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Previously, we talked about some of the best states for an MD to go and start practicing in. Which got me thinking of the inverse.
Are there any states I would avoid working in? Turns out, yes. Some states are absolutely the worst for doctors who are actively practicing in the field or even those just starting out.
This could be due to a variety of factors, ranging from heavy taxes to meager income and even just plain competition. That’s why choosing a state that fits your needs is so important, especially early on in your career. It plays a huge role in how your professional and personal life will pan out.
But choosing the wrong state? Well, that could set you back years. This is why we’ve compiled a list of the worst states for MDs to practice in and why exactly you need to avoid them like the plague! Today, we’ll discuss the following:
- What makes for a ‘bad state to practice in’
- States you need to avoid for your career
Read More:
- Highest Paid Specialties For Doctors
- Best States To Retire: Fixed Income Edition
- Best States To Retire: Pension Edition
The Criteria
So, maybe the whole ‘worst state’ thing sounds like an exaggeration but ‘states that are not as conducive to physician well-being than others’ just doesn’t roll off the tongue as well. But the truth is, some states just don’t help doctors settle the way others do.
It’s why the way we choose which state is worse than the other is based on issues that aren’t just career-based, but also factor in day-to-day life. So, here’s the system we’re going by:
Exploitative salary and work environment
This is a no-brainer. No one is going to go into student debt only to become a doctor in a state that doesn’t even pay $150,000 per annum.
While doctors do earn on the higher end of the spectrum, not all states give incentives that justify the work put in. Some states have awful finances when it comes to healthcare, with salaries on the lower end and barely any bonuses.
Not to mention the pressure of being overworked in an environment that underpays you. That’s the fastest route to burnout.
Heavy Taxes
Taxes are a huge problem in many states, but I feel like physicians get the worst of it.
Doctors might earn in the higher tax bracket, but it’s ridiculous just how much we have to spend before we start earning any of it back. Moving to a state with horrible tax policies only makes it that much harder.
I’m talking about states that enforce exorbitant state income taxes, additional sales tax on groceries, and more.
I mean, we already have the infamous 3% pay cut being discussed by the CMS. Our salaries are decreasing, so moving to a state with even higher taxes? That’s a death sentence right there. While you can justify paying more on taxes well into your career because it doesn’t make that big of a difference at that point, young doctors still need to be wary.
This is keeping in mind that a physician’s work is one of the most grueling and intense jobs out there, and we’re rarely compensated for our worth, especially when starting out.
Physician Density
What’s the point of going to practice somewhere where job vacancies are non-existent? Or worse, where there are too many jobs because the patient intake is too much to handle?
Physician density matters both ways here. Going to a state with too many doctors per capita leads to unnecessary competition between them, because who wants to let their practice go empty?
On the other hand, fewer physicians per capita means that a single doctor is under more pressure to deal with more patients than they can realistically handle.
Sure, the U.S. is diving head-first into a physician shortage, but there has to be a balance.
Terrible Living Conditions
Let’s say a state promises you your dream salary, a great work environment, a relaxed tax policy and the job market also looks good. None of that matters if you can’t afford a good quality of life in said state.
The cost of living and quality of living are both important here. And there are so many states that are unable to deliver on one or both. Either the cost of living is so high that, no matter how much you make, it just doesn’t last as long. Or the quality of life is so terrible that you’d rather move than stay there any longer.
The Worst Offender States
Now, with our system in mind, here are the top 5 states that we believe are the worst for MDs to practice in.
1. Maryland
If the rest of the country has too few doctors, Maryland has too many. And that high physician density makes Maryland so unattractive for physicians.
Amongst other things, of course. Maryland is the third worst state regarding job opportunities and ranks in the bottom 10 for its harsh work environment. It’s also just costly to practice medicine in, especially when you factor in absurdly expensive malpractice insurance.
Let’s not forget that Maryland has a high cost of living. But despite all the money you’re spending to live there? Security is a huge problem, with Maryland having the 8th highest crime rate in the US.
2. New York
New York, particularly its largest city, New York City, is renowned for its high cost of living. Although the Big Apple may seem glamorous from a distance, the underlying challenges, especially for practicing physicians, are becoming increasingly apparent.
New York is actually considered the second-worst state for doctors, thanks to its incomprehensible cost of living. That’s no surprise. New York is infamous for its housing and rental costs, which have skyrocketed in recent years. Even if it does pay physicians well, living in New York itself is nearly impossible to manage.
Malpractice insurance is also equally expensive, making New York a not-so-great state for physicians.
3. District of Columbia
You’d think the Capitol would have better conditions for physicians to thrive. But it’s the opposite.
Washington has one of the highest malpractice premiums in the country, and it is also an expensive state to live in. The average salary for physicians does not justify the exorbitant cost of living. However, because of its diverse community and quality of life, it has attracted quite a few doctors.
This has led to the problem of physician density, with competition rising in the most sought after districts. .
4. Connecticut
For all its small-town charm, Connecticut does not qualify as a state in which physicians can settle.
For one thing, it is riddled with high taxes. Income tax, property tax, and even gasoline cost way more than acceptable in Connecticut, making it the 8th most expensive state in the country. Its physician density also leads to one of the most shocking rates of burnout, with 61% of doctors reporting mental exhaustion.
And no wonder doctors are depressed there. Imagine living in one of the most expensive states with a pay that ranks lower than physician salaries.
5. California
Don’t let LA’s glamor fool you. California is not the place to be if you’re looking to get serious about your career in medicine.
California has great weather, but that means everyone wants to live there, which has caused housing costs to go through the roof. So, the ‘Sunshine Tax’ is a real thing, along with many other taxes, because California just loves to tax everything. Physicians pay a reported 10% in state income tax.
And how should a physician accumulate any savings between the high transportation costs and the even higher cost of living?
Final Thoughts
It’s true that some states are worse off than others when it comes to practicing medicine. But that doesn’t mean those states have zero doctors that actually like working there. Opinion varies across the board, and what works for some might not work for the majority.
It’s why we looked at the broader picture, to paint an idea of what basics you do need as a medical graduate entering the workforce.
Still, if you are stuck in one of the states here, don’t despair too much. Others made it work, and so will you!
13 thoughts on “Worst States For MDs To Practice In”
Very funny article. I guess vast majority of American doctors practice in New York and California and in other bad states, and by some obscure reasons do not run out of there to Montana, North Dakota and New Mexico. I wonder why.
Yes, wonder why? Culture, academia, interesting cases, ..being with progressive like minded people.
Yes, and apparently the authors of this article have NO interests in women’s healthcare or they would understand that the more than 20 states with abortion bans are incredibly obstructive to the practice of obstetrics and gynecology. How many doctors want to be forced to watch women experience completely avoidable death or permanent injury . If money is the only factor in where you practice you probably don’t belong in medicine anyway.
I’m with you. This is hilarious. They actually wrote that the worst states have the highest density. I wonder if the editors didn’t stop to think “hmmm?”. I live in Maryland and don’t even want to retire in those other states.
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Interesting article. I work in the southeast and, given the competitive salaries and lower cost of living, I can see why it missed the list. Still, it’s all about what you are willing to pay for and what you consider quality of life. For some, making less and living in a state with better schools for their children or access to specific job opportunities is more important. By the way, someone should inform the writer that D.C. is NOT one of the 50 states in the U.S. I wonder which state would have otherwise made the list.
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This article appears to be quite misinformed and overly generalized in its assessment of states for medical practice. Its portrayal of New York, for instance, fails to consider the many advantages and opportunities the state offers to physicians, particularly in urban areas. More importantly, the article completely overlooks a critical factor for OBGYNs – state laws regarding reproductive healthcare. States with restrictive abortion laws or limited reproductive health services should arguably top any list of places for OBGYNs to avoid, yet this crucial consideration is entirely absent from the analysis.
I agree, and will add that for New York, Dr. Sanchez appears to assume that the entire state is New York City. I’ve practiced in Rochester for 34 years and been very happy here, but can’t imagine living or practicing in NYC–they’re entirely different worlds. Dr. Sanchez makes sweeping generalizations based on limited criteria, not considering that a location that may be unacceptable for one may be considered highly desirable for another. While NYC would not be to my liking, there appears to be no shortage of doctors who DO want to live and work there despite Dr. Sanchez’s labeling it the second-worst place in the country for physicians.
This is a great point. I practice gyn/family planning and am very happy to be practicing in New York City.
Agree. The article is superficial and appears to have been written with “help” from AI.
I think when you said Washington, you meant Washington DC right, not Washington state? I would assume Washington state is actually one of the better places to work given no state income tax.
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