Issue link: https://viewer.e-digitaledition.com/i/77665
SPECIAL FEATURE Up Sizing A NUMBER OF FACTORS CAN INFLUENCE A PHYSICIAN'S DECISION ON WHICH U.S. STATE IS BEST FOR HIS OR HER PRACTICE, WITH DIFFERENT MEDICAL REGULATIONS, VARYING LEVELS OF ECONOMIC INTERVENTION AND UNIQUE LIFESTYLE COMPONENTS OFTEN RANKING HIGH AMONG THEM. T THE States HE BEST METHODS of determining "physician friendliness" cannot be entirely objective, as surgeons and anesthesiologists might fi nd certain aspects of state regulations more intrusive than would family physicians or pharmacists. Likewise, claiming that fewer disciplinary actions by medical boards means a state exhibits friendliness toward physicians is problematic; high accountability generally leads to high levels of performance. Nevertheless, fac- tors such as total malpractice claims paid, added regulations to federal physician requirements and workforce demand do affect whether a physician feels welcome in a certain state. The chart seen here is broken up into four categories based on factors that play prominent roles in the lives and practices of physicians: eco- nomics, workday situation, government interaction and overall lifestyle. Whether you prefer intense regulation or a free hand, high accountability or low malpractice-suit caps, the information found here will help you determine which states best meet your top "friendliness" standards. ■ 18 | Central New York MD NEWS ■ MDNEWS.COM Economics The average salary fi gure may be deceiving, as cost of living varies by state. Because salaries vary by specialty — surgeons generally have higher salaries, psychiatrists generally lower — the fi gure listed is for general and family practitioners. State and local spending is listed as a percentage of gross state product (GSP) instead of in total amounts to negate disproportionate population data. Government Interaction Although government interaction will play a role no matter which state you practice in, some states practice a more laissez-faire approach to medicine, at least as much as they can in a world of malpractice suits and state licensing programs. Presented here are the average payments of malpractice claims and the number of disciplin- ary actions by state medical boards. While states do have unique regulations for physicians, there are a few for which state regulations simply defer to federal regula- tions. These include Alabama and Montana. The state regulations in Mississippi, Nebraska and Nevada largely echo federal regulations with rules written in state-specifi c terms. Lifestyle It's nice to know the facts about issues such as disciplinary actions and patients who can't pay, but generally, those aren't the main reasons physicians choose to live where they do. Entire economic prin- ciples are based on the fact that human choice cannot be accurately predicted. Nevertheless, it can be measured. Here, state retention rates for premedical and medical school graduates are listed, showing which states new physicians liked enough to stay in. For a more general look at state lifestyles, average income per household is included, as well. Work Environment To determine whether a locale is physician-friendly, it is vital to examine factors that will affect the daily work environment. Although these factors are numerous and sometimes impossible to quantify, any determination of hospitality to physicians should include rankings of technology usage, demand for physicians and the percentage of individuals incapable of paying for medical care.