What states are best for physicians' careers, wallets?

Location makes all the difference, not just in real estate, but with physician recruitment. While lifestyle factors, such as proximity to cities or natural attractions, play an important role, the editors at Physicians Practice contend that a region's tax burden, Medicare rate, physician density and malpractice award payouts make an even bigger impact on a physician's practice life. Thus, the publication's annual Best States to Practice Report focuses on these "hard, comparable facts."

This year's best states to practice, according to the report, are Idaho, Alabama, Texas, Nevada and South Carolina. Idaho, which ranked number one for the second year in a row, touts low cost of living, low physician density and a relatively physician-friendly malpractice climate. "Along with its low cost of living, Idaho has a climate of physician independence that makes working there great for doctors," Bob Keaveney, editorial director of Physicians Practice, said in an announcement.

"We're less penetrated by managed care so I think physicians have a good degree of personal autonomy and individuality in terms of practice style," noted U.S. Army physician Ted Epperly, who practiced in several states before settling in Idaho, in the report. Because fewer doctors practice in the state, physicians also can enjoy their full scope of practice, Epperly said.

But with cultural attractions not factored into the rankings, popular vacation destinations, such as New York, Washington, D.C., and Hawaii, landed among the worst places to practice. "The financial issues involved in being in practice in New York are very, very complex, and it requires a lot of effort just to keep your head above water," said physician Steven Shapiro, who relocated from New York to Mississippi 17 years ago, in the report. "I feel that practicing in Mississippi has definitely prolonged my career," he added. "I don't know that I would still want to be actively involved in practice if I stayed in New York all of these years--I probably would not."

To learn more:
- read the report from Physicians Practice
- see the announcement