10 worst states for private practice physicians

A physician looking to go into private practice has to think about several factors when settling on a location. Prominent among them are the area's average pay, regulatory environment, amount of competition and individual insurance market.

Becker's ASC Review has compiled data from the 2020 Census, Bureau of Labor Statistics, state regulations on new practices and the Kaiser Family Foundation to create a ranking of states for private practice physicians.

The 10 worst states for private practice physicians:

State

Physicians Per 100k Population

Avg Physician Pay

Herfindahl-Hirschman Index

Becker's Composite

1. Vermont

155.50

$226,390

10,000

-5.24

2. Delaware

100.53

$219,940

9,952

-4.07

3. District of Columbia

105.78

$212,890

7,294

-3.43

4. Alaska

136.31

$266,200

9,997

-3.16

5. Wyoming

166.07

$263,540

9,580

-2.87

6. North Carolina

9.10

$198,750

9,505

-2.38

7. Alabama

18.59

$213,410

9,341

-1.98

8. North Dakota

88.12

$212,990

6,865

-1.80

9. Oklahoma

22.64

$205,440

8,964

-1.59

10. Mississippi

16.74

$184,170

4,958

-1.36

Note: The Herfindahl-Hirschman Index is a measure of market competitiveness, here applied to the individual insurance market. "Average physician pay" is taken from Bureau of Labor Statistics data that excludes pediatricians.

Methodology

To convert each dataset into comparable numbers, Becker's calculated the standard deviation and average of each, which were both used to determine the Z-scores for every value. The Z-score is a measure of how far a point of data is from its parent dataset's average.

For "Average physician pay," higher numbers are clearly better, but for "Physicians per 100K population" and "Herfindahl-Hirschman Index," golf rules apply: the lowest score wins. In calculating the Becker's Composite, the signs were reversed on the Z-score categories playing by golf rules, which were then summed with the physician pay Z-score and a value reflecting the restrictiveness of state regulations.

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