Each year Physicians Practice assesses practice conditions across the United States, in search of the best states to practice. We reach out to both public and private organizations to assemble objective datasets that we think are indicative of favorable practice conditions for physicians. Then we whittle our list down to the top five states — no small task, as there is such diversity and breadth of opportunities represented in our nation.
This year for our analysis we changed up the data just a bit. Rather than use physician disciplinary actions by state, we substituted that metric with residency retention rates (the percentage of physicians who chose to stay and practice in the state where they trained, two to 12 years post-residency). The other five state metrics are the same as last year (bit.ly/beststates-2015), with updated data: cost of living, physician density, tax burden per capita, malpractice paid loss (the amount paid in malpractice awards per state), and Medicare's Geographic Practice Cost Index (which adjusts physician reimbursement based on regional variation in the cost to treat patients). Together they paint an economic, regulatory and operational overview of practice conditions for each of the 50 states and the District of Columbia.
Of course, this doesn't account for geographic variation, sense of community, local values, or access to cultural and educational institutions. For that, you might ask your fellow physician where he or she feels most at home. Or you can read the following profiles for the physicians who hail from this year's top-five Best States to Practice: Texas, Idaho, Mississippi, Utah, and Georgia.
*If your state is not highlighted here, find out how it measures up by visiting our Best States to Practice Interactive Map at bit.ly/beststates-map.
What states were the worst. Click on the last page for the answer!
TEXAS — the Lone Star State
State Motto: Friendship
Lloyd Van Winkle has practiced family medicine in Castroville, Texas — a small town of 3,800 people, 25 miles from San Antonio — for over 30 years. Van Winkle, who grew up in the state, did his undergraduate training, medical school, and residency in Texas. He says the small-town camaraderie was one of the key draws that kept him in Texas. "Well I know everybody," he says. "So I know when they have diabetes and buy an ice cream at the grocery store, I know it. It's a nice experience to be in a small town. To have that kind of connection with your patients."
Van Winkle also appreciates the climate in Texas, noting, "In December when we are on the back porch barbecuing my brother says, 'You know what people in Minnesota are thinking about right now? Doing this next summer.'"
Because of a low physician density, low cost of living, reasonable tax burden, and high residency retention rate, Texas made the top of our list for the best states to practice. The only sour note was malpractice payouts, which ranked in the bottom-third of our analysis.
Since it is a large state, patients can sometimes have trouble finding a physician, especially in remote areas. Van Winkle says he practices in an underserved area federally designated as a Health Professional Shortage Area (HPSA). However, that can be a bonus for family physicians who are interested in a well-rounded scope of practice. Van Winkle says he delivered 688 babies before he got tired of the 3 a.m. wake-up calls.
Texas is very primary-care friendly, according to Van Winkle, who was past president of the Texas Academy of Family Physicians and former board member for the American Academy of Family Physicians. Because of the large number of family physicians practicing in Texas, he says, "A lot of healthcare in Texas is primary-care driven," rather than specialty directed.