Don't be surprised if you have a hard time getting in to see certain doctors: There already are signs of the physician shortage many experts predict in a few years.
Nationally, surveys point to long wait times for cardiologists, dermatologists, orthopedic surgeons and obstetricians in many cities, while Maryland physicians say there are signs of a shortage of anesthesiologists, general surgeons and family doctors.
"We can't see all the patients who want to see us," said Dr. Dana Frank, a Lutherville internist whose first available nonurgent appointments are in March.
"We are overwhelmed, and that is because there is a shortage" of internists and family practitioners.
The problems are nothing new in some rural and inner-city areas that many doctors consider so financially unattractive that the government offers incentives to practice there. But nationally, experts say shortages are expected to worsen in those areas and spread into others.
The reasons include a growing population, especially elderly people who need more care, and prosperous consumers who demand the latest drugs, medical devices or therapies.
At the same time demand is increasing, work force trends indicate some doctors are working fewer hours, while the overall number of physicians entering certain specialties - such as family medicine - remains depressed.
In Maryland, physicians complain that low insurer reimbursement, compared with other states, creates a disadvantage in recruiting some specialists.
Concerned about the apparent trends, the Council on Graduate Medical Education has recommended that U.S. medical schools increase enrollment in the next decade by 15 percent over 2002 levels and that the government fund more residencies. Some medical schools already have taken steps.
The University of New Mexico is moving to increase medical school enrollment from 75 to 100 students, and the University of Maryland School of Medicine increased its enrollment to about 150 per class from about 135 several years ago.
But limits on government funding for residencies remain, and if trends don't change there could be a shortage of up to 96,000 U.S. physicians by 2020, the Council on Graduate Medical Education says. One reason: Doctors are aging, too, and large numbers are expected to retire just when elderly baby boomers need more care.
