A dearth of specialists available to low-income patients presents one of the bigger hurdles facing the country as it tries to bring spiraling healthcare costs under control. Doctors say meeting new government mandates to keep patients healthy and out of hospitals—a linchpin in reducing medical spending—will be virtually impossible without the ability to make timely patient appointments with specialists. By the end of the decade, the nation will be short more than 46,000 surgeons and specialists, a nearly tenfold increase from 2010, according to the Assn. of American Medical Colleges. Healthcare reform is expected to worsen the problem as more patients—many with complex and deferred health needs—become insured and seek specialized treatment.