An increasing number of U.S. doctors are expected to leave private practice for hospital employment over the next 18 months, due to rising costs and technology mandates, according to a new report from Accenture.

By the end of 2013, the consulting firm estimates, one in three doctors remaining independent will offer patients with subscription-based services, such as telemedicine or online consultations, for sustaining profit—a trend that is expected to increase three-fold over the next three years.

Over the past decade, the number of independent U.S. physicians has dropped dramatically, from 57 percent in 2000 to 39 percent in 2012. By the end of 2013, Accenture predicts this number likely will drop further, to 36 percent.

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The main reason for this—as cited by 87 percent of physicians surveyed—is the cost and expense of running a business. Most doctors (65 percent) joining health systems said they expect to make the same or even less compensation than in private practice.

More than half of doctors (53 percent) cited electronic medical record requirements as a main reason for leaving private practice. Though electronic health records are often seen as one solution to the problems in our health care industry, reports have repeatedly reported that doctors have trouble with them, and aren't ready for them.

Accenture is the latest organization to to address the uncertain future of U.S. physicians. Last month, research from The Physicians Foundation found that if physician practice trends continue as is, more than 44,000 physicians will be lost from the workforce in the next four years.

"More independent physicians are offering subscription-based services as a way for patients to customize their care experience," says Kaveh Safavi, a doctor who leads Accenture's North America health industry. "Meanwhile, patients appreciate the opportunity to supplement their existing coverage with premium, subscription-based services, such as same-day appointments and online prescription refills."

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