Wondering if the grass really is greener on the other side? Trying to keep up with the Joneses? Just plain curious to see where you stand among your peers? We've got you covered.Whether you've just finishing up residency, are an established physician considering a move, or you just want to know how your state stacks up against the rest, we've gathered all the relevant information to help enlighten you.Across the country, state by state, we've looked at the key factors influencing the profitability and stability of your practice: cost-of-living rates, tax burden data, malpractice climate numbers, physician-density statistics, and more. Then, to determine the best states to practice, we've compiled that data and ranked each state according to its performance in each category. We’ve gathered here the five best-and five worst-places to be a doctor. We’ve also compiled all the data and every state (and the District of Columbia) into a handy sortable chart here.A few important notes: We didn't consider factors that are strictly lifestyle-oriented, such as weather, great restaurants, or proximity to cultural institutions. New York may have the best museums and Southern California the best weather. But you will pay dearly to live in such places, and it's the cost of living and practicing that matters for our purposes. Only you can decide the kind of lifestyle you want and what you're willing to sacrifice (financially and otherwise) to get it. Also, we do not attempt to rank the states from best to worst overall. We've identified five that are clearly among the best, five that are true stinkers, and are offering you the data necessary to make your own judgments about particular states.
Alabama helps physicians keep their money in their pockets. That's why it's included on our list this year. The Yellowhammer State has significantly below-average insurance liability premiums, the fourth-lowest tax burden per capita in the nation, and a low cost of living. It's also one of the least physician-dense states - and that creates some great perks for physicians, says family physician Beverly Jordan, who is president of the Alabama Academy of Family Physicians. "It really makes for a great practice environment where you're needed and you're appreciated for what you do," she says, adding that the relative scarcity of doctors also "makes for a great economic environment to practice in because there are incentives to keep the physician in the state." Incentives like state tax income credits for physicians practicing in rural communities, and similar medical school loan programs, she explains. As for quality of life, Jordan says don't be turned off by the term "rural." "We have access to the beach, access to lakes, and quick access to major cities," Jordan says. "It's a wonderful place to practice and gives both myself and my family a wonderful lifestyle."
Idaho: For doctors, Idaho is America's best-kept secret. With 168 physicians per 100,000 residents (compared the average rate of 271), Idaho is the nation's least physician-dense state. But that doesn't mean Idaho is a lonely place for providers. Instead, medicine in Idaho is cooperative precisely because the doctors need each other, says Boise-based family-practice resident Katie Schneider. "We rely on each other," Schneider says. "Everyone feels that community sense of working together to make the medical community as good as it can be." That united spirit among providers also makes the state a great place for recent medical school graduates like Schneider to start their careers. Idaho "is very open to training residents, and it's open to letting people into their practices, and everyone's really willing to teach," she says. "In terms of medicine it's a really great place to be trained." Another reason less is more in Idaho? Fewer physicians mean more patients per physician. Idaho physicians like Schneider - who plans to stay there upon completing her residency - will not have to scramble for patients. Idaho also ranks 12th for cost of living, 15th for tax burden, and its medical liability premiums are below average.
Mississippi: The Magnolia State is an outstanding performer in multiple data categories this year. In fact, Mississippi is one of only three states to rank in the top 10 in three categories - for low tax burden, physician density, and cost of living. In addition, the passage of tort reform in 2004 - which limited noneconomic damages in malpractice suits like it did in Texas - eased the stress of malpractice threats and liability rates in the state. But that's not why dermatologist Steven Shapiro, who spent 25 years practicing all over the country, from Brooklyn, N.Y., to California, chose to move to Mississippi 15 years ago and has practiced there ever since. Providing medical care in Mississippi is much more of a "professional endeavor than it is a job," he says, meaning that providers care more about their patients than anything else - even money. "The people here are much more involved in the care of patients, much more dedicated to the well-being of people than I noted in other locations," Shapiro says. "In my years in medicine it's probably the best place I've ever been to practice."
South Dakota: For those providers looking for more variety in their work, family physician Mary Jo Olson says her state is the place to be. South Dakota's rural nature means physicians perform a wider variety of services than they do elsewhere, says Olson, who practices in Vermillion. In fact, Olson had overseen the delivery of a baby shortly before being interviewed for this article. "I can see the babies and the children, I can see the moms and dads, I can see the grandmas and grandpas, I can do procedures," she says. "We're not just relegated to an internal medicine type of practice." You might wonder whether all that generalization leads to more medical errors. But South Dakota has some of the lowest malpractice insurance rates in the country, and its state medical board is less aggressive than most in issuing disciplinary actions. South Dakota's physicians are also very much appreciated - both on the state and the local levels. The South Dakota Physician Tuition Reimbursement Program offers qualifying family physicians a payment in return for three years of practice in a rural community. The amount of reimbursement is double the University of South Dakota School of Medicine's resident tuition for the most recent four-year period. And, Olson says, there's a great dynamic between physicians and their patients, because the patients are grateful for the work their physicians do. In South Dakota, Olson says, it's medical "practice like it should be."
Texas: The Lone Star State usually scores as one of the physician-friendliest. But this year, Texas simply shined. Across the board, in every category, Texas was near the top. In Texas, the living is cheap (fifth-lowest in the country) and the competition is slim (it ranks 10th for lowest physician density). But while Texas is certainly a comfortable place for physicians to practice, there's something else that makes it so special, says Douglas Curran, a family physician who grew up in Arkansas but has practiced in Texas for nearly 32 years. He calls it the "independent spirit" of Texas, and he says it has served him and his fellow Texas-based physicians well. "We have hassles from insurance companies, hassles from the government, hassles from everybody," Curran says, "but it just seems to be a little less in general in Texas." It's clear that other physicians agree with him. Since the passage of tort reform in 2003 - which restricted caps on noneconomic damages that malpractice plaintiffs could win in suits - about 10,000 physicians have moved to Texas, according to the Texas Medical Board. "The environment in general makes you want to be here," Curran says. "It makes it a good place to practice; it makes it a good place for me to do my job."
The Worst States to Practice: Connecticut, District of Columbia, Maryland, New Jersey, New YorkDoctors, whatever you do, don’t board that Acela train. The states in the Northeast/Mid-Atlantic corridor from the nation’s capital to Hartford are expensive places to live with high tax burdens and pricey malpractice insurance premiums. They tend to have meddlesome medical boards, too. Yet they’re densely packed with physicians - more, really, than even their thick populations require, so physicians have to compete harder against each other for patients and have less clout with their employers and with insurers. Connecticut and Washington, D.C. each ranked among the five-worst performers in five of the six data categories that Physicians Practice examines to determine its Best States to Practice. We’re impressed: It’s not easy to be that bad at, well, just about everything. Of course, there are other reasons to live in these places, and many people do so. New York City is, of course, an incomparable place; its high prices and dense traffic are reflections of its popularity, while Connecticut and New Jersey are similarly popular because of their proximity to the Big Apple. But if you’re not already living there, you ought to know what you’d be giving up for great restaurants and musical theater.