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Dr. Reed Wilson operates his private practice in a city famous for its extravagance and nip/tuck reputation.

But despite his Beverly Hills, 90210 address and his proximity to specialists who use scalpels and Botox to break the spell of aging, Wilson and other primary care physicians from Los Angeles and beyond are fighting to preserve the heart of their profession. It is a challenge in today's health care landscape for primary care doctors, Wilson and other say.

They are traditionally the first in line to treat a patient and their numbers are declining.

"When we look out at our patients, we wonder who's going to care for them," said Wilson, president of the 200 member group Private Practice Doctors, which helps to support those who run their own business.

"Young people don't want to go into primary care," he said. "Our system rewards those for doing procedures, not thought process."

The nation needs at least 40,000 new primary care doctors in the next seven years to fill in what some say is an anticipated shortage of physicians

In California, 42 of the state's 58 counties have less than 60 to 80 primary care physicians per 100,000 population, according to a report released last year by the Association of American Medical Colleges.

Of all active physicians in the state, 67 percent reported being non-primary care physicians.

About 25 percent of medical school graduates go into primary care, and most of those end up working for large health systems, Wilson and others say.

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