What Makes a Best Place to Practice Medicine?

Shelly Reese

Disclosures

May 16, 2016

In This Article

Shifting Demographics and Market Competition Make a Difference

For doctors, the shifting demographic and healthcare landscapes are redefining what a "best place" to practice looks like. Years ago, selecting a practice location was a little more straightforward. You could analyze data points—physician density, malpractice costs, tort reform, and other such factors—then head for a new location and set up your practice.

Today, the situation is far more complicated. There's a generation gap. Millennials, Gen Xers, and baby boomers often have very different views on what constitutes a great community. Market forces are changing the economics. The question is no longer an objective, "Where is the best place to practice?" Instead, "it's really a question of where are you right now in life," says Jason Farr of the Medicus Firm, a physician recruiting company.

What Has Changed?

Market consolidation, the physician shortage, the erosion of regional pay disparities, the rise of two-income households and a mobile workforce, and a divergence in generational priorities are changing the way doctors select their practice locations.

Regional compensation differences—once a key consideration in selecting a practice location—aren't nearly as vast as they used to be. In 2016, the difference between average pay in the most lucrative region (the North Central states, which include Iowa and the Dakotas) vs the least (the Northeast) was just 11% ($296,000 vs $266,000), according to the 2016 Medscape Physician Compensation Report.

Health systems are acquiring private practices, employing physicians, and footing the bill for their malpractice coverage. Some rural hospitals are closing. Such perks as loan forgiveness and signing bonuses, once a critical differentiator for rural systems, are now common fare in many urban markets, where health systems are battling for physicians and market share.

Those trends are shifting recruitment to the cities. The Medicus Firm reported that last year, placements in urban and metropolitan areas with a population of more than 500,000 outpaced those in midsized and rural communities for the first year in the company's history. This increase in search and placement activity in metropolitan areas is indicative of the intensified level of competition for physicians, even in markets traditionally considered highly desirable.

Broader economic trends—such as plunging oil prices and the rise of the information economy—are likewise coming into play by affecting employment opportunities, housing prices, and overall market desirability.

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