.42%), and staffing by physical persons rose from 79.09 to 87.93% (+8.84 pp) while the number of staff positions decreased by 4.65%. The counterfactual calculation showed that the real inflow of specialists accounted for 4.75 pp (53.7%) of the staffing increase, and the reduction in the number of staff positions for 4.09 pp (46.3%). The part-time coefficient remained stable (≈1.06). In 2024, provision across entities ranged from 1.73 to 6.36 per 10,000 with a median of 3.75; intra-district differentiation often exceeded inter-district differentiation. Discussion. The positive staffing dynamics are twofold in nature: the formal increase in staffing is only about half explained by the real inflow of specialists; the growth is accompanied by a persistent deficit and marked regional differentiation. Conclusions. The growth in DT provision is twofold in nature: about half of the increase in staffing by physical persons is due to the real inflow of specialists (4.75 pp; 53.7%), and the other half to the reduction in the number of staff positions (4.09 pp; 46.3%). The positive dynamics are accompanied by a persistent deficit and stable territorial differentiation.