The Royal College of GPs says Northern Ireland’s primary care system is at risk of complete destabilisation.
It’s understood 30 GP practices are on the brink of handing back their contracts.
Thirteen have already done so in the last 12 months, which is an unprecedented number.
Dr Ursula Mason, RCGP Chair in Northern Ireland, told UTV a domino effect could take hold.
“Certainly in Northern Ireland we are at risk of complete destabilisation," Dr Mason said. "So if we have many more contract hand backs we will find ourselves in that situation."
There are 320 practices in Northern Ireland and 25% of GPs are aged 55 or over.
But primary care is struggling from a recruitment and workforce crisis.
There are too many patients in Northern Ireland but not enough GPs to care for them - a problem which is particularly acute in Co Fermanagh.
Maple Healthcare in Lisnaskea is one of the most recent practices to hand back their contract.
It cares for 14,000 patients, many who come from four surrounding practices which have already collapsed.
Maple Healthcare was once run by eight doctors in partnership but is now down to two.
Doctor Rachel Wright says they had little choice, saying: “The workload is going up but the number of people to deliver it is going down and when you add in the extra pressure of running a business it all piles on."
The RCGP says boosting GP recruitment and retention will stabilise the situation, but says it can only happen with government funding and support.
Most patients have 90% of their healthcare needs met through primary care.
Dr Mason says losing that in any area will have catastrophic consequences.
She said: “We need to shore up support, sustain and build general practice for the future. If we do that the other parts of the system get supported as well."
Local federations of GPs have stepped in to help run some practices that have handed back contracts on a not for profit basis.
A health trust has made the unprecedented move of doing the same for another Co Tyrone practice to maintain its service.
It’s feared these are not sustainable, long term solutions with the NCGPs warning that allowing too many practices to collapse could usher in a two tier system in primary care.
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