Journal of Medicine - Physician business models are transforming, with a sustained shift away from independent practice, according to report released by the consulting firm Accenture.

Kristin Ficery, from Accenture Health Strategy in Atlanta, and colleagues conducted a survey of 204 physicians equally split between primary care and specialty practices. Physicians were geographically distributed across the United States. According to the report, private practice doctors have increasingly sought employment, leaving independent practice. The number of independent physicians has dropped from 57 percent in 2000 to 39 percent in 2012. It is estimated that by the end of 2013 the market of independent physicians will decline further to 36 percent. One of the main reasons for physicians seeking employment is the cost and expense of running a business, cited by 87 percent of independent physicians surveyed. Other concerns causing physicians to seek employment include the prevalence of managed care (61 percent), electronic medical record requirements (53 percent), and maintaining/managing staff (53 percent). For doctors who wish to remain independent, an estimated one in three will adopt subscription-based care models, and this trend is likely to increase 100 percent per year for three years. "Accenture research shows that independent physicians continue to dwindle and that those remaining will turn to subscription-based models to sustain profits and improve care," the authors wrote.