Wade Dowell is a family physician who practices in the small town of Indianola, Miss., population 13,000, and a true native son of Mississippi. Dowell, who is also immediate past president of the Mississippi Academy of Family Physicians, says, "I have lived within 30 miles of [Indianola] my entire life, other than medical school and residency. … I like the rural setting." When he's not treating patients you might find him with a hunting rifle: he's an avid outdoorsman who thoroughly enjoys the varied opportunities for fishing and hunting along the rivers and lakes of Mississippi.
So it's clear to see that he likes practicing medicine in Mississippi. We think it is a great place to practice, too. According to Physicians Practice's annual "Best States to Practice" rankings, Mississippi places at the top of the pack in 2014, as it did last year. Alabama, Texas, and Nevada round out the top four states in the latest rankings, but that shouldn't mean they are the only desirable places to hang up a shingle. The following states also did well in our ranking: Tennessee, South Carolina, Indiana, South Dakota, Arkansas, and Oklahoma.
If you are curious about practice conditions in our top four states, or just wondering why they are so darn physician-friendly, here are the results of our 2014 analysis.
While it is hard to definitively identify the "best" places to practice, we looked at key factors that can affect a medical practice's financial health. Factors such as: cost of living, disciplinary actions taken against physicians, tax burden per capita, Medicare's Geographic Practice Cost Index (which adjusts reimbursement amounts to reflect the variation in practice costs from area to area),physician density, and malpractice award payouts per capita.
Rather than produce a purely numbers-driven ranking, we also looked at the number of times a particular state placed in the top-10 for each category, to gain an overall picture of physician-friendliness. And, as much as we would have liked to include lifestyle factors such as proximity to world-class museums, professional sports teams, skiing, or rock climbing, we realize that individual physicians have different tastes.
If your state is not highlighted here, click here to see a more in-depth view of how each state (and the District of Columbia) performs in each data category.
Nevada: the great outdoors
Nevada is a tale of two regions: the more urban, northern half of the state, which includes Reno and Carson City, and the southern, more rural half. According to Donald Farrimond, a family physician practicing in Reno and president of the Nevada Academy of Family Physicians, there is a significant shortage of primary-care physicians in the rural part of the state. That jives with our ranking, placing Nevada fifth in physician density, ranking from lowest to highest. It also makes our short list for low disciplinary actions and low malpractice payouts.
Because of the demographic differences in the state, the southern part of Nevada has a greater managed-care penetration; making it harder for physicians to negotiate contracts. However Farrimond says the picture is much rosier in northern Nevada. "I think it is a favorable place … to negotiate contracts. … They really haven't introduced capitation up here in the northern parts. So income preservation … is fairly nice."
Nevada boasts grand vistas, mountain ranges, and Lake Tahoe, essentially making it an outdoorsman's paradise; which was a big draw for Farrimond. In fact, after a year out of state following his residency, he returned to Nevada to stay. "I actually love living in Nevada," he says. "If you really enjoy rock-climbing and skiing and fishing and hunting … I don't think there could be a much better place to live."