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Most and Least Physician-Friendly States


Not all states are created equal, and just like many considerations go into choosing a place to retire, the same can be said for which state a physician decides to practice medicine.

Not all states are created equal, and just like many considerations go into choosing a place to retire, the same can be said for which state a physician decides to practice medicine.

Many physicians are unhappy with the current practice environment, opting to get out of private practice in favor of employment. Every year Physicians Practice determines the best states for physicians to run a private practice based on qualitative data.

The key factors influencing which states were considered physician friendly were cost of living, disciplinary actions taken against physicians, tax burden per capita, the Medicare geographic practice cost index, physician density and malpractice award payouts per capita.

The East Coast did particularly poorly, with four of the five worst states to practice in situated in that part of the country. These states all had high physician density, high cost of living, high tax burden and expensive malpractice coverage, according to Physicians Practice. Meanwhile, the South did particularly well.

Here are the five best and five worst states to practice medicine.


5. Massachusetts

The malpractice payout amount in Massachusetts was one of the 10 highest in the country for 2012, and the payout per capita was the fourth highest at $22.75. Furthermore, Massachusetts has the second-highest physician density, behind only the District of Columbia.



4. Connecticut

Connecticut’s malpractice payout per capita of $21.01 landed it as the fifth most in the country. Plus, with the second-highest real estate taxes, living there isn’t cheap. And if you retire in Connecticut, be prepared for the state to tax your Social Security benefits.

New Haven


3. Maryland

The malpractice per capita payout of $19.40 is the seventh worst in the country. Maryland also has a lot of physician competition ranking third for density. Physicians will be happy to know, however, that Maryland has the third-best medication adherence in the country.



2. Hawaii

Malpractice isn’t such a huge issue in Hawaii, which lands roughly in the middle of the pack, but Hawaii has the highest cost of living in the country. Also, if you’re planning to have a family, Hawaii is the seventh-most expensive state to raise a child. One good thing, though, is the Hawaii is the least stressed state.



1. New York

Malpractice payouts per capita in New York were $39, which is far greater than second-place Pennsylvania’s $24.77. Plus, according to data from Diederich Healthcare, New York had the largest overall payouts in 2012 with $763 million. On top of that, New York has the worst local and state tax burden in the country, according to The Tax Foundation.

Tribeca, New York City


5. Tennessee

While Tennessee has many rural areas with poor populations, it “also boasts preeminent medical centers like Vanderbilt University,” according to Physicians Practice. Plus, the state has a lower-than-average cost of living, making it one of the top cities to live in during medical school.

Tennessee also landed in the top quartile for lowest malpractice awards payouts per capita.



4. Texas

Although Texas is the second largest state in the U.S., it has a lot of rural communities and low physician density, which could be a blessing or a curse depending on what you’re looking for in your practice. Texas ranks first in lowest malpractice award payouts per capita.

Plus, residents will get the best bang for their buck in Texas with median home prices of $189,900, income around the national average, no income tax and a low cost of living.

San Antonio


3. Alabama

According to Physicians Practice, Alabama has solid doctor-patient relationships since the state has little managed care. Plus, physicians considering moving there will be happy to know that Alabama has low physician density, minimal tax burden and low rates of malpractice award payouts per capita. However, Alabama is one of 12 states that forbids a cap on medical malpractice awards.

The state’s cost of living is well below the national average and the median home price is just $164,900 — in fact Mobile is one of the least expensive housing markets in the country.



2. Nevada

Two-thirds of Nevada’s population lives in or near the Las Vegas metropolitan area, which must be trying on residents’ finances as they are the most financially unstable people in the country.

However, for physicians, Nevada is near the top of the pack for low physician density, low disciplinary actions and low malpractice award payouts per capita. Plus, it has the third-best tax climate with no income tax.

Las Vegas Strip


1. Mississippi

According to Physicians Practice, Mississippi was the only state to rank in the top 20% in four out of six data categories — it ranked first for both low physician density and low tax burden, and fourth for the lowest medical malpractice payouts per capita.

Plus, for physicians considering moving to Mississippi, two cities — Natchez and Jackson — were named among America’s friendliest cities.

Mississippi also has a large population of low-income residents, had the fourth largest increase in obesity from 2000 to 2011 and physicians running a business might not like to know that Mississippi’s residents are the third most financially unstable.


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Victor J. Dzau, MD, gives expert advice
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