In a recent NY Times article," Doctor Shortage Likely to Worsen With Health Law," there were a number of areas throughout the country listed with shortages of physicians. The impact on the shortage by the Affordable Care Act is the number of newly eligible individuals nationwide for insurance coverage. These communities are talking about shortages in every specialty, sub-specialty and primary care today and that problem is only going to worsen. Right now, patients are being transferred to other hospitals for care, waiting excessively to be seen in Emergency Departments, overusing EDs and even foregoing care. Rural areas, as well as urban areas, throughout the country are especially hard hit. In Maryland, rural areas are significantly impacted, with urban areas faring much better than most due to Johns Hopkins and the University of Maryland in Baltimore and many hospitals in Washington DC supporting PG County. At WMHS, we have been able to hold our own in attracting new physicians (the new Hospital has helped greatly) with the exception of Gastroenterology. We have call coverage issues due to having only three GI docs in Allegany County and only one of the three who is employed by WMHS. We continue to recruit; in fact, we have offered $10,000 to anyone who brings us a GI doc who joins our staff and remains in the community for at least one year. When we recruited our last GI doc to Cumberland, there were 500 openings or opportunities for every one Gastroenterologist coming out of training. We continue to recruit and will do so until we are successful. In the meantime, we, along with the rest of the country, are re-engineering how we deliver care as to its efficiency and appropriateness. We want to make sure that individuals are being cared for in the most appropriate setting, reducing the burden on the ED and acute care. Also, as a state, Maryland leads the country in its treatment of Nurse Practitioners. They can now practice on their own without the supervision of a physician and that has helped greatly in Primary Care. In this day and age, as well as with what is on the horizon, every little bit helps.