"We're seeing more nurse practitioners and physician's assistants, who do a very good job with primary care," he said.
But Kowalski said there are times when the patient would most benefit from the advanced knowledge of a physician. He compared the tiers of primary care to working on a car.
"When I have to change my oil or rotate my tires, I take my car to my local mechanic," the doctor said. "But when there's something seriously wrong, I take it to the dealer.
"Doctors are kind of like the dealer."
Even though mid-level medical professionals are working to fill in the gaps, Kowalski said America is facing a shortage of them also.
However, changes in education could help.
Nurse practitioner Dot Behrns of Family Care Associates in Effingham said the advent of distance education is helping nurses upgrade their training to become nurse practitioners.
"We're definitely seeing more nurse practitioner students coming through," Behrns said. "Distance learning capabilities are allowing more nurses to become nurse practitioners."
Behrns said her clinic — with six doctors and five nurse practitioners — should be able to handle any influx of new patients. But she questioned whether rural counties in deep southern Illinois are in the same boat.
"We're very fortunate in Effingham in that we have a lot of primary care physicians," she said. "Southern Illinois is probably not as fortunate, because people in that area are already having to travel quite a bit for health care."
Kowalski said yet another factor leading to a physician shortage is the increasing amount of time that doctors have to spend away from their patients, including paperwork and regulatory matters.
"When I first moved here in 1997, I spent 20 percent of my time on non-patient care issues," he said. "Now it's closer to 50 percent."