Lovelace faces a huge battle on the money and political experience front. A successful campaign is expected to cost at least $6 million and Sanford already has raised about half that amount.
Sanford served three terms in the U.S. House before he ran for governor as a political outsider and unseated Democrat Jim Hodges in 2002. Lovelace has no political experience apart from serving as student body president at Clemson University, where he graduated in 1981.
Lovelace says he had a "eureka moment" that prompted him to run. While the state has an elected education superintended tending to public schools and an elected adjutant general charged with security issues, there's no one taking a statewide role leading medical issues, he said.
When people are asked what their most important asset is, "they don't say 'The road in front of my house.' They say, 'My health,'" Lovelace said.
Lovelace led a panel along with former Gov. James Edwards that looked at the state's top health concerns. Among other things, the panel recommended raising the state's cigarette tax, linking Medicaid patients to doctors much like private insurance plans and limiting medical malpractice lawsuits.
Lovelace, who runs a small, rural family practice, sees himself as more in touch with people than Sanford.
"This is a battle of ideas. I'm taking a step in faith by running for political office. I'm not wealthy. I don't have a trust fund to bank on. ... I'm trusting that if God desires for these ideas to survive, the people of South Carolina will support me," Lovelace said.
Sanford also hasn't worked well with legislators on key issues, Lovelace said.
"I think you have to question some of the tactics that have occurred in these last two years," including bringing pigs to the door of the House's chambers, Lovelace said.
"I won't bringing any livestock from the farm," he said. "You've got to be able to somehow work together with people."
Lovelace, 45, is married and has three sons and a daughter. He's a 1987 graduate of the Medical University of South Carolina and did his residency work at the University of Virginia. Sanford earned his master's degree in business administration from that UVA's Darden School of Business.
Lovelace said he talked with Edwards, a Charleston dentist, about running. Edwards didn't discourage him, he said. However, he underscored, the fundraising needs.
And there's a greater need - visibility for a political unknown.
"In the horse-race coverage, this is not a huge blip," Winthrop University political science professor Scott Huffmon said.
Still, Sanford is "going to have to defend a lot of his action and ideas against someone in his own party," Huffmon said.
There is some good news, however. With a primary challenger, Sanford would be able to double dip on campaign contributions, raising money for a primary contest and the general election.
Last month, Sen. Tommy Moore of Clearwater became the first Democrat to announce his candidacy for governor.