Doctor in the house?

Good physicians are getting harder to find in many parts of the country, including northwest Ohio. The time to address the growing doctor shortage, locally and nationally, is now.

A recent New York Times article cited a projected shortage of 62,900 doctors by 2015. A shortage of more than 100,000 doctors is likely by 2025, the newspaper said, even as Obamacare prepares to extend health-care coverage to 30 million more Americans starting in 2014.

Doctors retire faster than they're replaced. Baby Boomers are aging. Medical advances are allowing people to live longer with high-maintenance diseases such as cancer and diabetes.

Dr. Jeffrey Gold, the executive vice president of the University of Toledo Medical Center, has studied the nation's physician supply as chairman of an American Medical Association task force. He says current estimates of the doctor shortage are conservative.

For years, Dr. Gold says, northwest Ohio has lagged behind the Cleveland-Columbus-Cincinnati corridor, where the percentage of doctors is on par with state and national averages. The problem appears to be related to a shortage of residency programs rather than talent.

Residencies can take three to five years, and fellowships two to four years. In all, doctors require about a decade of training, which cannot be compromised.

The answer may be more residencies, not shorter ones. That will require more ingenuity from the private and public sectors, along with recognition that a crunch is inevitable in the short term.

Physicians' compensation also should be revisited. The proportion of medical students entering primary care has declined in the past 15 years. Specialists often make twice their salary.

As more Americans gain medical coverage under Obamacare, the doctor-patient ratio will need to improve, not get worse. Medical schools, hospitals, and public programs such as Medicaid, which is expected to account for one-third of the overall growth in coverage under health-care reform, need to work together now to reverse the shortage.