South Carolina could face a critical shortage of doctors during the next decade as baby boomers age, many physicians reach retirement age, and the state doesn't train enough replacements, according to a report released by the agency that tracks the health care work force in the state.

"The demand for physicians is undoubtedly going to go up. Whether we're able to keep up with it is the big unknown," said Linda Lacey, the director of the Office for Healthcare Workforce Analysis and Planning, part of an education consortium at the Medical University of South Carolina in Charleston.

The recently released report shows that while the number of doctors in the state has been growing faster than the population, the number per 10,000 people is lower than in most states.

There are just over 10,000 physicians in South Carolina, but about 200 a year will be retiring during the coming decade.

Currently the state graduates about 250 doctors a year, but not all remain in the state.

"If they leave the state for residency training, there is a chance we don't get them back," Lacey said. "We know that if we educate students here and keep them here for residency training, then we keep about 75 percent of them."

One concern is that most of those residencies are funded through Medicare and Medicaid, programs that may be trimmed as governments work to cut their budgets.

The state will be graduating more doctors in the coming years as the University of South Carolina opens a branch medical school in Greenville.

The Edward Via College of Osteopathic Medicine, based in Virginia, also opened a branch campus in Spartanburg this year.

Lacey said the situation in South Carolina reflects the situation nationally, and much depends on changes in health care with a new the emphasis on prevention, keeping people healthier longer and in the community instead of more expensive hospitals and nursing homes.

"But if we keep on going the way we are, there is no doubt we're going to see a shortage of all types of health care personnel simply because of the demand from the population for hospital care, nursing home care and home health care," she said.

Another thing to consider is what happens in 30 years when the baby boomers have passed on and the numbers needing health care declines. Doctors training now may find fewer and fewer patients as they reach middle age.

"It's one thing that as a workforce planner bothers me greatly," she said. "There may be a point at which we have overproduced doctors, and that is never a good thing."

because people can't find jobs in their field. I have no idea what may happen at that point."