This shift is having a domino effect on patients who are being left out in the cold.
Chandler Francis is a patient at Raleigh Family Physicians. At least she was a patient, until the office went bankrupt and her doctor was no longer there.
"I really don't know what to do. I don't know where to turn," Francis said. "This has been my doctor for six or seven years and all of a sudden, I can't even talk to him."
Chandler is among 60,000 patients affected by the bankruptcy of North Carolina Medical Associates. Some 20 doctors at four clinics have stopped working because their practice management company has not paid their salaries in three months.
The North Carolina Medical Associates is not the only doctor's group having problems. At the Lakewood Family Clinic in Durham, doctors walked off the job in July in a dispute with their practice management group.
The North Carolina Medical Societysays more and more doctors are turning to management companies to handle the increasing paperwork associated with health insurance.
The problem is that even the management companies are finding it hard to reimburse the doctors for services.
"They'll file a claim, it'll come back, it'll get lost, and months can go by before they actually get paid for a service they've provided," said Sandy van der Vaart of the North Carolina Medical Society.
The management companies in question are promising to keep the offices open by hiring new doctors. Patients who choose to change doctors have a right to obtain a copy of their records for a fee, which is up to 50 cents per page or a $10 minimum fee. The companies will also forward records to the patient's new doctor.
Patients can get a copy of their medical records at any time by asking their doctor.