There is good news and bad news about America’s doctors. The good news is that they are among the best in the world. The bad news, however, is that there are not enough of them to go around.

According to the U.S. Department of Health and Human Services, about 20 percent of the nation’s population – a hefty 60 million – live in the parts of the country designated by the government as Health Professional Shortage Areas. Those are primarily rural regions, or specific population groups impacted by the shortage, such as migrant workers.

On a global scale, the U.S. averages 2.3 doctors per 1,000 residents, well below the 2.9 recommended by the Organization for Economic Co-operation and Development, and adhered to by most industrialized nations.

What these figures mean is that, although we now have about 800,000 active physicians — up from 500,000 two decades ago – that is not enough to fill the needs of the growing and aging population. As a result, millions of Americans are finding access to convenient and quality health care limited. And, they have to wait longer for diagnostic procedures and medical treatments.

“People are waiting weeks for appointments; emergency departments have lines out the door,” said Phil Miller, a spokesman for Merritt, Hawkins & Associates, a national physician search firm. “Doctors are working longer hours than they want. They are having a hard time taking vacations, a hard time getting their patients in to specialists.”

In other words, the supply — 25,000 new doctors every year– is not keeping up with the growing demand. “The public expects good, innovative health care,” says Richard Cooper, director of the Health Policy Institute at the Medical College of Wisconsin. “But we’re not producing enough physicians to provide it.”

And the prognosis for the foreseeable future is grim. Cooper notes that currently the new crop of physicians just about compensates for those retiring every year. Within a decade, however, a large number of doctors licensed in the 1960s, 1970s and 1980s will no longer practice, creating a hard-to-fill void.

Studies show that an estimated 3,000 to10, 000 more physicians are needed to boost the ranks of active doctors every year to meet the needs of not only the population at large, but also of the increasing number of retiring baby boomers.

But producing doctors is not as simple as it may sound, for it is more a political than an academic process. Congress provides federal funding for medical residencies, and Medicare reimburses hospitals for the cost of resident training. The government currently spends an estimated $11 billion a year on 100,000 medical residents. The financially strapped Medicare already pays 3% of its shoestring budget on physician training and does not have the resources to increase the spending.

At least some of the responsibility for the current and looming crisis lies on the shoulders of the medical profession itself. Several decades ago the American Medical Association (AMA) warned of an expected “oversupply” of doctors, leading to an almost 20-year moratorium on new medical schools. The oversupply theory was reiterated as recently as 1994, when the AMA Journal predicted an excess of 165,000 physicians by the year 2000.

The predictions did not pan out, but the damage was done. “We face at least a decade of severe physician shortages because a bunch of people cooked up numbers to support a position that was obviously wrong,” Cooper said. “This is a desperate situation. And we need to act now because it takes a long time to train a doctor.”

The good news is that the Association of American Medical Colleges dropped the long-standing “oversupply” view in 2002; Florida State University’s College of Medicine, the first new allopathic medical school to open since 1982, graduated its first class of new doctors in 2005. Other states are considering expanding their medical schools as well.

The question of whether there will be enough doctors in the house to provide medical care to all those who need it, remains open. But now at least the alarm has been sounded – and heard.