best state to practice medicine in

[ecf1975do]

I am currently and intern and while having some down time on call was thinking where id like to practice and settle down. regardless of specialty (im doing anesthesia) where are some of the more desirable places for a doc to practice ( i guess taking into consideration as factors like cost of living, weather, schools, nightlife, malpractice, etc).. thanks!

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[normalforce]

I am currently and intern and while having some down time on call was thinking where id like to practice and settle down. regardless of specialty (im doing anesthesia) where are some of the more desirable places for a doc to practice ( i guess taking into consideration as factors like cost of living, weather, schools, nightlife, malpractice, etc).. thanks!

Indianapolis, IN

 

[fourthyearmed]

I think it all depends on where you want to live. We can't tell you where you would like it. I may love the hot weather in the South and you may hate it. You may want to live in a town with professional football while I could care less. Also cost of living can be relative to what you are used to. If you grew up in California, everywhere else seems cheaper, if you grew up in Louisiana just about everywhere seems expensive. Etc, etc, etc.

 

[UHS2005_2]

South Dakota is where you want to be. Low malpractice, no income tax, and a thriving health system.

 

[NinerNiner999]

If you manage your salary, invest wisely, and find a good accountant, the only difference one state versus another may make is a year or two to catch up. After that, there is no need to worry in any state, regardless of malpractice premiums or cost of living...

 

[Voxel]

NinerNiner999 your first statement is not true. When you take into account wide geographic differences in salary and cost of living and combine that with the understanding of compounding interest/return on investment, it can make a large difference as to where you live. It could mean the difference between retiring at age 50 vs 65 to pursue other interests. How much are 15 or 10 years free of required work obligations worth to you?

 

[dbiddy808]

Go live where ever you think you'll be happiest. We'll all die rich regardless of where we practice.

 

[aphistis]

Indianapolis, IN

Seconded.

 

[NinerNiner999]

NinerNiner999 your first statement is not true. When you take into account wide geographic differences in salary and cost of living and combine that with the understanding of compounding interest/return on investment, it can make a large difference as to where you live. It could mean the difference between retiring at age 50 vs 65 to pursue other interests. How much are 15 or 10 years free of required work obligations worth to you?

Well, say I make $200k in Louisana. I'll spend maybe $40k per year for living (house, bills, car, etc), leaving (after taxes at 50% rate) $60k per year to invest. This leaves $3 million saved in 30 years of work.

Scenario 2 puts me in San Diego California, earning the same salary but spending $80k for the same expenses, again, at 50% tax leaving me with $20k per year. At this rate it will take 32 years to save the same $3 million.

These calculations are based on a savings rate of 8%, and a starting balance of $0.00 (like new attendings). http://www.bankrate.com/brm/cgi-bin/million.asp

 

[Rudy Guliani]

Why does most every answer on this board need to be so esoteric about everything? "Practice wherever you're happiest." That's great. Can't anyone out there comment on actual factors related to practicing in different states, e.g. malpractice rates are really bad here, or the medical community is really strong there, etc, etc? I would post the information but I'm not practicing yet, so we need some docs out there to submit some useful information.

 

[dr_almondjoy_do]

New York City Baby! Best city in all the world!

Seriously, you can find all of this out by putting in the website of the towns you are intersted in. For example, I'm interested in Philadelphia, or Wilmington, DE. I punched in the towns and got a whole bunch on stats on average income, age, utility bills, racial demographics, level of education, school systems, nightlife, culture, etc..

And then I looked up malpractice premiums and average salary in the area for family practice (no not salary.com, but the U.S. dept of labor) and you can get information you can trust.

Three websites per city/town...any city/town...

This took me all of 30 minutes one day.

But practice whereve you're happiest! Ha!

 

[chauffeur]

Well, say I make $200k in Louisana. I'll spend maybe $40k per year for living (house, bills, car, etc), leaving (after taxes at 50% rate) $60k per year to invest. This leaves $3 million saved in 30 years of work.

Scenario 2 puts me in San Diego California, earning the same salary but spending $80k for the same expenses, again, at 50% tax leaving me with $20k per year. At this rate it will take 32 years to save the same $3 million.

These calculations are based on a savings rate of 8%, and a starting balance of $0.00 (like new attendings). http://www.bankrate.com/brm/cgi-bin/million.asp

in such a case, i would think that the point of moving to lousiana would be to make $350k. i would love to make that money in manhattan, but with a saturated market (for certain specialties) you can't. my friend's wife just finished a GI fellowship and received some insane amount on money to practice in Kentucky, but decided to take half of that to work in the mahattan area (i think at a VA hospital)

i do agree... just practice where you will be most happy, which for me would be close to family and friends, and in a fairly diverse city.

 

[imtiaz]

it's funny you mention this. two orthopaedic surgeons were talking in the lounge today about malpractice premiums. the guy said his premium now to practice in illinois is like $100,000 a year, and he goes you know what, i met a guy who practices in indianapolis who is paying $12,500. so it's definitely better if you want to be a surgeon.

 

[Myopic]

This is where the money is BABY...No Taxes either
It may not exactly be a state, but it never is cold there
http://www.ngha.med.sa/KKH/kkh.html

 

[starayamoskva]

I am currently and intern and while having some down time on call was thinking where id like to practice and settle down. regardless of specialty (im doing anesthesia) where are some of the more desirable places for a doc to practice ( i guess taking into consideration as factors like cost of living, weather, schools, nightlife, malpractice, etc).. thanks!

The state of relaxation. Just chill out! If you really enjoy your work it doesn't matter where you are.

 

[Rudy Guliani]

yeah KKH sounds real good, but I kind of have this thing about my head...I like keeping it attached to my body.

 

[wooo]

There is not a question in mind about this topic. Every doctor should move to Columbia Illinois.

 

[wooo]

...on Elm Street

 

[VentdependenT]

Perhaps your family, friends, and significant other should be accounted for as well. When your parents/friends/family get sick or need help and you are bumbletown that extra 50,000 bucks you're making isn't quite commensurate.

That being said go to Nebraska.

 

[Voxel]

Perhaps your family, friends, and significant other should be accounted for as well. When your parents/friends/family get sick or need help and you are bumbletown that extra 50,000 bucks you're making isn't quite commensurate.

That being said go to Nebraska.

Family and Friends will likely be a important decision where you wind up practicing. But I stand by my first post. And in many cases it's more than an extra 50K and that compounded over 15-30 years is big bucks. See you on the beach, I'll be drinking mai tais.

 

[Hudson]

This is where the money is BABY...No Taxes either
It may not exactly be a state, but it never is cold there
http://www.ngha.med.sa/KKH/kkh.html

Seriously, lets all leave America, take our hard earned medical knowledge to another country that contributed nothing to our education, maybe get kidnapped and make international television, and possibly lose our life. The only way I'm going to the middle east is in a United States uniform with a red cross on my shoulder, helping our own who are fighting for US (and the rest of the world eventhough some are too MYOPIC to see it.)

 

[IndyXRT]

If you want low malpractice, friendly laws, low cost of living, and appreciative patients, then you should find your way to Indiana. I don't think there are very many better places to be a doctor. But I'm biased

 

[Rudy Guliani]

Hello, I am currently in school in a part of the country that has a high percentage of really dumb people, both in terms of knowing how to take care of their health and in common sense and in just everyday activities. After 3 years here and one more to go, I find that I cannot fathom the thought of spending any more time in this brain-forsaken area. Is there any part of the country that has a relatively well-educated population? Boston comes to mind, anywhere else?

 

[docB]

Hello, I am currently in school in a part of the country that has a high percentage of really dumb people, both in terms of knowing how to take care of their health and in common sense and in just everyday activities. After 3 years here and one more to go, I find that I cannot fathom the thought of spending any more time in this brain-forsaken area. Is there any part of the country that has a relatively well-educated population? Boston comes to mind, anywhere else?

I would argue that every city has its share of the smart and the dumb. The hospital in which you practice is much more important than the city. The other painful truth is that a smarter, richer population is usually much more demanding, unreasonable and infuriating than a county type population. I know of what I speak. My group covers 4 hospitals. 2 serve low income county pops and 2 serve rich pops. Rich people are a grand pain in the butt.

 

[Sanman]

I'm fairly sure I read somewhere that San Francisco had the highest number of PhD's the the country.

 

[kas23]

I would argue that every city has its share of the smart and the dumb. The hospital in which you practice is much more important than the city. The other painful truth is that a smarter, richer population is usually much more demanding, unreasonable and infuriating than a county type population. I know of what I speak. My group covers 4 hospitals. 2 serve low income county pops and 2 serve rich pops. Rich people are a grand pain in the butt.

I am a 4th year at a school where we rotate through 7 different hospitals. While it is "hip" and liberal to say that rich people are a pain in the ass to deal with, I would rather practice at our small affluent community hospital than my county hospital.

The people at county hospitals will soak up your time filling out wellfare and disability papers, constipate the ED with trivial problems like a sniffle, and will turn around and sell their narcotic script or just toss their "water pill" down the toilet. It is not a stereotype type if you say less educated, poor patients go to the county (hence, the county), but it is if you say all rich are snobs and more difficult to deal with.

 

[docB]

I am a 4th year at a school where we rotate through 7 different hospitals. While it is "hip" and liberal to say that rich people are a pain in the ass to deal with, I would rather practice at our small affluent community hospital than my county hospital.

The people at county hospitals will soak up your time filling out wellfare and disability papers, constipate the ED with trivial problems like a sniffle, and will turn around and sell their narcotic script or just toss their "water pill" down the toilet. It is not a stereotype type if you say less educated, poor patients go to the county (hence, the county), but it is if you say all rich are snobs and more difficult to deal with.

I am neither hip nor liberal. I'm the most conservative guy in my time zone. Based on my experience the rich people at the rich hospital are a pain in the butt. The county pts can be tough to deal with too but I say the butt pain is generally less.

 

[kas23]

Fair enough. You are also working in Emergency Medicine, where the poor people just want either something to do, a place to stay, or a problem that should have been dealt with months ago by a GP. So they can't be too much of a problem. I'll agree, the rich people who go to the ED are most apt to point the finger or demand. But, things seem different than this when you are either on the floors or in the office.

 

[docB]

Fair enough. You are also working in Emergency Medicine, where the poor people just want either something to do, a place to stay, or a problem that should have been dealt with months ago by a GP. So they can't be too much of a problem. I'll agree, the rich people who go to the ED are most apt to point the finger or demand. But, things seem different than this when you are either on the floors or in the office.

Good point. Another reason the poor are easier to deal with in the ER than in the office is that I get paid the same for non pays and insured (as a group we get hosed as the payer mix goes down but on a pt by pt basis I don't take the bath alone for the no pay). Wheras if you see a no pay in the office you're paying for the opportunity to see them.

 

[Philo Beddo]

Indigent care in the outpatient setting is almost impossible.

1. Paperwork: medicaid, disability, work comp, parking tags, drug assistance applications, the list goes on and on and on . .
2. Many addicted to tobacco or ETOH or worse.
3. Getting them referals for specialists = almost impossible.
5. Getting them to show up for their specialist visit = nearly impossible.
6. Expecting the same level of responsibility from them is difficult.

And when they have >2 children . . . it is impossible. They are trapped. They simply dont have/cant obtain the resources to care for themselves.

ugh, it puts me a foul mood. 95% of the time a Dermatologist contributes very little to a patients actual health (you know its true), and gets paid 4 times as much. Insanity.

Philo,
hippocritis.com <--- medical satire.

 

[Sessamoid]

Good point. Another reason the poor are easier to deal with in the ER than in the office is that I get paid the same for non pays and insured (as a group we get hosed as the payer mix goes down but on a pt by pt basis I don't take the bath alone for the no pay). Wheras if you see a no pay in the office you're paying for the opportunity to see them.

As more of our malpractice coverage goes on a per incident basis, you'll find that we're paying for the privilege to work for free as well when the uninsured come to the ED. In that vein, if you live in California, vote YES ON 67!

 

[docB]

As more of our malpractice coverage goes on a per incident basis, you'll find that we're paying for the privilege to work for free as well when the uninsured come to the ED. In that vein, if you live in California, vote YES ON 67!

Oh, I absolutely agree that EP pay to treat the uninsured too. I'm just noting that when I walk into the room I don't feel the bite as much as a PMD because I share the burden with 30 other guys. We had a thread on the EM forum (I'll bump it) a little while ago where I tried to figure out how much my group and each doc in the group lose to see the uninsured. That does'nt count the amount paid bu us (in malpractice) to see them.

And if you're in Nevada Yes on 3 and No on 4 and 5.