There are more than 800,000 doctors in the United States, up from a half million only 20 years ago. Each and every one of these professionals face a tidal wave of change whether or not Obamacare passes out of the Congress in the next 90 days.

If the Obama/Pleosi/Reid plans does make it out of the House and Senate and it includes the so-called "government option" - a government-sponsored health insurance plan open to enrollment to every American -  not only will the changes ahead for doctors be massive, they will also mean a significant drop in their ability to earn incomes anything like those they are making today.

Right now the country faces an unfolding doctor shortage. According to research surveyed by Slate's Juliet Lapidos, "The demand for doctors will rise to between 1.09 million and 1.17 million by 2020 — many tens of thousands more than we'll actually have."
The reasons are straightforward: There is a rise in demand for medical services as our population ages and we haven't been turning out enough doctors. Once Obamacare is in place, expect the shortage to worsen as potential future doctors rightly calculate that the likely return on their investment of years of incredibly difficult training and very high borrowing will be dropping precipitously, even as the independence and authority they associate with traditional medical practice first diminishes and then disappears as the "government option" quickly becomes "single payer," which then becomes the maker and enforcer of all rules regarding treatment and payment options.

If the more than three-quarter of a million doctors actually began to demand the sorts of reform that befits the delivery of medical services, they could have an enormous impact on the debate that is beginning in earnest this month.
If, for example, the so-called "Blue Dog Democrats" in the House and incumbent Democratic senators facing the voters in 2010 like Arkansas' Blanche Lincoln and Colorado's Michael Bennett were to hear from even a fraction of the doctors in their districts or states that they will work against the re-election of any member who votes for the "government option," the push to single payer would die a quick and deserved death.

But thus far, there has been almost no peep from the medical community which will be charged with making the new system that Congress decrees result in patient health. The American Medical Association has been largely quiet, choosing to try and negotiate a separate peace with Montana's Max Baucus, an effort that looks doomed to failure now that even Baucus has declared for a "government option."

Of course, the always vocal minority of left-wing doctors is cheering the march towards the socialization of health care. There is also a split between family practitioners and the specialists, a split that makes almost no sense when one considers they will all be losers under "single-payer."

But the momentum towards the radical restructuring of American medicine, though large, isn't irreversible. What it requires is vocal opposition from across the community of physicians. Waiting for the AMA to lead the battle means defeat. Allowing the GOP to lead assures that the MSM will dismiss the effort and blunt the force of the arguments against collectivization.

Doctors have to self-motivate and self-organize, via practice groups and hospital staffs,, and use the power of sustained, personal appeals to elected members. "I'm a ________, and I see ___ patients a week," the calls to each Congressional office should begin, "and I oppose a government option in health insurance."

"If Congressman/Senator _____ votes for a government option, I will be contributing to and working for their opponent in 2010. If he/she insists on destroying the way I practice medicine, I look forward to helping them into retirement where they can try and find a real job."

"The prospect of hanging concentrates the mind wonderfully," Dr. Johnson noted. Doctors should know that the scaffolding is going up. Whether they are obliged to mount the steps depends largely upon the choices they themselves make in the next two months.

Examiner columnist Hugh Hewitt is a law professor at Chapman University Law School and a nationally syndicated radio talk show host who blogs daily at