Primary care workforce shortage - is it real?

  Recent JAMA article by Freed and Stockman tackles this question (not sure if link will work for most) from a different angle - paediatrics primary care.  The authors briefly state that 

"the most recent published data regarding pediatric residents completing training in 2008 demonstrated that 40% were planning to pursue a career in primary care, with 10% still undecided... For the specialty of pediatrics, it appears that a close to appropriate proportion of trainees continues to enter the primary care arena... While the absolute number of children in the United States has remained relatively stable, the number of pediatricians has increased substantially. This has resulted in an increase in the number of primary care pediatricians, from 32 to 78 per 100 000 children in the period 1975 to 2005."

It is interesting - the primary care debate has really focused around adults, but this data seems pretty compelling for increasing availability of primary care for children.  What the authors dont comment on is that with expansion of coverage we will need more primary care doctors, and more strategically placed (esp in underserved areas).  This is definitely an issue with SCHIP expanding children's coverage.  And it's what we've seen in Massachusetts - with expansion of coverage, wait times for primary care appointments have risen.  Even though we have gone to 78 per 100k children, is that enough?  And are they in the right places?  I don't know and this article doesn't tackle those questions.  

Given that you can't just turn on and off the workforce pipeline for physicians, long term workforce planning is necessary.  And this is much more difficult in a fragmented education system like the US.  Interesting paper, nonetheless.