Trend watch: who’s making the move now and whySince Congress passed the Affordable Care Act (ACA) in 2010, doctors have been bailing out of practices posthaste. Exasperated by surging expenses, shrinking reimbursements and costly-to-cover government mandates, frustrated physicians are citing healthcare reform-related spending as a major reason for selling practices as the rollout progresses. According to a study by Jackson Healthcare, the nation’s third largest healthcare staffing agency, 12 percent of physicians who sold their practices before sweeping federal legislation became law made the change because they didn’t have appropriate resources to comply with the law and maintain a reasonable ROI. Within the last three years, the rate of physicians selling their practices for the same reason – especially now with dwindling ways to stay fiscally healthy – jumped to 30 percent. “Of those now considering selling their practices, 36 percent cite the complexity of the healthcare reform law as a reason; and 24 percent say they don’t have the resources necessary to comply with the law,” according to Jackson Healthcare’s report. “The burdens also appear to be taking physicians away from their families. They want better work-life balance, with less time working and more time in their private lives. Forty-three percent feel employment, rather than ownership, will give them that balance.”Even though no statistical differential denotes the type of physicians who want to remain in private practice versus those actively marketing their practice, nearly half actively seeking to sell are internal medicine subspecialists (23 percent), primary care physicians (14 percent) and surgeons (12 percent). Of those internal medicine subspecialists, 23 percent are otolaryngologists, 17 percent are urologists, and 13 percent are cardiologists. Reimbursement cuts (79 percent) and the cost of maintaining a practice (64 percent) were the most commonly cited reasons among internal medicine subspecialists who want to sell; 57 percent also pointed to the complexities of healthcare reform as a reason for selling, cited the report. Three of four surgeons marketing their practices said reimbursement cuts and healthcare law complexities were contributing factors in the decision to sell. Not surprisingly, hospitals and health systems are acquiring most physician practices (52 percent). Interestingly, solo practitioners accounted for 19 percent of physician practice buys, while physician-owned groups made 18 percent of group acquisitions. Ten percent of doctors who sold their practices listed their buyer as “other.”Even though physicians are leaving the ownership aspect of private practice, most aren’t departing the practice of medicine. Only 9 percent sold their practices because they wanted to retire; 6 percent sold because they wanted to leave the practice of medicine. “Physicians in private practice still outnumber those employed, but this could be shifting as less than half of the respondents with an ownership stake say they plan to remain in private practice,” according to the report. The last cycle of hospitals snapping up private practices occurred in the 1990s, when hospitals saw the acquisitions as a way of gaining access to more patients. As a result, physicians got sweet deals. But in this buying cycle, the deals aren’t as financially rewarding. Yet the circumstances provide a way for private practice doctors to step out of time-consuming administrative roles while also appreciating a steady income and sometimes improved hours as employees. A post-sale downside that impacts physicians to widely varying degrees: adjusting to the loss of autonomy. Simply put, the private practice model has become very expensive to operate, John Dubis, CEO of St. Elizabeth Healthcare in Cincinnati, Ohio, explained to CNN Money. “That's why it's diminishing,” he said, noting that most of the 300 physicians employed by the hospital's specialty physicians group were plucked from private practices. In December 2012, Montana-based St. Vincent Healthcare acquired Frontier Cancer Center, established in 1982. The close-knit group of five oncologists had struggled financially pre-healthcare reform, taking a significant hit in 2003, when Medicare changed the way it reimbursed doctors for chemotherapy drugs. Despite taking significant pay cuts, the group closed one of its four locations in 2008. With the dark cloud of bankruptcy looming, the group was happy to find a buyer.  “We have a joke,” said Patrick Cobb, MD, an oncologist in the Frontier group told CNN Money, “that there are two kinds of private practices left in America: those that sold to hospitals and those that are about to be sold.” In a companion survey released by Jackson & Coker, a subsidiary of Jackson Healthcare, a majority of doctors want to see ACA defunded or repealed. A scant 6 percent said it should remain unchanged. “The more physicians learn about ACA, the more they dislike it and want to start over,” said Richard L. Jackson, chairman and CEO of Jackson Healthcare.