Survey: Tennessee one of the 10 best states for doctors

Tennessee is a great state for doctors to practice, with recent medical school graduates earning the top salaries nationwide if you adjust for the local cost of living, according to a new survey.

Overall, Tennessee ranks 10th in terms of best places to practice medicine, based on a survey by the financial website WalletHub.com.

The survey was based on 14 criteria, including physicians' average salaries, the number of hospitals and doctors per capita, percentage of the population that is elderly, percentage with health insurance, plus some criteria aimed directly at doctors, such as the number of hours of required continuing education and the cost of medical malpractice insurance.

Iowa ranked first in the U.S., and most of the top 10 states were in the Midwest or Northwest, including Minnesota in second place, followed by Idaho, Wisconsin, Kansas, South Dakota and Montana. Alabama was rated eighth in the U.S. and Mississippi ninth, just ahead of Tennessee. Georgia ranked No. 26.

Besides having the top monthly starting salary, Tennessee ranked ninth in terms of competition, 15th in annual salary, and 16th on the potential competition in 2024 and in malpractice insurance rates.

New York ranked last, below (in order) the District of Columbia, New Jersey, Maryland, Rhode Island, Massachusetts, and Connecticut.

New York's last-place rating was in part due to its medical malpractice insurance costs, rated the highest in the nation, accompanied by the highest medical malpractice payouts per capita.

Tennessee has made significant progress in that area, according to Dave Chaney, vice president of the Tennessee Medical Association (TMA), which represents physicians in the state. "Tort reforms enacted since 2008 [led by TMA] have resulted in a 40 percent drop in volume of medical liability claims filed against physicians and a 37 percent drop in physicians' insurance premiums," Chaney said.

Among those reforms is a requirement that an attorney obtain a statement from an expert (generally a physician) within 90 days after filing a lawsuit stating that a claim has merit, said Rae Bond, executive director of the Medical Society of Chattanooga and Hamilton County, which represent area doctors. "That has raised the bar a little bit-it has eliminated a lot of the frivolous lawsuits that had become a problem," she said.

Even though Tennessee ranks highly overall, there are still disparities between urban and rural areas of the state in terms of how attractive they are to doctors.

"One thing that is clearly an issue is that for certain specialties, doctors need to practice where there is access to a hospital," Bond said. "In rural areas, there isn't ready access to the hospital they would need to do certain procedures."

More doctors are turning to specialties, in part to pay off the big bills they often incur for student loans while in medical school. The WalletHub survey noted that the average medical school graduate faces $189,000 in student loans at graduation.

"Most young people entering the medical field are becoming specialists where they have greater earning potential," said Chaney. "Primary care is where the real need exists, and it is more difficult to attract primary care providers to rural areas. We need more funding for graduate medical education and other programs and incentives to help recruit and retain physicians to practice in rural areas."

While doctors make high salaries, there are questions about the future of their profession, given the national debate over health care. Many doctors report they are unhappy with their work lives, as they spend less time with patients and more time on administrative work.

"[A] big issue is the high levels of dissatisfaction and burnout now seen across the profession as a whole," said Timothy Hall, a health care management specialist at Northeastern University. "Improving the everyday work lives of most physicians remains a top priority."

Experts said physicians face real concerns in complying with complicated billing requirements from insurers or government agencies.

"Compliance with billing and reimbursement issues is extremely risky, costly, and creates anxiety, as many health care laws are complex and broadly written," said Christine Coughlin, a professor at Wake Forest University. "[M]istakes in the arena of billing and reimbursement come with dire personal consequences for physicians, including the threat of criminal prosecution for what many doctors are concerned are honest billing mistakes."

Contact staff writer Steve Johnson at 423-757-6673, sjohnson@timesfreepress.com, on Twitter @stevejohnsonTFP, and on Facebook, www.facebook.com/noogahealth.