The L+M Medical Group and its president, Dr. Christopher M. Lehrach, are right on target in trying to aggressively recruit more primary care physicians (PCP) into the group and into the region generally. The medical group comes under the corporate umbrella of L + M Healthcare, the parent corporation of Lawrence + Memorial Hospital.

Pointing to trends that show the shortage of primary care physicians growing more acute, and concerned that the medical group disproportionately consisted of specialists, Dr. Lehrach said he saw a need to focus on primary care recruitment. He became president of the L+M Medical Group last August.

Dr. Lehrach joked about the challenge in a competitive environment of finding PCPs and signing them to contracts.

"They're like unicorns," he said during a meeting with The Day's editorial board on Monday.

If current trends continue, the Association of American Medical Colleges projects there will be a shortage of 45,000 primary care doctors in the United States by 2020. According to the U.S. Census Bureau, the number of Americans over 65 will grow by 36 percent over the next decade, while the physician supply will increase by only 7 percent.

Connecticut faces the challenge of adding another 404 PCPs by 2030, a 15 percent increase, if it wants to meet the needs of a growing, aging and increasingly insured population, according to the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, based in Washington D.C.

A 2010 study found that nearly one in four Connecticut PCPs, already facing large workloads, were refusing to take on new patients.

Money and lifestyle choices continue to drive more medical students into specialty fields. Primary care doctors need to assess a wide range of health issues. It is a critically important, but challenging role in the health care system. Yet over the course of their careers, these PCPs can expect to earn around $3 million less than their colleagues in specialty fields, according to the Kaiser Family Foundation.

There are also concerns that fewer of the nation's "best and brightest" will want to become doctors at all, with many drawn instead to the fields of computer technology and innovation or to the riches of investment banking.

Out of the L+M Medical Group's staff of 110 doctors and 320 support staff, 49 are focused on primary care, including 36 PCPs, as well as physician assistants and advanced practice registered nurses, said Dr. Lehrach. There have been six new hires who have started or soon will. Two more primary care doctors should join the group if contract negotiations are successful, he said.

In one positive note, the Kaiser Family Foundation reports that so far the nation's primary care system does appear to be handling the number of new patients seeking access to care due to insurance provided through or because of the Affordable Care Act. That has been true with the L+M Medical Group as well, said Dr. Lehrach.

Technology and the use of physician assistants and advanced practice RNs will play an increasing role, allowing PCPs to provide care to more patients. More follow-up visits will take place using Skype telecommuting rather than office visits. Increasingly, patients will be fitted with electronic monitors to track their conditions and provide medication reminders, with doctors' offices able to remotely access the data.

None of this, however, eliminates the need for more family doctors. Needed are national and state policies that reduce the cost of becoming a PCP, make these careers more financially attractive, and recruit more students into these programs. The focus of the state's newest medical school - the Frank H. Netter MD School of Medicine at Quinnipiac University - on graduating primary care doctors is a welcomed development.

How to provide and pay for health care remains a divisive political topic, but all policymakers should agree on the need to boost the number primary care physicians.