Oh joy. Waiting to see a doctor will replace baseball as the national pastime

President Barack Obama's health overhaul, aiming to add 36 million Americans to the insurance rolls, will worsen a family-doctor shortage, triggering longer waits for office visits and crowded emergency rooms. "This is already a catastrophic crisis," said Joseph Stubbs, president of the Philadelphia-based American College of Physicians, the second-largest doctor's group in the U.S. "Now we're talking 30 million more people who will want to see a doctor. The supply of doctors just won't be there for them."

Underserved areas in the U.S. currently need 16,679 more primary-care physicians to reach a "medically appropriate" target of 1 for every 2,000 residents, U.S. databills before Congress would raise pay for family doctors, increase residency training and forgive school debt to help meet that deficit. Those measures, though, will take years to make a difference, said Stubbs, who also works as an internist in Albany, Georgia.

More family doctors are needed to cut health costs through early diagnosis and prevention, and increase access to medical care, Obama said in a June 15 speech to the American Medical Association meeting in Chicago. The Massachusetts health-care initiative shows what can go wrong if the primary-care system isn't fixed simultaneously with the start of universal coverage, said Allan Goroll, a professor of medicine at Harvard Medical School in Boston.
shows. The health-care overhaul

The average waiting time to see a family-medicine doctor in Boston, a city with 14 teaching hospitals, is 63 days, the most among 15 cities in a 2009 survey by Merritt Hawkins & Associates, a recruiting and research firm in Irving, Texas. People in Los Angeles waited 59 days, while those in Miami saw doctors in 7 days, the survey found.

Boston's longer wait was "driven in part by the health- care reform initiative," the report said.

"The primary lesson of health-care reform in Massachusetts is that you can't increase the number of insured unless you have a strong primary-care base in place to receive them," Goroll said. "Without that foundation of primary care, Massachusetts has ended up with higher costs and people going to emergency rooms when they can't find a doctor."