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Penn Medicine, one of the nation’s largest family medicine practices, announced Monday that it is planning to close its doors in 2019 after almost a decade of being in business.

The Pennsylvania Medical Society and the American Medical Association had previously said they supported a deal between the two sides to stay open, but the new plan would require the doctors to give up a large portion of their medical practice and the services they provide to patients, which is a departure from past agreements.

The agreement also includes a $300 million commitment to retire 10,000 to 15,000 members of the staff.

“We are very disappointed by the decision by the Philadelphia Board of Medicine, which we have been supportive of,” Penn Medicine CEO Andrew N. Schwartz said in a statement.

“We appreciate the support of the Philadelphia community and our physicians.

We have been working closely with our members and their families and we remain committed to continuing to do so.

We will work with the Board to reach a resolution that provides us with the resources we need to continue to provide quality care.”

Schwartz said the medical center, which has more than 4,000 patients, has plans to relocate to another state.

The hospital had planned to stay in Pennsylvania for years, but this year, the state legislature passed a law that allowed it to stay and operate.

In 2018, the medical group said it would be shutting down for the rest of 2019.

But in a letter to patients and patients’ families, Schwartz said he could not commit to a date for the closing.

“The future of our family medicine practice and its patients is in question,” he wrote.

“While we are saddened to be closing our doors for the remainder of 2019, we are committed to working together to address the challenges facing the family medicine community.”

The move follows an announcement last month that the American College of Rheumatology and the Rheumatic Diseases Society of America would be stepping up efforts to expand access to family medicine services.

The new organizations, which will be known as the American Rheumatism Society and Rheology Society of the American Academy of Rhetoric, will meet in early 2019.

The move comes amid a wave of closures and retirements across the country as hospitals are grappling with a shortage of patients.

Earlier this month, Anthem announced it was closing three of its primary care centers and was closing seven hospitals in Pennsylvania, Maryland, Ohio, Virginia and New Jersey.