THE STATES THAT WANT MORE PHYSICIANS
THE STATES TRYING TO INCREASE PHYSICIAN NUMBERS
THE MASSIVE PHYSICIAN SHORTAGE HAS STARTED
Some states and groups take physicians for granted. In an effort to "protect" the the public some state actions scare excellent physicians. Physicians see medical boards, malpractice agencies of hospitals acting aggressively and leave the state—forever. Physicians are very herd conscious. Meaning what you do to ten physicians is noted by a majority in the state, and even some pondering moving to your state.
Smart doctors, after completing residency, or when ready to move from where they trained, are looking for very pro-MD states.
For example, managed care is managed poor care. I have watched it in medical team care meetings in which the managed care staff member promoted inferior care. Everyone knows managed care is cost control and not top care. Indeed, some leaders in managed care have come to me and paid cash, and rejected physicians in their free managed care company.
The idea of being sanctioned by a managed care company might be a badge of honor. It is hardly meaningful to most clinicians to be "sanctioned" by people they sometimes feel are inferior physicians. Many physicians feel the motives of managed care "review" nurses, pharmacists or physicians have motives undermined by who pays them. "Education" coming from managed care is very dated medicine and is cost control "education." It never seems to address hard to treat patients.
The list of Pro-MD states is a bit simplistic, so if you are a new graduate physician looking to start a practice or a physician looking to move to a new opportunity, you need to ponder more than just this list of state board friendliness.
For example, Florida is ranked as pro-MD state based only on the medical board, but three malpractice cases can end your entire USA medical career, and it is possible to lose your license in Florida if you really do three acts of malpractice in any time frame. My belief is high malpractice lawyer numbers like those that seem omnipresent on Florida TV might cause physicians to avoid any patient or any service that could lead to a malpractice case--so if you are willing to try life-saving risky surgeries or treat very complex patients, some may avoid this risk in high malpractice states. Florida had an issue with a small number of super narcotic dispensers, and now few are comfortable writing for pain medicines--you can be disciplined in Florida for excess pain treatment or under treatment. So why would any Florida or Pennsylvania physician treat pain over 2 weeks, when in PA for example, any annoyed insurance BC/BS clerk with no knowledge of advanced doctoral level medicine can call the medical board?
The other issue is Florida is like a number of other states in being a pro-arrest state, with some areas like Naples and Tampa, you can see in some areas a police officer on every corner. Perhaps they do not want to be like the shrinking number of fire fighters, and are trying to cover their salary with arrests. Raise your voice to your wife in Florida--you can get arrested as a domestic violent person. Use a gun to stop a robber or former violent husband of your new girlfriend, who is trying to severely harm you--you may end up in jail. Carry a gun legally and get pulled over for traffic stop, plan on being arrested. Some sheriffs and police reject the pro-gun laws of their state, and follow their street law on the 2nd Amendment.
Another issue in picking a state for medical practice involves hospital relationships. Delaware demands you report any physician with any possible impairment. If you work in a hospital, you may interact with twenty physicians in a week. So legally and ethically in that state you have to be comfortable reporting on physicians that might seem "off" to you. Further, if you get two hours sleep before working, you might appear "off" to other physicians, despite this being routine during an internship.
I will never be part of any hospital, unless I have full control of the wing I am involved with. All that has to happen is to have some consultant not agree with your approach. They may say it is a violation of the "standard of care." The fact is that this "standard" is useless to some unknown percent of patients. And you have to be comfortable telling people you cannot help them if synthetic drugs or operations will not help them. Are you comfortable with MD "standards" limited to 2012-patented drugs and surgery options? Some like to add to this foundation, but that means you are not a standard allopathic [MD] physician.
THE FOLLOWING HAVE PRO-MD MEDICAL BOARDS AS A TREND
These all have problems but these tend to less anti-MD. They understand physicians will not come if the state is seen as aggressive. But each has trouble areas, so look at each place and ponder what type of medicine you do. Some are safe and some are less safe. For example, if you sometimes like treating tick infections over four weeks, South Carolina, Wisconsin and Connecticut may prosecute you, but they are in the top four in terms of low medical board attacks.
These states are: Minnesota, South Carolina, Wisconsin, Connecticut, Massachusetts, Rhode Island, Florida, New Hampshire, Utah and Vermont.
THE WORST STATES FOR PHYSICIANS IF YOU ARE A PHYSICIAN WHO DOES NOT WANT TROUBLE WITH MEDICAL BOARDS
These include: Louisiana, Alaska, Ohio, Oklahoma, Wyoming, North Dakota, New Mexico, Arizona, Nebraska, and Colorado.
EMERGING ANTI-MD MEDICAL BOARDS
THESE STATES ARE INCREASING THEIR ATTACKS ON PHYSICIANS SIGNIFICANTLY SO THINK TWICE IF YOU ARE MOVING TO THESE LOCATIONS AFTER A RESIDENCY OR IF YOU LIKE THE STATE AND WANT TO RELOCATE
You must look at the trend of a medical board if you are wasting 5-10 years moving to a state. For example, Delaware went from a very physician friendly state a very aggressive state with many rules and expectations. You must know these rules to be sure you do not violate their law and to determine if you feel comfortable with them. Since Delaware is next door Pennsylvania which has tons of medical schools and residency locations, Delaware does not need many physicians, and so they may not be hit hard in the next decade as physician numbers fall profoundly.
These States Below are Increasingly Anti-MD, Maine, North Carolina, Washington, and Arkansas.