Best & Worst Places to Practice 2021
Best & Worst Places to Practice 2021
Medicine is both an art and a science. So is selecting a best place to practice medicine. To identify this year's Best Places to Practice, we ranked the states according to their performance on seven "hard" measures (including malpractice payouts, compensation, and health system performance) and three "soft" measures (happiness at work, happiness outside of work, and burnout, according to physicians who practice there). Find out which states have the "secret sauce" that makes them great places to practice.
Best & Worst Places to Practice 2021
Minnesota claimed top marks for livability, low incidence of adverse actions against doctors, and the performance of its health system. The share of doctors in Minnesota reporting burnout and/or depression is below the national average, while the percentage who say they are "very happy" outside of work is above it.
A suburb of the Twin Cities, Woodbury offers 3000 acres of parks, 140 miles of trails, and a 92,000–square-foot indoor park for the frigid winter months.
Best & Worst Places to Practice 2021
Malpractice payouts for physicians fell dramatically in 2020 to the second lowest level in the nation, while the number of adverse actions against doctors in the state fell to its lowest level since 2008. In terms of livability, Wisconsin offers a strong educational system and a stable economy.
Home to die-hard Packers fans, Green Bay offers big-city amenities with a small-town vibe and plenty of outdoor activities.
Best & Worst Places to Practice 2021
U.S. News and World Report calls Washington the most livable state in the country. It's also among the top 10 for health, happy doctors, and a strong health system. Adjusted for the state's high cost of living, physician compensation is below the national average.
The financial, cultural, and retail center of the "Inland Northwest," Spokane is a more affordable, less crowded alternative to its sister cities on Puget Sound.
Best & Worst Places to Practice 2021
Physicians in Colorado are among the happiest both at and outside of work, and the state boasts a high retention rate for residents who train there. It is among the healthiest states and has a top 10 health system, although physician compensation is below the national average.
This college town, which claimed the No. 1 spot on U.S. News and World Report's latest best places list, could be a particularly good fit for doctors who are favorable to alternative treatments.
Best & Worst Places to Practice 2021
Looking for a healthy, livable state where the doctors are among the happiest both at and outside of work? Think Utah. A stunning landscape, low crime rate, and high quality of life are some of the benefits of living there.
By major metro standards, Salt Lake is affordable, and healthcare organizations are among the city's largest employers.
Best & Worst Places to Practice 2021
Nebraska could be described as a well-rounded state in which to practice medicine: livable, affordable, with a moderate number of adverse actions against physicians and low average malpractice payouts for physicians.
Dubbed the "silicon prairie," Nebraska's state capital offers an appealing mix of innovation, low unemployment, and great quality of life.
Best & Worst Places to Practice 2021
If burnout is a major concern, consider moving to Iowa. While about a third of the state's full-time physicians described themselves as burned out or depressed, that's well below the national average of almost 47%. Doctors also report a high level of happiness outside of work.
Those who think of Iowa as a fly-over state have never landed in Des Moines, which offers plenty of cultural events and family-friendly neighborhoods.
Best & Worst Places to Practice 2021
With mountains, cities, and a beautiful coast, North Carolina offers a lot in terms of quality of life, and doctors there also report an above-average level of happiness at work. In 2020, adverse actions against physicians were well below the national average.
A major metro area that offers both a cosmopolitan atmosphere and plenty of Southern charm, Charlotte is a hot, fast-growing market.
Best & Worst Places to Practice 2021
Massachusetts is an expensive place to live and it doesn't lack for doctors, with more than 36,600 professionally active physicians in the state. Massachusetts is also the healthiest state in the nation and has the No. 2 health system.
For the doctor who craves big-city life, four distinct seasons, and a medically innovative healthcare environment, it's hard to top Boston.
Best & Worst Places to Practice 2021
Idaho ranks in the second or third quintile for nine of the 10 metrics we considered. In addition, nearly 61% of medical residents who completed their training in Idaho in the past decade have chosen to put down roots and practice there, a decision that speaks well for the state.
With a river and greenbelt running through the heart of downtown, doctors who love outdoor recreation will enjoy their time in Boise.
Best & Worst Places to Practice 2021
Doctors in Texas are more likely to report being "very happy" both at and outside of work than physicians in most other states. This may partly explain why two thirds of physicians who complete their residency in Texas choose to practice there.
A fast-growing, prosperous suburb of Dallas, Plano feels like a city itself. Many major employers have corporate offices there, and it's a top city for tech jobs.
Best & Worst Places to Practice 2021
Virginia ranks in the top 10 for livability. Physician burnout and depression, and payouts for malpractice claims against doctors, are both below the national average. The state has a low incidence of crime, a diversified economy, and a solid public education system.
Richmond, the artsy, historic state capital, offers a mix of culture, family-friendly activities, and abundant college sports and other activities.
Best & Worst Places to Practice 2021
South Dakota's lenient pandemic protocols concerned public health experts, but South Dakota physicians enjoy generous compensation when adjusted for cost of living, and the state receives high livability marks, particularly for its natural environment.
A master-planned community sandwiched between the Big Sioux and Missouri rivers, Dakota Dunes is less than 20 minutes west of Sioux City, Iowa.
Best & Worst Places to Practice 2021
Hawaii is one of the most livable states and has one of the nation's best public health systems. Doctors report a low rate of burnout and depression despite earning rock-bottom compensation once it is adjusted for the state's exorbitant cost of living.
Living in an island paradise is not cheap, but it does have its benefits. Honolulu routinely ranks among the best US cities for overall well-being.
Best & Worst Places to Practice 2021
New Hampshire earns high marks for livability. The state ranks in the top 10 for healthcare access, and its residents are among the healthiest in the nation. Nature and the outdoors hold great appeal for many. Still, the cost of living in New England is high and New Hampshire has a high incidence of adverse actions against doctors.
Surrounded by mountains and forests, Manchester is just an hour away from Boston.
Best & Worst Places to Practice 2021
California retains more than three quarters of the medical residents who train there, more than any other state. Almost two thirds (64%) of doctors say they are very or somewhat happy outside of work, while the share who say they are burned out or depressed is on par with the national average.
This Sacramento suburb offers a respite from California's steep cost of living. A median-priced home in Roseville costs about 10% less than the state average.
Best & Worst Places to Practice 2021
Relative to its population size, North Dakota had the lowest level of malpractice payouts for claims against physicians of any of the states. Resident retention is slightly above the national average, and the state ranks in the second quintile for livability and population health.
Often dubbed "a city of growth," West Fargo's population has more than doubled in the past 20 years thanks to investments in agricultural technology, drone research, and entrepreneurship.
Best & Worst Places to Practice 2021
Maine retains nearly 6 out of 10 medical residents who train there, and 2020 malpractice payouts for claims against doctors were well below the national average in 2020. Maine ranks in the top 10 in terms of population health.
Maine's largest metro area and the state's economic hub, Portland has a home-grown ethos that pervades everything from its farm-to-table restaurants to its craft beers.
Best & Worst Places to Practice 2021
Have a taste for coastal living but not its typical price tag? You might want to consider Michigan, surrounded by Lakes Michigan, Huron, and Erie. Physician compensation is good, the cost of living is comfortably below the national average, and malpractice payouts per capita are low.
Urban meets rural in this sporty, smart, outdoorsy, high-tech college town that is home to the nationally ranked University of Michigan Hospitals-Michigan Medicine.
Best & Worst Places to Practice 2021
Tennessee physicians are more likely to report being "very happy" both inside and outside of the clinic than are doctors in most other states. Adjusted for the cost of living, the state ranks No. 3 in average physician compensation, and malpractice payouts are among the lowest in the nation.
Home to country music, Nashville is a booming market for innovation, but the city's rapid growth makes it an expensive city to live in.
Best & Worst Places to Practice 2021
Almost 63% of the physicians who train in the Sunshine State stay there to practice. Florida doctors are more likely to be very happy at and outside of work and less likely to be burned out. Compensation is middling and malpractice payouts are higher than the national average.
On the Gulf side of Florida, residents enjoy Sarasota's fantastic beaches and cultural activities every bit as much as snowbirds do. Sarasota schools get high marks.
Best & Worst Places to Practice 2021
Physicians in Montana are more likely to report being "very happy" at work than are doctors anywhere else in the country. Montana docs are also more likely to report being very happy outside of work and less likely to say they are depressed and/or burned out.
Nicknamed "Montana's Trailhead," Billings is home to two of the state's top three hospitals, according to U.S. News and World Report.
Best & Worst Places to Practice 2021
Ohio offers a diverse array of practice opportunities, an affordable cost of living, and adjusted compensation in the second quintile. The rate of adverse actions against physicians is among the lowest in the county.
Ranked a top 25 best place for families, Cincinnati has a relatively low cost of living, great schools, numerous health systems, and a top pediatric hospital.
Best & Worst Places to Practice 2021
Arkansas ranks No. 2 for physician-adjusted compensation. Malpractice payouts were lower than the national average in 2020, and doctors in the state are more likely to say they are very happy at and outside of work than US physicians as a whole.
Northwest Arkansas is exploding, thanks to employers like Walmart, Tyson Foods, and the University of Arkansas.
Best & Worst Places to Practice 2021
Georgia is in the top 10 for affordability and gets high marks for its economy, infrastructure, and fiscal stability. From a medical perspective, doctors in Georgia report happiness levels on par with doctors nationwide.
In 2020, Money magazine ranked this small city on the South Carolina border the best place to live in the United States, thanks in part to its well-paying jobs in healthcare and affordable cost of living.
Best & Worst Places to Practice 2021
5 Worst States
While doctors practicing in "best" states may have access to strong public health systems or enjoy higher compensation, those practicing in "worst" states often face headwinds that can contribute to frustration. All of the "worst" states this year ranked in the bottom two quintiles for livability and adverse actions against doctors. Four ranked in the bottom two quintiles for population health, malpractice payouts for physicians relative to the size of the state's population, and health system ranking.
Best & Worst Places to Practice 2021
West Virginia may be "almost heaven" for some, but doctors there may confront a bevy of challenges. The state ranks among the least livable and healthy. Doctors face a high rate of adverse actions, and malpractice payouts in 2020 were high relative to the state's fairly small population.
A college town on the Monongahela River, Morgantown is a collection of neighborhoods, several of which were once small towns.
Best & Worst Places to Practice 2021
Louisiana is considered by some to be among the least livable states and least healthy state. It's in the bottom quintile for adverse actions against doctors, malpractice payouts for claims against doctors, and health system performance. More than half of Louisiana's physicians surveyed say they are burned out and/or depressed. Still, the state's health system improved in 2020.
For those who relish Cajun culture but would rather avoid the tourists of New Orleans, this capital city offers all the perks but moves at a more suburban pace.
Best & Worst Places to Practice 2021
New Mexico had a higher rate of adverse actions against physicians than any other state with the exception of New York. The state fared poorly for livability, malpractice payouts for claims against doctors, and medical resident retention. Still, fully three quarters (75%) of physicians there say they are very or somewhat happy in their life outside of work.
With more than 310 days of sunshine on average each year, Albuquerque residents find plenty of ways to enjoy the outdoors.
Best & Worst Places to Practice 2021
Nevada's health system performance deteriorated slightly in 2020 due in part to a significant increase in avoidable hospital use and cost, plus growing disparity in care. The state ranked poorly in population health and physician happiness.
America's Biggest Little City's emphasis on diversifying its tourism-driven economy enabled it to attract 30 new companies to the area in 2020, including 11 corporate headquarters.
Best & Worst Places to Practice 2021
Malpractice payouts against doctors were more than twice the national average in 2020, and adjusted physician compensation is low. Rhode Island ranked No. 48 in medical resident retention. However, physician burnout is below the national average, and the state ranks No. 4 in access to healthcare.
Providence is a metro area with a distinct New England appeal. A revitalized downtown and premiere schools, including Brown University and the Rhode Island School of Design, add to its vitality.
Best & Worst Places to Practice 2021
Data Sources and Criteria
Overall rank was based on combining criteria from the following sources, accessed March 10-12, 2021.
Burnout and Happiness
Physicians reporting burnout and/or depression: Medscape survey used to compile 'Death by 1000 Cuts': Medscape National Physician Burnout & Suicide Report 2021
Physician happiness at work and outside of work: Medscape survey used to compile Medscape Physician Lifestyle & Happiness Report 2021
Practice Environment
Compensation (adjusted for cost of living): Medscape survey used to compile Medscape Physician Compensation Report 2020. Cost-of-living adjustments were made on the basis of the Missouri Economic Research and Information Center's (MERIC) 2020 Cost of Living Data Series.
Malpractice payouts per capita: Estimated malpractice payouts per capita were based on malpractice payouts in claims filed against physicians divided by state population. Payout data come from Harnam Singh, PhD, author of "National Practitioner Data Bank: Adverse Action and Medical Malpractice Reports (1990-Dec. 31, 2020)." Payout data were divided by state population data from the Kaiser Family Foundation estimates based on the Census Bureau's American Community Survey, 2008-2018.
Adverse actions against physicians: Adverse actions against physicians in 2019 (excluding reinstatement and restorations) by state. Data from Harnam Singh, PhD, author of "National Practitioner Data Bank: Adverse Action and Medical Malpractice Reports (1990-2019)." Compared with the number of currently active MDs and DOs as of September 2020 perKaiser Family Foundation State Health Facts.
Resident retention: Association of American Medical Colleges Report on Residents.
State Health and Health System Performance
Health: America's Health Rankings, a United Health Foundation ranking system based on the World Health Organization's definition of health.
Health system performance: The Commonwealth Fund 2020 Scorecard on State Health System Performance.
Overall Livability
U.S. News and World ReportBest States 2021 ranks life in each of the 50 states according to 71 metrics in eight classifications.
Additional Sources:
Suggested cities were identified according to ratings and recommendations from numerous sources, including USnews.com, Money.com, Niche.com, Livability.com, Sperling's BestPlaces.net, Homecity.com, Doorsteps.com, Bizjournals.com, and Greatschools.org.
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