Best state to be a Psychiatrist

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SMC123

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What are the best states to practice psych in regards to taxes, medical coverage, patients, physician density, etc.? I've read the Medscape report but I figure I would ask in a more Psych specific group.

Also, in terms of residency, do most residents end up practicing where they do their residency? Do you form ties with the community that will help going into a full fledge practice?
 
SMC123 said:
in terms of residency, do most residents end up practicing where they do their residency? Do you form ties with the community that will help going into a full fledge practice?
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the AAMC publishes studies about this. i forget the name but if you browse their studies i'm sure you'll find it. in my state, i think it's about 50% of residents stay in the state where they do their residency. if they also went to medical school here then it's like 60% who stay. if they went to medical school here but not residency it's something like 40%. i bet it changes from state to state!
 
SMC123 said:
Also, in terms of residency, do most residents end up practicing where they do their residency? Do you form ties with the community that will help going into a full fledge practice?
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Yes and yes.

I seem to remember a stat that 70% or some such of psychiatrists ending up practicing within a certain distance if where they did residency. This doesn't mean you have to, obviously, and many people likely choose a residency at least in part based on their desire to live in an area. But going to a residency in an area you hope to build a practice is a big help. You have a built in referral network that you will never have otherwise that will help for the lifetime of your career. Even if I don't know a doc in the community, I am more comfortable referring a patient to him/her than someone from another program because I'm familiar with the first's level of training. You can open a practice anywhere, but doing so near where you went to residency (assuming you are good) is much easier.

No clue on the best state to practice as n of one and no interest in moving...
 
not florida illinois or cali I hear either. .texas is high up there
 
digitlnoize said:
What's wrong with Florida? I have a few psych friends practicing there that love it...
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Humidity, sink holes, mosquitoes, and the tallest mountain is the Miami dump. I’m sure every state can be made fun of, but Florida does have some easy targets. On the other hand, no state taxes, South Beach, Joe’s crab shack, art deco,…
 
whats the take on the midwest? michigan? or a little east such as Pennsylvania?
 
SMC123 said:
whats the take on the midwest? michigan? or a little east such as Pennsylvania?
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I've never seen a psychiatrist complain about the Midwest. We don't have the "no state tax" thing going for us in Missouri, but St. Louis gives you the wonderful combination of relatively high income (see the Medscape salary survey), low cost of living, benign traffic, friendly Midwestern atmosphere, etc. In most fields, people get paid less in St. Louis because of those added benefits... for some reason, medicine is different and the Midwest pays especially well.

We can't compete with the lack of state tax in TX/FL, although they have lower earnings according to the Medscape report.

St. Louis and Kansas City are the only two major cities in the "north central" geographic area, which has the highest income after California (where you have to adjust for significantly higher cost-of-living). Both of those cities are in Missouri. They are also both as inexpensive as any major city in the US. And they both have 2 major academic medical centers if that's a major concern for you, as well as another one that's halfway in between the two cities.

So if you're determining "best state" based largely on standard of living (from a financial perspective, with the assumption that you want to live in a decent-sized city), I think Missouri might be the winner.
 
MacDonaldTriad said:
Humidity, sink holes, mosquitoes, and the tallest mountain is the Miami dump. I’m sure every state can be made fun of, but Florida does have some easy targets. On the other hand, no state taxes, South Beach, Joe’s crab shack, art deco,…
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Haha, no I meant psych specific stuff. I loved my time in the Tampa-Sarasota area...
 
Shikima said:
Be sure to get a Gero fellowship under your belt for FL.
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To be honest, I'm amazed at how few gero-fellowship trained physicians there were in Florida in all areas of Medicine. As of 2007 there wasn't a single board-certified geriatrician in Sarasota County (per the Herald Tribune, the local paper). Basically geri becomes your specialty down there eventually regardless of your previous training. Still, despite the sunshine, I have my reservations about practicing in FL. The entire state is basically one big Axis II.

Though I think this thread kind of misses the point. Metro area is way more important to consider than State anyway. There's a big difference between a job offer in "Chicago," and one in "Illinois" if you get where I'm going with this...
 
touchpause13 said:
How's MN?
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I've heard good things about it... 😉

Taxes relatively high, but quality of education and availabilty of social services for mental health patients is high also--sometimes you get what you pay for.
myPsychAlt makes a good point which applies to Metro vs. "Greater MN" as well.​
 
OldPsychDoc said:


I've heard good things about it... 😉

Taxes relatively high, but quality of education and availabilty of social services for mental health patients is high also--sometimes you get what you pay for.
myPsychAlt makes a good point which applies to Metro vs. "Greater MN" as well.​
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Fair enough. I love the cities. And my dad is a very well established psychologist there with his own private practice. So... advantages lol
 
shan564 said:
I've never seen a psychiatrist complain about the Midwest. ...
St. Louis and Kansas City are the only two major cities in the "north central" geographic area....
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Was going to admonish you about this, since there is a fairly major city a couple of states upriver from you*--but then I found this earlier posting, which I presume you're referring to, and realized that MN gets inexplicably lumped into the Great Lakes region, despite average salaries more consistent with "North Central" than "Great Lakes", based on this map.


*which of course means that you're drinking water that well, we've already used once... :naughty:
🤢
 
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SMC123 said:
What are the best states to practice psych in regards to taxes, medical coverage, patients, physician density, etc.? I've read the Medscape report but I figure I would ask in a more Psych specific group.

Also, in terms of residency, do most residents end up practicing where they do their residency? Do you form ties with the community that will help going into a full fledge practice?
Click to expand...

Canada.
 
slappy said:
Texas and Taxes don't go together. The state has no income tax, physicians get paid a lot, and you can have tacos for breakfast. 'Nuff said.
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No, that's not enough said. Do you know how much a Texas medical license costs? Are you aware that the reason it costs so much (not just the first time, but every single year?) is because Texas, lacking income tax and having failed to convene what's known in 46 other states as an annual meeting of the legislature, can't run a state agency to save its life? (Except, of course, for their famed Board of Education.) Oh and that's not including your fees to the Department of Public (un)Safety who will force you to duplicate the process you go through with the federal government to get your DEA number, for no discernible reason other than, I suppose, Rick Perry can always use the money for hairspray. (It sure isn't going to fix the potholes in the road that will decimate your tires and possibly your car's whole suspension system within your first week there. Good luck riding the bus in any Texas city!) Do you know why the DPS process will be the bottleneck step in your months' long wait to get a job? Because the one guy working in the DPS "license application processing" cubicle in Austin ALSO processes gun license applications from all over Texas, and he has exactly ONE single metal inbasket, meaning that your application for a DPS number is lumped in among the gun permit applications. You can wait your turn.

And do you really think psychiatrists in Texas are raking it in? The salaries are pretty midling actually. Plus, if you're a typical Texan, you won't have health or auto or most other kinds of insurance (ok I'm guessing about auto but it's an educated guess). So have fun paying for everything out of pocket. Also, psychiatry is highly stigmatized in Texas and so are psychiatrists. Everyone from the surgeons to the pediatriticans to the genetic medicine people will look down their noses at you.

But if it's your cup of tea, go for it. No income tax! 'Nuff said.
 
I don't know anything about Texas apart from my brief stint at UTSW Dallas. But your post affirms my observation that even though the state appears to be a paradise for practicing medicine to an outsider (low cost of living, low competition, high compensation), the physicians actually working there don't seem all that happy!
 
Oh let me add something - and I say this to men and women because men will be bearing children before Texas learns the meaning of maternity leave - I hope you can give birth and recuperate in one day. And by that I mean a Saturday or Sunday. Don't expect your employer to give you an extra minute off for the purpose of expanding the population of your faux brick home and your giant, brand new and already defaulted-on Suburban.
 
nancysinatra said:
Oh let me add something - and I say this to men and women because men will be bearing children before Texas learns the meaning of maternity leave - I hope you can give birth and recuperate in one day. And by that I mean a Saturday or Sunday. Don't expect your employer to give you an extra minute off for the purpose of expanding the population of your faux brick home and your giant, brand new and already defaulted-on Suburban.
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Damn that sounds horrible
 
slappy said:
I don't know anything about Texas apart from my brief stint at UTSW Dallas. But your post affirms my observation that even though the state appears to be a paradise for practicing medicine to an outsider (low cost of living, low competition, high compensation), the physicians actually working there don't seem all that happy!
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Oh I think many of them are probably extremely happy. Don't listen to me... I mean, someone had to vote in the members of the Board of Education! And actually, one good, progressive thing about Texas - they have instituted malpractice caps. That should make anyone happy.
 
nancy what state would you recommend? or region?
 
Ok actually what I would recommend is North Dakota. They pay extremely well (a couple years ago it was $300K starting plus bonuses) and my impression is that there is little hassle in that state aside from having to deal with the occasional roving bison. (But seriously, I'd deal with a bison anyday over some DPS administrator.) You do need to bring your own trailer, is my understanding.

Outside the US, I'd look at Australia. They pay well, have a good medical system, and speak English. Plus you can scuba dive!
 
nancysinatra said:
Ok actually what I would recommend is North Dakota. They pay extremely well (a couple years ago it was $300K starting plus bonuses) and my impression is that there is little hassle in that state aside from having to deal with the occasional roving bison. (But seriously, I'd deal with a bison anyday over some DPS administrator.) You do need to bring your own trailer, is my understanding.
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People give us crap but it's really not that bad and nd desperately needs more psychiatrists.

People are friendly, if you live around one of the bigger cities you have access to a lot more than what you would originally imagine. The only thing is I would say to stay away from the west side of the coast because it's not very safe out there.
 
touchpause13 said:
I know. Those god awful accents...
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Are you saying people don't actually speak that way in ND? That's a bummer. I loved the accents in that movie and wanted to visit just to hear people speak!

nancysinatra said:
Which actually took place entirely in Minnesota!
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That's right. Because the Coen brothers knew MN better!


Guess we've successfully completed 100% digression in this thread now.
 
slappy said:
Are you saying people don't actually speak that way in ND? That's a bummer. I loved the accents in that movie and wanted to visit just to hear people speak!



That's right. Because the Coen brothers knew MN better!


Guess we've successfully completed 100% digression in this thread now.
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I don't consider it digression to provide accurate information about various US states in a thread called "Best State to Be a Psychiatrist."
 
slappy said:
Are you saying people don't actually speak that way in ND? That's a bummer. I loved the accents in that movie and wanted to visit just to hear people speak!



That's right. Because the Coen brothers knew MN better!


Guess we've successfully completed 100% digression in this thread now.
Click to expand...

Most people don't actually speak like that. Honestly that accent sounds more Canadian than anything else.
 
slappy said:
And live with venomous spiders!
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I went to med school in Australia, and I spent most of my time at a hospital in the part of Sydney that's home to the infamous funnel web spider, one of the deadliest spiders around. Throughout med school, I never saw (or heard of anybody else seeing) a venomous spider bite in our hospital.
 
Side note: Texas makes up for it's non-existent income tax by implementing astronomical property taxes.
 
Frazier said:
Side note: Texas makes up for it's non-existent income tax by implementing astronomical property taxes.
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Yeah that's a myth. The truth is, you'll end up living in a motel if you move there, since most property in Texas gets wiped out in tornadoes or hurricanes or the inevitable (and previously uninsured) fertilizer plant explosion. At least that's how it seems based on the current insurance market. Just in case anyone wants to know, if you try to buy auto/home/renter's/fertilizer plant or whatever insurance in El Paso on a day that a hurricane is predicted to make landfall anywhere in the Gulf (i.e. somewhere between Galveston and Tampa), you're out of luck. And if you try to buy insurance in Galveston on a day that tornadoes may be expected in Amarillo or Lubbock, again, no go. The whole state shuts down all at once. That's like closing the schools in Charlotte, NC because snow "may be" predicted in Boston, or for that matter, Bermuda.

Not to mention, having the Texas Board of Education in your state pretty much affects property values in the same way it would to have Chernobyl right in your own backyard.
 
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Nancy, are you on PCP? Regarding the idea of buying insurance in the midst of a catastrophe, I don't even know how to respond. Anyway, with the limited time I have at the moment the first things I'd like to state is that renewal of medical license is Q2 years and this August when my wife had our third kid, I'll be taking a week of paid PATERNITY leave.
 
thanks nancy for dropping all this Texas knowledge in this thread

time to quit my grass is greener mentality and happily pay my Cali taxes
 
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