It’s possible. I go to school in a rural area and spent my 3rd year in a relatively rural area as well (to most).
1) Private practice with procedures. A lot of family medicine doctors nowadays forego doing procedures or biopsies in the office and refer most of them out. But the private practice doc I did my first rotation with did a ton in his office for a few extra bucks. This can include cryotherapy for AKs, shave biopsies, much biopsies, joint injections, laceration repair, toenail cutting and shaving for diabetics, etc.
2) No-life it and do combined inpatient and outpatient medicine. In the rural area a lot of the docs did rounds on 10-20 people at 5am and then had the med student write the notes and meet them at the outpatient clinic. They’d then see 20-30 patients at the clinic and do evening rounds. Some even combined the two models and did procedures as well. A lot of them were IM trained but in a rural area it doesn’t matter, IM and FM are doing the same thing. This is also the old-school model of doing things but now it pays a lot better to manage your own patients rather than admit to a hospitalist. The ones that still did this on my rotations were all grossing over $1 million (one showed me his tax returns at a party at his house), but working 12+ hour days including weekend call every 4 weeks, with at least 1 being on the verge of divorce.