Over the next two decades, the US could find itself short of 200,000 doctors unless steps are taken to curb current trends, according to a new report.

Still, what should be done to remedy the problem remains unclear.

The report, which is authored by Dr. Richard A. Cooper, from the Medical College of Wisconsin in Milwaukee, appears in the Annals of Internal Medicine.

For the last two decades, medical school policy decisions have been based on the expectation that there would be a surplus of physicians, Cooper notes. Not only did this surplus never materialize, he explains, but there is increasing evidence that a shortage is looming.

Using a planning model that couples economic growth to health care spending and physician demand, Dr. Cooper estimated the difference between the number of doctors that will be needed and the number available in the coming years.

His conclusion? A physician shortage is just beginning now, and it will likely increase dramatically in the next 20 years. By 2020, there could be a shortage of 200,000 doctors - about 20 percent of the required workforce.

“The picture that emerges is uncomplicated and unambiguous. In simple numeric terms, the number of physicians is no longer keeping up with population growth,” Cooper concludes.

In a related editorial Dr. Alan M. Garber, from the Stanford University School of Medicine in California, and Dr. Harold C. Sox, from the American College of Physicians in Philadelphia, write that “increasing the supply of physicians gradually, in small increments - ones that would not require major new investments in capital or teaching personnel - is a prudent strategy.”

SOURCE: Annals of Internal Medicine, November 2, 2004.