Best & Worst States for Doctors in 2024 (2024)

Doctors have one of the most essential professions, and they are well compensated for the hard work they do to keep patients healthy. They are among the highest-paid and most educated professionals in the U.S., with family medicine physicians having a median salary of $211,000 per year. The high salary makes sense, given the importance of their life-saving work and the struggles that come with life in the medical profession. However, doctors don’t start out wealthy. The average medical-school debt is around $202,000.

In light of the cost of pursuing medicine and the difficulty of the job, it’s important for doctors to live in a state that provides solid financial opportunities in addition to good working conditions. To help doctors decide where to practice, WalletHub compared the 50 states and the District of Columbia across 19 key metrics. Our data set ranges from the average annual wage of physicians to the number of hospitals per capita to the quality of the public hospital system.

Main Findings

Best States to Practice Medicine

Note: With the exception of “Total Score,” all of the columns in the table above depict the relative rank of that state, where a rank of 1 represents the best conditions for that metric category.

In-Depth Look at the Best States for Doctors

Montana

Montana is the best state for doctors, and it has one of the top hospital systems in the country, with 82.5% of patients giving their hospital a score of 9 or 10 out of 10. Montana doctors also receive high wages. For example, the state has the second-highest average income for obstetricians and gynecologists, at nearly $375,000, and one of the highest incomes for surgeons, at almost $420,000 on average.

In addition, the Treasure State is a good place for doctors’ mental health, with the lowest rate of physicians reporting that they are burned out. Over 63% of medical residents who train in the state end up staying there, too – one of the highest retention rates in the country.

South Dakota

South Dakota is the second-best state for doctors, and one contributing factor is that physicians have one of the highest starting salaries in the country, at $5,330 per month. The state also ranks especially high when it comes to the yearly salaries of obstetricians and gynecologists ($348,000) and general internal medicine physicians ($309,000).

The Mount Rushmore State has around 8.7 hospitals for every 100,000 residents, which is the seventh-highest number in the country. In addition, doctors in South Dakota pay less for malpractice insurance premiums than people in most other states.

Nebraska

Nebraska ranks as the third-best state for doctors, in part because it has the third-best hospital system in the country. Nearly 81% of patients in the state give their hospital a rating of 9 or 10 out of 10. Nebraska doctors seem to benefit from these good hospital conditions, as they have the second-lowest burnout rate in the country.

In addition, doctors in Nebraska have high salaries. For example, the state has the highest mean wage in the country for anesthesiologists, at over $418,000.

Ask the Experts

Medicine is changing rapidly, and the way it is taught and practiced has to change too. The industry faces an aging population, new regulations and technological breakthroughs. With that in mind, we asked a panel of experts the following key questions:

1. How does state and local policy influence the lives of doctors and other medical professionals?
2. What tips can you offer current medical students about what specialty to pursue and where to practice?
3. To what extent does the threat of a malpractice lawsuit affect doctors’ ability to do their job?
4. In evaluating the best states for doctors, what are the top five indicators?
5. What are the biggest issues facing doctors today?

Methodology

In order to identify the best states for doctors, WalletHub compared the 50 states and the District of Columbia across two key dimensions, “Opportunity & Competition” and “Medical Environment.”

We evaluated those dimensions using 19 relevant metrics, which are listed below with their corresponding weights. Each metric was graded on a 100-point scale, with a score of 100 representing the most favorable conditions for practicing doctors.

We then determined each state and the District’s weighted average across all metrics to calculate its overall score and used the resulting scores to rank-order the states.

Opportunity & Competition – Total Points: 70

• Physicians’ Average Annual Wage: Double Weight (~11.67 Points)
  Note: Data for this metric were adjusted for the cost of living.
• Physicians’ Average Monthly Starting Salary: Full Weight (~5.83 Points)
  Note: Data for this metric were adjusted for the cost of living.
• Hospitals per Capita: Full Weight (~5.83 Points)
• Insured Population Rate: Full Weight (~5.83 Points)
  Note: “Population” includes noninstitutionalized civilians aged 16 and older.
• Employer-Based Insurance Rate: Full Weight (~5.83 Points)
• Projected Share of Elderly Population: Full Weight (~5.83 Points)
  Note: This metric measures the projected percentage of the population aged 65 and older by 2030.
• Current Competition: Full Weight (~5.83 Points)
  Note: This metric measures both the number of physicians per 1,000 Residents and the percentage of the population living in a primary-care HPSA, or Health Professional Shortage Area. HPSAs, as defined by the Health Resources & Services Administration, “are designations that indicate health care provider shortages in: Primary care; Dental health; or Mental Health” and “may be geographic-, population-, or facility-based.”
• Share of Medical Residents Retained: Full Weight (~5.83 Points)
  Note: The metric measures the net number of medical residents being added to the physician workforce of each state.
• Projected Competition: Full Weight (~5.83 Points)
  Note: This metric measures the projected number of physicians per 1,000 Residents by 2030.
• Number of CME Credits Required: Full Weight (~5.83 Points)
  Note: “CME” stands for Continuing Medical Education, credits for which the state may require medical professionals to earn in order to maintain their licenses.
• Presence of Interstate Medical Licensure Compact Law: Full Weight (~5.83 Points)
  Note: This metric is based on data from the Interstate Medical Licensure Compact and considers whether compact legislation has been enacted, introduced or not been introduced.

Medical Environment – Total Points: 30

• Quality of Public Hospital System: Full Weight (~3.75 Points)
  Note: This metric is based on data from the Centers for Medicare & Medicaid Services.
• Hospitals Safety - Percentage of “A” Hospitals: Full Weight (~3.75 Points)
  Note: This metric is based on data from Leapfrog Hospital Safety Grade which ranked hospitals across the states based on 22 measures of publicly available hospital safety data.
• Presence of Nationally Accredited Health Departments: Full Weight (~3.75 Points)
  Note: This binary metric measures the presence or absence of national accredited health departments in a state.
• Physician Assistants per Capita: Full Weight (~3.75 Points)
• Punitiveness of State Medical Board: Full Weight (~3.75 Points)
  Note: This metric measures the number of serious disciplinary actions (per 1,000 physicians) taken by the state medical board.
• Malpractice Award Payout Amount per Capita: Full Weight (~3.75 Points)
• Annual Malpractice Liability Insurance Rate: Full Weight (~3.75 Points)
• Physician Burnout: Full Weight (~3.75 Points)
  Note: Physician burnout is defined as “a feeling of physical, emotional, or mental exhaustion, as well as frustration and cynicism related to work; and doubts about your competence and the value of your work.”

Sources: Data used to create this ranking were collected as of February 26, 2024 from the U.S. Census Bureau, Bureau of Labor Statistics, Council for Community and Economic Research, Health Resources & Services Administration, Association of American Medical Colleges, Projections Central’s State Occupational Projections, Federation of State Medical Boards, Leapfrog Group, Public Health Accreditation Board, Interstate Medical Licensure Compact, Arthur J. Gallagher & Co., Centers for Medicare & Medicaid Services, WebMD, Public Citizen and MEDPLI Insurance Services.

Supporting Video Files:

• YouTube - National (for web embedding)
• YouTube - Montana (for web embedding)
• Raw video files (for editing into clips)

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