Wisconsin's shortage of primary-care doctors will get worse if steps aren't taken to recruit and retain more physicians, especially in rural areas and inner-city Milwaukee, medical groups said in a report released Monday.

With an aging population expected to increase the need for care, "the supply of physicians will not keep up with the demand of patients," said Dr. Carl Getto, senior vice president of medical affairs at UW Hospital.

More than 600 physician job openings are posted on a new Web site designed to boost recruiting efforts.

The state, which has nearly 10,000 doctors, needs 374 more primary-care physicians, including family practice and internal medicine doctors, according to the report by the Wisconsin Council on Medical Education and Workforce. Most of the shortage is in rural areas but about 20 of the positions are needed in Milwaukee.

Some progress has been made since a similar report four years ago. The UW School of Medicine and Public Health established the Wisconsin Academy for Rural Medicine to encourage medical students from rural parts of the state to return to their hometowns or work in other small towns when they finish their medical training.

A similar effort is being discussed to target Milwaukee.

But more must be done, Getto and other officials said in the report:

• The UW medical school and the Medical College of Wisconsin in Milwaukee should enroll more students who will stay in Wisconsin. Now, about 38 percent of graduates do.

• The number of nurse practitioners and physician assistants should be increased to ease some of the doctor shortage.

• State and private tuition reimbursement programs should be expanded to reduce the medical debt that causes many medical students to pursue higher-paying specialties. The average debt for a new graduate of the UW medical school is $125,000.

• Wisconsin's favorable malpractice climate, including a $750,000 cap on noneconomic damages and the Injured Patients and Families Compensation Fund that covers awards of more than $1 million, should be maintained.

Dr. Tim Bartholow, a senior vice president at the Wisconsin Medical Society, said investing in primary-care doctors can save money by preventing hospitalizations among people with chronic diseases such as diabetes and heart disease.

"Diligent primary care actually saves the health system cost," Bartholow said.

The council releasing the report includes the medical society, the two medical schools, the Wisconsin Hospital Association, the Rural Wisconsin Health Cooperative, the Wisconsin Academy of Family Physicians and the Wisconsin Academy of Physician Assistants.