Many have focused on how the current healthcare payment system is helping create shortages among primary-care doctors, internists and others on the front lines of medicine. But often lost is how the system is endangering some of the country's most highly trained specialties, such as endocrinologists, rheumatologists and pulmonologists. These specialties, which don't involve performing many procedures, face acute shortages. Critics say the decrease in specialists can hurt patients in need of proper diagnosis and treatment.