Healthcare reform will usher in a new era of medicine in which physicians will largely cease to operate as full-time, independent, private practitioners accepting third party payments. Instead, they will work as employees, as part-timers, as administrators, in cash-only "concierge" practices, or they will walk away from medicine altogether.

These are some of the findings of a new report commissioned by The Physicians Foundation entitled "Health Reform and the Decline of Physician Private Practice". The report outlines provisions in the Patient Protection and Affordable Care Act and examines economic, demographic and other forces impacting the way doctors structure their practices and deliver care.

The report offers a road map for where medical practice is headed in the post-reform era, says Lou Goodman, PhD, president of The Physicians Foundation and chief executive officer of the Texas Medical Association.

"The private practice physician is rapidly disappearing," Goodman notes. "Both market forces and the health care reform law are forcing physicians to find new ways of running a practice. We are extremely concerned about how this will affect patient care."