With an aging Baby Boom generation looming over the public health landscape, will there soon be a shortage of doctors?

There already is a shortage of general surgeons. Over the past 25 years, the number of general surgeons per 100,000 people in the United States has fallen by more than 25 percent, according to researchers from the University of Washington at Seattle, who analyzed data from the American Medical Association's Physician Masterfiles from 1981, 1991, 2001 and 2005.

They found that there were 17,394 active general surgeons working in the U.S. in 1981, 17,922 in 2001, and 16,662 in 2005. The ratio of general surgeons was 7.68 per 100,000 people in 1981 and 5.69 per 100,000 people in 2005.

That means there was a 25.91 percent decrease in the surgeon-to-population ratio over those years, with a greater decrease (27.24 percent) in urban areas than in rural areas (21.07 percent).

The number of women surgeons has increased, but these were disproportionately concentrated in urban areas. The study also found that the average age of general surgeons in rural areas was higher compared with surgeons in urban areas.

"There is some question as to whether there will be an adequate number of general surgeons to care for an increasingly elderly population, with its attendant increased demand for surgical care," the researchers wrote.

They suggested a number of ways to increase the number of general surgeons, including "increased funding of residency positions and exploring and addressing the issues surrounding training, remuneration and lifestyle that seem to have made general surgery less attractive than other specialties to medical students, especially women."

In addition, medical schools and surgical residences should "ensure that general surgical residents are sufficiently exposed to rural surgical practice through rural training tracks and rural-based residencies."

The study was published in the April issue of the journal Archives of Surgery.