What makes Minnesota one of the best states to practice

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Medscape has frequently ranked Minnesota as one of the best states for physicians to practice in its annual list based on a number of factors. What makes the state an attractive place for healthcare workers?

Medscape ranks states according to compensation, health system performance, happiness in and outside of work, and physician burnout, among other measures. Minnesota was listed in the top five states for four out of the past five years.

Minnesota was viewed highly in terms of overall livability and health system performance. Average compensation for Minnesota physicians in 2020 was $244,720. Although it has a high percentage of burnout, Minnesota has been ranked as having the lowest malpractice rates and ranked highly for well-being, public health and higher education levels.

William Nicholson, MD, is a hospitalist at M Health Fairview and vice president of medical affairs for Fairview's St. John's Hospital, Woodwinds Hospital and St. Joseph's Campus. Dr. Nicholson said he advocates for the state to be the best not only in his role at Fairview, but as a member of the Minnesota Medical Association and chair of the organization's political action committee.

"We try to elect lawmakers who are more in tune with what patients need and what it means to have a great health system and we've done pretty well at that in Minnesota," Dr. Nicholson said. "Minnesota has a long tradition of politicians and leaders in healthcare who get it. They understand that it's not about winning the argument. It's about getting the outcome for the patient that matters at the end of the day."

Dr. Nicholson also attributed the success of hospitals and Minnesota's overall livability to the "Minnesota Miracle" of 1971, a series of reforms passed by state officials to improve several key areas, including education, infrastructure and taxes. This, he said, has had long-term effects still seen today.

"As a physician, you see the end pathway of unsafe living, pollution, education [and] socioeconomic gaps. It's not just nice and pretty to live in a city that has great public spaces and high-quality schools that are well supported and robust cultural activities," Dr. Nicholson said. "We see it as protective of our patients and something that makes our practices better, not only because it prevents illness, but because when someone gets ill we know that there are resources that will support them."

Marc Gorelick, MD, president and CEO of Minneapolis-based Children's Minnesota, said the medical device industry in Minnesota is attractive to physicians as well.

According to the Minnesota Department of Employment and Economic Development, implantable cardiac pacemakers, mechanical heart valves and implantable infusion pumps are just a few devices to come out of the state, which also ranks highly for the number of device patents per 1 million people. Manufacturing employment is also four times more concentrated than the national average, with nearly 32,700 employees.

"We have a thriving medical device industry here in the Twin Cities region that is, I would argue, second to none," Dr. Gorelick said. "That makes it an attractive environment because there is that spirit of always wanting to innovate and drive improvements in healthcare. Those are some of the things that make this a place where people can be happy to work in healthcare as physicians or other providers."

Dr. Gorelick added that two major aspects that attract physicians to practice in Minnesota are the number of top performing hospitals and the collaboration between hospital systems.

"We have a long history of health systems working together to collaboratively address things around overall quality of care, patient safety and, more recently, issues of health equity," Dr. Gorelick said. "That spirit of collaboration runs deep here and is also an attractive environment for somebody who wants to practice and wants to see the population of the state thrive."

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