For several years, the medical industry has been facing a major shift from private to group practices. Privately owned practices are increasingly giving way to group practices directed by larger corporations or to new providers aiming to offer services directly to patients — and primary care physicians are leading the trend.

There are several reasons why this shift is occurring; these include decreased profitability, operational challenges arising from reform efforts, and a drive for efficiency. Declining reimbursements and an increase in time spent on administration — not to mention the expense of integrating and maintaining electronic systems — are making the private practice less viable. But there are also larger market forces at play.