08/02/2010 05:12 pm ET Updated May 25, 2011

The Other Health Care Crisis

The health care reform bill provides millions of dollars to educate new doctors via several programs, but the nation still faces a severe shortage of physicians and it's uncertain if medical schools have the capability or desire to add an adequate number of physicians to fill the void. "The act increases incentives for primary care and it adds maybe 300 more physicians trained per year in residency slots, which is a drop in the bucket," said Valerie Parisi, M.D., interim dean at the Wayne State University School of Medicine in Detroit. That's quite an understatement, considering that the nation presently has approximately 756,000 active physicians. Given an estimated United States population of 309,000,000, that adds up to just one physician for every 408 persons. What's more, the majority of America's physicians are concentrated in urban areas; doctors are a scarce commodity and specialists remains virtually nonexistent in rural areas.

The doctor deficit goes back to the 1980s and 1990s when medical schools capped their enrollments at 16,000 students per year because they believed that managed care would create a physician glut. The exact opposite has happened and medical schools were "woefully wrong" in their assessment, according to Josef Fischer, chairman of surgery at Beth Israel Deaconess Medical Center in Boston.

Just 10 years from now, the nation will face a shortage of 66,000 primary-care physicians, including 7,000 in underserved urban and rural areas, according to the Department of Health and Human Services. An additional 100,000 specialty physicians will be needed, such as geriatric specialists and pulmonologists as the estimated 76 million baby boomers retire and require treatment for chronic health conditions. Compounding the crisis is the fact that between 1985 and 2006, the percentage of physicians aged 55 and older climbed from 27 percent to 34 percent, according to statistics from the Association of American Medical Colleges (AAMC). Approximately 250,000 active physicians are expected to retire between now and 2020. These shortages are especially critical among surgeons and family medicine practitioners.

In the United Kingdom's National Health Service, which is facing a similar physician shortage, they're flying in general practitioners from as far away as Lithuania, Poland, France, Germany, Hungary, Italy and Switzerland -- at significant cost. Last year, more than 20,000 doctors from 123 countries registered to work in the UK. The doctor shortage is particularly acute in London, where many areas have deficiencies exceeding 10 percent.