New rankings offer advice on best states in which to practice

U.S. roadmap

Texas, Idaho, Mississippi, Utah and Georgia topped a new list of best states in which to practice medicine, with Ohio, West Virginia, Maine, Minnesota and Illinois ranking worst.

The rankings, published by Physicians Practice, rely on a combination of residency retention rates, malpractice award metrics, Medicare’s Geographic Practice Cost Index and physician density, as well as socioeconomic factors such as cost of living and tax burden. The publication admits it does not take into account less-tangible factors that affect quality of life, such as sense of community, cultural values or geographic variation.

Nevertheless, “small-town camaraderie” was one of the major features that drew Lloyd Van Winkle, M.D., to Castroville, Texas, where he practices family medicine, according to the article. “I know everybody, so I know when they have diabetes and buy an ice cream at the grocery store,” he says. While Texas took the top spot for its high rating on most of the publication’s criteria, its malpractice payouts ranked in the bottom third of states.

The article also notes that the state’s low physician density, combined with its size, can make it difficult for patients in rural areas to locate a physician, an issue common among the top five states. In Idaho, the relative lack of physicians represents a double-edged sword, according to Zachary Warnock, M.D., a family physician at Intermountain Medical Clinic. “We obviously need more people to provide for the needs of patients and the population in Idaho,” he says.

Among states at the bottom of the list, the common thread tended to be a poor showing on financial metrics, including cost of living, tax burden and malpractice payouts. This year’s ranking focused less on high physician density, which moved states with generally wealthier populations and a high physician density out of the bottom places, which the publication believes “more accurately represents overall negative practice conditions for physicians.”