One of the lesser-known consequences of health care reform in the US is a massive consolidation of doctors. Former private practice physicians are getting sucked into hospitals or networks of affiliated practices and hospitals. Beyond hospital recruiting, uncertainty about the health care market, lower insurance and Medicare payments, and malpractice premiums have driven many private practices to consolidate and change the way doctors are paid. Last year, 64% of doctors' job offers, placed through firm Merritt Hawkins, involved hospital employment, which is typically salaried, versus just 11% in 2004. Another physician recruitment firm estimates that the number of private practice sales has increased by as much as 40% in recent years.