Worst states to practice medicine in 2019

By John Murphy, MDLinx
Published April 18, 2019

Key Takeaways

Happiness is a state of mind, not a destination, a wise person once said. In other words, you may be happy right where you are—even if it's in one of the states that made it on our list of worst states to practice medicine. But, that saying also implies that moving to a new destination may not make you happy either. (For reference, see our analysis of the "Best States to Practice Medicine in 2019.")

Yet, even though you may be happy (or unhappy) in your state of mind, the state where you live and work still matters. So, where did your state rank on our list? Read on to find out.

As noted, this analysis considered several key factors, in both career and lifestyle, which all weighed equally on the final score. Check out our scoring methodology here.

Now without further ado, here are MDLinx's 10 worst places to practice in 2019.

10. Arkansas

Worst in cultural activity along with poor health care

Arkansas' Ozark Mountains offer rugged beauty, stunning vistas, sparkling rivers, fish-filled lakes, and miles of hiking and biking trails. But for physicians in the Natural State, the landscape isn't quite as great. Arkansas is #3 in lowest cost of living, but it ranks near the bottom in healthcare quality (#46), health & wellbeing (#47), and physician pay (#48), and it comes in dead last in cultural activity (#50).

9. Kentucky

Low marks in health care and in health & wellness

Kentucky is famous for its horseracing and its bourbon—and those pursuits might be better bets than pursuing medicine in the Bluegrass State. Kentucky is at the back of the pack in health & wellbeing (#45), culture (#46), and healthcare quality (#49). On the bright side, it ranks #14 in physician pay.

8. Alabama

Lack of culture, higher education, and health

Lynyrd Skynyrd sang about Sweet Home Alabama, "where the skies are so blue." But physicians who call this state home might find that practicing here is not exactly pie in the sky. The state ranks poorly in terms of health & wellbeing (#44), a place to raise a family (#46), cultural activities (#47), and higher education (#49). It's not that sweet for salary either (#39), although it ranks #6 in cost of living.

7. Ohio

Poor quality of life is but one lackluster lifestyle factor

The Buckeye State is home to the Rock & Roll Hall of Fame, the Cleveland Clinic, and other attractions. Nevertheless, Ohio ranks in the bottom 10 in terms of quality of life (#40), higher education (#41), and health & wellbeing (#43). A silver lining—it's in the top 25 for wages (#24) and cost of living (#16).

6. Maryland

Quality higher education amid crowds of competition

The small state of Maryland has one of the higher scores for higher education (#12). But at the same time, it has nearly the highest percentage of doctors crammed into its borders, with a physician density rank of #49 (second only to Massachusetts). Maryland physicians also face a worrisome economic triple threat: low physician pay (#40), poor tax-friendliness (#44), and high cost of living (#46).

5. New York

Worst tax climate and highest cost of malpractice insurance

The state of New York often sets itself apart. Unfortunately, that's not a good thing for doctors in the Empire State. New York has both the highest average cost of medical malpractice coverage (#50) and the worst tax-friendliness of any state (#50). To add insult to injury, the state has the second worst physician pay (#49), and it's the third highest in both cost of living (#48), and physician density (#48). New York does rank high in cultural activities (#13) and, perhaps surprisingly, as a place to raise a family (#6).

4. Louisiana

Low malpractice cost doesn't outweigh unhealthy living

Although well known for jazz, jambalaya, and Mardi Gras, Louisiana should perhaps also be known as the state with the worst health & wellbeing (#50)—blame it on the beignets and boudin. The Pelican State also ranks low for health care quality (#48), family friendliness (#48), physician pay (#44), higher education (#42), and quality of life (#42). However, it does have the nation's third-lowest medical malpractice cost.

3. Pennsylvania

High cost of higher education just one of several negative factors

Even though Pennsylvania has nearly 250 institutes of higher learning, the state ranks worst in terms of higher education (#50). Why? Because its graduates bear some of nation's highest tuition and debt. The Keystone State also ranks among the bottom 10 in several categories, including high cost of malpractice insurance (#42), high physician density (#43), and low quality of life (#44).

2. Illinois

Population decline coupled with poor fiscal stability

Illinois is one of the few states to have a loss in population in recent years. To add to the state's woes, it's ranked last for fiscal stability (#50), according to U.S. News & World Report. In our survey, the Prairie State ranks near the bottom for its high medical malpractice insurance (#47), low quality of life (#47), and unfriendly tax environment (#46).

And the number 1 worst state to practice medicine is…West Virginia!

Ranks in the bottom 10 in five categories, despite good pay

First, the good news about West Virginia: It ranks #13 for physician pay. But now the bad news: According to U.S. News & World Report, West Virginia has the second worst economy of all US states (#49), right after Alaska. It's also just been judged the worst state for millennials. (Is that such a bad thing, though, if you're not a millennial?) For physicians, the Mountain State ranks low for higher education (#43), quality of life (#45), healthcare quality (#47), raising a family (#47), and health & wellbeing (#48).

Continue reading for the full list of Worst 25 States to Practice, and Worst 10s for Career and for Lifestyle.

Worst 25 States for Physicians to Practice

32North Carolina
38South Carolina
39New Jersey
46New York
50West Virginia

Worst 10 States for Physicians—Career Factors

47New Jersey
50New York

Worst 10 States for Physicians—Lifestyle Factors

46South Carolina
49West Virginia

Ready to make a change? Or are you at least curious about which states made our list of Best States to Practice Medicine in 2019? Read that analysis here.

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