Family doctors from 15 Maine communities were in Washington, D.C., on Wednesday, joining their counterparts from other states in a rally for health care reform at the national level. The demonstration coincided with the release of a study showing that all 50 states face a critical shortage of family physicians.

Maine ranked in the middle of all the states with the study indicating Maine will need 34 percent more family doctors by 2020.

Family practice doctors are the do-it-all workhorses of American medicine, descendants of the “general practitioners” of previous generations. Practitioners must be able to recognize and treat mental health and behavioral disorders as well as physical problems for patients of all ages and both sexes. Within their communities, they are often looked to in medical emergencies and public health crises.

According to the report conducted by the American Academy of Family Physicians and made public Wednesday morning, by the year 2020 the country will need to increase its supply of family care doctors by 39 percent over the current number. That means the number of family practice doctors in the U.S. will need to increase from 100,431 currently working to 139,531 if the needs of the country’s changing population are to be met.

In Maine, 438 family doctors are now practicing. This number includes both medical doctors and doctors of osteopathy. The study projects that, given the state’s anticipated growth in population, the incidence of chronic disease and Mainers’ advancing average age, Maine by 2020 will need 589 family practice doctors, an increase of 34 percent.

Maine ranks in the middle among states, with Nevada needing a 79 percent increase and Delaware needing a 5 percent increase.

According to Jane Ham, director of the Maine Recruitment Center for the Maine Hospital Association, the state is experiencing the highest demand for all categories of doctors since her office opened in 1999. Ham is trying to fill 206 positions in Maine hospitals and hospital-affiliated health care practices – 79 medical specialists, 26 surgeons, nine psychiatrists and 92 primary care doctors. Primary care doctors include family practice, pediatric, internal medicine and OB-GYN doctors. Of the 92 primary care positions Ham is trying to fill, 44 are for family practice doctors.

Part of the problem is that many family doctors now in practice are nearing retirement.

“The greatest challenge is in Maine’s rural areas,” Ham said Wednesday. Newly minted doctors are often reluctant to practice far from the medical and social amenities of more urban areas or the university hospitals where they trained, she said. Other impediments include the availability of employment for doctors’ spouses or domestic partners and the perception that rural areas offer less desirable schools for their children.

The flip side is the allure of small-town living, Ham said, which is what she stresses when approaching interested physicians. “If people are looking for four-season recreation, safe communities and small-town living, we have all that,” she said. It is relatively easier to recruit doctors to small communities in southern Maine or the midcoast area, she said, but towns in the northern and western parts of the state are a hard sell.

“When people visit Maine, their experience tends to be coastal,” she said. “If we can just get them up into Penobscot or Piscataquis [counties], they’d see how beautiful it is there.”

At the Maine Primary Care Association, which represents 50 community health clinics, mostly located in rural areas across the state, recruiter Jim Dowling said he’s currently looking for 12 doctors and six nurse practitioners or physician assistants. This represents a vacancy rate of about 20 percent of clinic positions in the state. “The need right now is extreme,” Dowling said.

Like Ham, Dowling said the attraction for the physicians who choose to practice in Maine is more related to lifestyle than to career-building. “Maine appeals to doctors who want to make a comfortable living and live and raise their kids in a beautiful place,” he said. “It also takes a real commitment to working with the underserved.”

Both Dowling and Ham said the presence of the DO program at the University of New England in Biddeford attracts many medical students who then choose to practice in Maine. State and federal tuition repayment programs also offer incentives for practicing in rural areas, Dowling said. Both recruiters said family practitioners in Maine could expect to earn about $100,000 a year to start, in addition to the school loan repayment incentives and other deal-sweeteners offered in some positions.

The AAFP is encouraging voters this fall to demand solutions to the country’s health care crisis.

Rick Kellerman, president-elect of AAFP, said in a press release that major health reforms are needed at the federal level in order to attract more doctors to the practice of family medicine.

“There is a growing need for more family physicians to provide primary care in communities across the nation, but without health reforms it will be impossible to accomplish,” he said. “Lower [Medicare and Medicaid] payments combined with higher liability insurance costs mean more and more family physicians are being forced to limit services or retire early. … This is happening at a time when Congress is cutting family physician training programs. … [And] the health care environment is making it harder to continue to practice community-based medicine.”

In an e-mail from Washington, where he joined other doctors in the Capitol Hill rally on Wednesday, Dr. James Raczek, vice president and chief medical officer at Eastern Maine Medical Center in Bangor, said Americans should press their congressional representatives to find solutions for the nation’s health care crisis.

“The important thing to remember is that all of us in Maine have a voice in what happens in America’s health care system,” he said. “Together, we can command the attention of candidates running for national office this fall and make sure they understand that the American people view health care as one of their top priorities.”