Nurse practitioner Julie Dance closed her midwife practice and joined Women's Health Specialists in April. With the move, Dance will continue to offer midwifery care as well as obstetrics and gynecology.

After owning and operating his own practice since March 2010, Dr. Robert Barnett is also joining Women's Health Specialists, located at 2911 S. 8th Ave., in June. He, too, is returning to full scope obstetrical and gynecological care.

Dance and Barnett are part of a trend that has doctors closing their small, independent practices and consolidating offices with other health-care practitioners.

They aren't alone. In 2000, 57 percent of America's physicians were independent. By 2013, just 33 percent are, according to the American Enterprise Institute.

In addition, the number of independent physicians will decline by 5 percent a year starting in 2013, reports Accenture Health, a consulting firm.

Why is this happening?

Many say the Patient Protection and Affordable Care Act (PPACA), commonly called Obamacare, is driving the trend.

It's all about the PPACA, or Obamacare. It has so many complexities, said Wendy Steward, Women's Health Specialists administrator.

The law includes changes in privacy, coding and billing requirements. New regulations even require new terminology.

It's one of the most complex things I've ever heard of. It's changing the payment mechanism, it's changing everything we know about health care, Stewart explained.

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Health care consolidation