As our county deals with the serious shortage of primary care physicians, our Congress is facing an opportunity to act in a manner that may create an even greater disaster for our community.

Why are so many counties going without enough primary care physicians? The answer is complex, but a major contributor is the way we pay primary care doctors for the services they provide. Research has consistently shown that without the family physicians who help you stay healthy and work with you to manage a chronic health problem, you have a greater chance of being hospitalized, developing potentially life-threatening problems and even shortening your lifespan.

Doctors' offices are vital to their communities, but they are also businesses that must generate enough income to keep their doors open.

For the last seven years, family doctors have had an average 7-percent drop in their businesses' income. Federal Medicare reimbursement policy has been driving existing primary care doctors out of business and discouraging medical students from choosing a family medicine career.

For the last seven years, annual changes in Medicare reimbursements have either stagnated or dropped from the previous year.

For the last seven years, Medicare reimbursements to physicians have failed to match inflation. In fact, the average practice revenue for primary care doctors plummeted 21 percent in 2005, according to a Medical Economics survey. Although family physicians saw a 2 percent Medicare reimbursement increase in 2006, annual inflation that year was 2.5 percent.

So you're not of Medicare age, why does this affect you now? As Medicare cuts payments, most other insurers follow suit. This results in your physician being unable to generate the business income he or she needs to keep their doors open.

This year, Medicare plans to make a 10.6 percent cut in reimbursement rates, effective July 1, without Congressional action this spring. Doctors have been dealing with this problem yearly since Congress fails to change the Medicare formula. Instead, they choose temporary band-aids that postpone the inevitable each year.

That approach allows Congress the luxury of short-term planning. This worsens the uncertainty for all patients. Many patients do not have short-term health issues. The elderly cope with an average of five chronic conditions that, if not properly treated and monitored, can cascade into life-threatening complications. Without a stable health-care system in which doctors can predict revenues, patients cannot be certain their physician will be open for business when they need medical care.

We can do something about it. Congress needs to hear from all of us. Our congressional representatives, Barbara Boxer, Diane Feinstein and John Doolittle, have the power to help enact change. Contact them and ask that they support legislation that provides adequate reimbursement for the care you, your family, and friends receive from your doctor.

This is not just a problem for the aging people in our country but a problem for each and every one of us. Our health-care system suffers from many broken parts, and this is just one of the pieces in that puzzle. Here is an opportunity to stand up and be counted.

Your single voice then becomes our total voice.

Rene C. Kronland, M.D., is a family physician in Grass Valley.