Quite possibly the biggest problem facing the health care system today is a frightening shortage of doctors.
The United States' population is aging and millions of uninsured may soon flood the system.
Some 78 million Baby Boomers are fast approaching senior citizen status, meaning they will likely need increased medical attention.
Unfortunately, Baby Boomer doctors will also retire, and there simply aren't enough new doctors to take their place.
The doctor shortage began in the 1970s when the Institute of Medicine and other national advisory groups incorrectly predicted a doctor surplus. In response, medical schools capped enrollments that remained flat through 2005. At the same time, the American population grew by 70 million people.
Medicine's gatekeepers, the family doctors, are now fighting a losing battle. As their numbers shrink, the number of future patients is exploding.
Dr. Phillip Snider, a physician specializing in family practice, said there will be future problems at doctor visits.
"If we continue the way we're doing now definitely we'll have longer wait times in the waiting room shorter times with the doctor because we're constantly being told you need to see more patients in the same amount of time and yet we have more paperwork to do that pulls us away," he said.
Medical schools striving to admit more students are reporting their largest freshman class ever at nearly 18,000. That is a good start, but they won't be finished with their training for another 10 years.
The number of medical students going into family practice is also down more than 51 percent, mainly because of pay.
"Medical school tuition is relatively expensive compared to college," said Jason Wagner, a student at the Eastern Virginia Medical School. "And the average income now for a family practitioner is between $120,000 and $170,000 a year, which might seem like a lot in the general mindset of a career in the United States."
"But when you look at all the debt you've taken up, a quarter million dollars by the time you're said and done with college and medical school, it's kind of hard to try to find a way to pay that back," he added.
Family doctors make less because they are mostly decision-makers. The real money is in procedures.
One solution is to rely more on physician assistants or nurse practitioners who can handle routine visits.
"Patients come in and they've always only seen the physician and they're a little confused sometimes and that's a trust issue," said Physician Assistant Tom Hare. "But as they gain familiarity and trust with the P.A., those issues go away."
Primary care physicians are increasingly difficult to find anywhere, but the doctor shortage is most critical in rural America, where all types of doctors are in short supply.
Virginia's Eastern Shore is made up mainly of people who earn a modest living harvesting crab, fish and oysters from the Chesapeake Bay as well as tomatoes, corn and soybeans from the fertile farmland.
There is also only one orthopedic surgeon servicing the entire area - Dr. Bradley Butkovich.
"Most orthopedic surgeons aren't going into rural areas," he said. "There is a shortage of orthopedic surgeons right now in the United States of America."
Those who stay usually do so because they like the environment. Their patients appreciate not having to drive long distances for lifesaving care.
"It's very important to me because I have a lot of health problems that I have someplace that I can get to immediately," patient Arlene Frisch said.
But if she has to visit a hospital, she may face a long wait because rural hospitals struggle to attract doctors with less money than city hospitals.
Health Care Reform Movement
Joseph Zager, Administrator of Riverside Shore Memorial Hospital, a rural hospital explained why.
"The government, when they instituted the current payment system for Medicaid and Medicare patients back in '84, they paid rural communities significantly less than urban communities and that caused rural communities to fall behind a little bit," Zager said.
The last part of the doctor shortage dilemma is the current health care reform movement, which could add millions of uninsured to a system already bursting at the seams.
"I'm already seeing 60 people a day," Dr. Burkovich lamented. "Where are we going to put these patients? The family practice doctors who also have a shortage, that refer to me, it's going to be a bottleneck and so these people are going have to wait."
"I mean that's the simple fact: that people are going have to wait to even get in to see me," he added. "I'm backlogged already."
This is clear evidence that any final prescription for the country's healthcare system must address the nation's demand for doctors.
*Originally aired Oct. 13, 2009