The 10 worst states for physicians in 2026

For all the talk about physician shortages, some states make it more difficult than others for doctors to build a sustainable, rewarding career.

WalletHub's 2026 Best & Worst States for Doctors ranking, which evaluates all 50 states and the District of Columbia across 19 metrics, finds that several of the nation's most prominent medical markets are among the least hospitable for practicing physicians.

The 19 metrics were categorized into two main categories: Opportunity & Competition and Medical Environment.

Opportunity & Competition, which carries 70% of the total weight, measures the financial and market conditions physicians face in a given state, including cost-of-living-adjusted wages, starting salaries, hospitals per capita, insurance coverage rates, projected physician supply through 2032, medical resident retention and continuing medical education (CME) requirements.

Medical Environment, which accounts for the remaining 30%, evaluates the clinical and regulatory landscape, factoring in public hospital quality and safety grades, state medical board punitiveness, malpractice insurance costs and lawsuit payouts, physician assistant staffing levels, accredited health departments and physician burnout rates.

The bottom of the list is dominated by states and jurisdictions where high costs of living erode what appear to be competitive salaries on paper, where malpractice insurance and lawsuit payouts run well above the national norm and where an oversupply of physicians creates intense competition for patients and positions. The best state for doctors scored 66.15 out of 100 in WalletHub's methodology. The worst scored 43.89.

Here are the 10 worst states, including Washington, D.C., for practicing physicians in 2026.