(Bloomberg) — The Obama administration's push to transform the way the United States pays for health care is splitting the medical profession, as family doctors embrace changes that oncologists, neurologists and other specialists are concerned will cause turmoil.

The government set a timetable last week to extinguish Medicare's "fee-for-service" system, which rewards the quantity of care over quality. That's adding to pressure on physicians who have been debating whether to join their local hospital, merge their practices into ever-bigger groups or get out of medicine.

Specialists warn that patients in some areas of the country may have difficulty finding their services as small, rural practices close and the doctors join larger companies. Just 35 percent of physicians described their practices as independent in a 2014 survey, down from 62 percent in 2008, according to the Physicians Foundation, a nonprofit advocacy group for the profession.

"You're really losing ready access in many parts of the country that are rural," said Bruce Sigsbee, a neurologist who works for a hospital system in Rockport, Maine. He is the immediate past president of the American Academy of Neurology. "There does seem to be a perceived push for people to leave independent practice by these policies."

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