Worst Places to Practice Medicine

Medscape periodically publishes a “Best” and “Worst” places to practice medicine (1). We were struck by this year’s list because three of the five worst places to practice medicine are in the Southwest (Table 1).

Table 1. Medscape’s “worst” places to practice medicine.

1. New Orleans, Louisiana
2. Phoenix, Arizona
3. Las Vegas, Nevada
4. Albuquerque, New Mexico
5. Tulsa, Oklahoma

While Minneapolis rated the best place to practice, only 2 cities from the Southwest made the top 25 “Best” list-Salt Lake City at 13^th and Colorado Springs at 24^th. Most of the top 25 are from the Midwest or Northeast. None from California made the best places list and only the only Southern location was Virginia Beach, Virginia. 

Rankings resulted from the combination of twelve 50-state rankings: medical board actions per doctor; malpractice lawsuits per doctor; office-based primary care physicians per population; physician income; employer-based insurance rate per population; insurance coverage per population; reported rates of well-being of the general population; violent crime rates; participation in wildlife-related recreation; divorce rates; use of family-friendly amenities; and cost of living.

Phoenix, Las Vegas and Albuquerque were singled out for high rates of uninsured patients. Phoenix was also singled out for its moderately high malpractice suit rate.

Before everyone in the Southwest decides to move, these ratings may be meaningless, much like hospital rankings (2). Furthermore, there seems little that physicians can do to improve the situation based on the selected metrics. What can be done is to continue our efforts through our professional organizations to educate the public and their elected representatives that job satisfaction is necessary to recruit and retain physicians, as well as nurses and other health care professionals. A healthcare organization without these well-educated and caring people lacks quality and attempts to substitute substandard care is much like trying to substitute a Yugo for a Mercedes.

Richard A. Robbins, MD

Editor, SWJPCC

References

1. Page L. Best places to practice to avoid burnout. Medscape. May 10, 2017. Available at: http://www.medscape.com/viewarticle/879573 (accessed 5/16/17).
2. Robbins RA, Gerkin RD. A comparison between hospital rankings and outcomes data. Southwest J Pulm Crit Care. 2013;7(3):196-203. [CrossRef] 

Cite as: Robbins RA. Worst places to practice medicine. Southwest J Pulm Crit Care. 2017;14(5):236-7. doi: https://doi.org/10.13175/swjpcc060-17 PDF