By Chris Caraveo
With National Doctors’ Day March 30, and “physician” being the highest-paid job of 2018, personal-finance website WalletHub recently released its report on 2019’s Best & Worst States for Doctors.
Arizona isn’t great, but it also isn’t among the worst, coming in at No. 24.Montana is No. 1, followed by Wisconsin, Idaho, Minnesota and Iowa. New York is the worst state for doctors, according to the report.
“Arizona lacks in number of hospitals per capita, having less than three per 100,000 residents,” WalletHub Analyst Jill Gonzalez told the Daily News-Sun. “The insured population rate is less than 88 percent, and the share of employer-based health insurance is smaller than 41 percent, both percentages among the lowest in the country.”
To identify the best states for those in the business of saving lives, WalletHub compared the 50 states and the District of Columbia across 18 key metrics. The data set ranges from average annual wage of physicians to hospitals per capita to quality of public hospital system.
The metrics are categorized under “Opportunity & Competition” and “Medical Environment,” with 70 points distributed among metrics under the first category.
“While medical environment is important, we considered opportunity and competition to be the main factor in doctors’ decisions to work in a state or another,” Ms. Gonzalez stated.
Probably to no surprise, average annual wage has the most weight among all metrics.
Arizona ranks in the Top 15 in projected share of people 65 and older by 2026. It is estimated 22.14 percent of Arizona will be seniors in seven years.
“Senior citizens require a lot more medical care,” Ms. Gonzalez stated. “This is why the projected share of elderly population is important. A larger percentage is beneficial to doctors, as they are sure to have patients visiting their offices.”
The state also fares well in current competition (9th), share of medical residents retained (16th) and number of CME credits required (6th).
Despite the middle-of-the-pack ranking, Arizona has made some adjustments to better appeal to physicians.
In 2018, House Bill 2322 was unanimously passed to ensure insurance companies completed the process to credential and load physicians into their networks so they are able to treat patients in a more timely fashion. The law requires both processes to be done in 100 days or less.
HB2322 took effect at the start of this year. Before then, physicians undergoing this process may have faced delays exceeding nine months, according to a release.
Among the negatives before the law took effect: reimbursement shortfalls for physicians, gaps in access to care for patients awaiting referrals to specialists, competitive disadvantage for hospitals trying to recruit out-of-state physicians where the processes work more efficiently.
“We are grateful to the legislators, stakeholders and fellow healthcare community leaders who came together to address this issue and come up with a workable, necessary solution,” Arizona Osteopathic Medical Association Executive Director Pete Wertheim stated last year. “This bill will provide insurers ample, reasonable time to credential physicians and allow them to get to work doing what they do best: caring for patients.”
Arizona has a lower malpractice award payout amount per capita and a lower annual malpractice liability insurance rate than Montana, the nations top state for doctors.
Higher amounts and rates can be negative selling points for doctors as they choose where to practice.
“Especially if the wages are lower,” Ms. Gonzalez stated. “Since malpractice regulations vary substantially among states, higher insurance rates can drive doctors away.”
Fortunately for doctors in Montana, their average monthly wage is the best in the nation ($5,106) and exceeds Arizona’s by $1,500.
Dr. Jinhai Huo, an assistant professor at the University of Florida, listed burnout, quality measurement and electronic health record integration as some of the few major challenges doctors face today.
“Both state and local policy will have an impact on the doctor’s practice,” Dr. Huo stated. “After medical students pass the medical exams, they need to get license from each state’s licensing board and this license cannot be transferred to other states directly.”
However, Arizona recently introduced House Bill 2569, a universal-licensing bill that would ease restrictions on out-of-state practitioners looking to work in the state.
In his State of the State address in January, Gov. Doug Ducey mentioned more than 100,000 people moved to Arizona between July 2017 and July 2018. Among those may be people seeking employment but have occupational licenses from other states.
“There’s a job available for every one of them,” Mr. Ducey stated. “Standing in their way of earning a living in Arizona, our own licensing boards, and their cronies who tell them — ‘You can’t work here. You haven’t paid the piper.’”
Keep in mind, out-of-state licensees would still have to meet certain requirements, to include being licensed for a least one year in the original state and be in good standing.
According to a 2018 report conducted by the Arizona and American Medical Associations, physicians aided the state’s economy by creating 198,921 jobs and generating $33.5 billion in economic activity.
Across the U.S., physicians add $2.3 trillion to the economy, support more than 12.6 million jobs, contribute $1 trillion in total wages and benefits paid to workers, and generate $92.9 billion in state and local tax revenue.
Mississippi has the highest average annual wage for surgeons (adjusted for cost of living), $316,828, which is 2.7 times higher than in the District of Columbia, the lowest at $117,763.
Oklahoma has the lowest number of physicians per 1,000 residents, 0.99, which is 6.3 times lower than in the District of Columbia, the highest at 6.20.
Florida has the highest projected share of the population aged 65 and older by 2030, 27.08 percent, which is two times higher than in Utah, the lowest at 13.21 percent.
Nebraska has the lowest annual malpractice liability insurance rate, $4,977, which is 8.2 times lower than in New York, the highest at $40,826.