Best and worst cities in the U.S. to practice

Medscape has released its third-annual list of the best and worst big cities and small towns in the United States to practice, based on lifestyle, climate, practice conditions, and amenities. So did your city make the list? 

The list divides the country up into six regions-West and Northwest, Great Lakes and North Central, Northeast, Mid-Atlantic, Southeast, and Southwest and South Central.

Medscape looked at:

• State-level data, such as tax burden data

• Malpractice claims information

• Medical board disciplinary actions

• Cities and towns within the most favorable states that offered the best opportunities for physicians, as recommended by doctors and recruiters

• Market-specific data from the U.S. Census Bureau, Coldwell banker Real Estate, Sperling’s Best Places, Bureau of Labor Statistics to assess economics, demographics, housing costs, and quality of life.

West and Northwest

The best big city: Tri-Cities (Kenneqick, Pasco, and Richland), WA.

• High reimbursement rates

• Great place to raise children

• Low crime rate

• Average home price: $303,388

• State and local taxes: 9.4%

Best small town: Douglas, WY

• Top critical access hospital (Douglas Memorial Hospital)

• Wealth-friendly state

• Plenty of outdoor activities

• Unemployment: 4.7%

• Average home price: $227,415

• State and local taxes: 6.9%

Worst city: Los Angeles

• Bad traffic

• High cost of living

• Intense healthcare market consolidation

• Low reimbursement rates

• Average home price: $383,900

• State and local taxes: 11.4%

According to Medscape, “Southern California reimbursement rates are low, and state and local taxes are extremely high. Doctors in Los Angeles are likely to earn less than their peers in less populous markets while paying substantially more for housing.”

Next: Great Lakes and North Central

Great Lakes and North Central

Best city: Indianapolis

• Center for medical research

• Family-friendly environment

• Low cost of living

• Average home price: $187,037

• State and local taxes: 9.5%

• Per capita malpractice claims in 2013: $4.18

Best small town: Duluth, MN

• Low physician density

• Good salaries

• Average home price: $189,713

• State and local taxes: 10.7%

• Doctors can practice full extent of their training, but still have access to a full range of medical resources

Worst city: Detroit

• Bankrupt city

• 47% of adults are functionally illiterate

• Intense healthcare consolidation

• Average home price: $66,500

• State and local taxes: 9.6%

According to Medscape, “Detroit is one of the cities hardest hit by the housing crisis. The subprime mortgage debacle, the downsizing and outsourcing of the auto industry, and corrupt local politicians have take their toll…The Robert Wood Johnson Foundation ranks Wayne County the most unhealthy county in Michigan.”

Next: Northeast

Northeast

Best big city: Boston

• Top medical schools and hospitals

• Rich cultural attractions

• Access to both beaches and mountains

• Unemployment below national rate

• Average home price: $494,864

• State and local taxes: 10.3%

Best small town: Merrimack, NH

• Young, educated population

• Beautiful environment

• Low malpractice claim rate

• About an hour north of Boston

• Average home price: $236,891

• State and local taxes: 8%

• Named on CNNMoney’s “Best Places to Live” list last year 

Worst city: Providence, RI

• Tax-unfriendly state

• High unemployment (9.7%)

• Uncompetitive business climate

• Average home price: $147,055

• State and local taxes: 10.5%

According to Medscape, “Although Providence has a lot to offer-excellent higher education and healthcare, and a prime location-Economic Modeling Specialists International named Providence/New Bedford/Fall River area among the 10 least competitive metro areas in the country. Similarly, Kiplinger says that Rhode Island is one of the five least-friendly tax states." 

Next: Mid-Atlantic

Mid-Atlantic

Best big city: Raleigh, NC

• Good economy driven by technology and healthcare

• Relatively low cost of living

• Major metro healthcare center

• Average home price: $255,860

• State and local taxes: 9.8%

• Ranked third best metro area for business and careers by Forbes 

• Ranked fourth best city for dating by Sperling’s

Best small town: Blacksburg, VA

• Low cost of living

• Excellent high school

• Outdoor activities

• Low crime

• Average home price: $255,667

• State and local taxes: 9.2%

• Named one of the best college towns in the South by Southern Living 

Worst city: Washington, DC

• Very high physician density-2.5 times the national average

• High cost of living

• Bad rush hour traffic with high rate of accidents

• Average home cost: $588,648

• State and local taxes: 9.7%

According to Medscape, “finding a doctor is about as tough as finding a politician.”

Next: Southeast

Southeast

Best big city: Nashville, TN

• Excellent city for business and job growth

• Great music and entertainment scene

• Affordable costs of living

• Average home price: $195,425

• State and local taxes: 7.6%

• Fairly saturated healthcare market, but still room for growth

• Ranked by Forbes as fifth best metro area for business and careers

Best small town: LaGrange, GA

• Low cost of living

• Excellent public schools

• Outdoor activities

• Average home price: $189,435

• Local and state taxes: 8.8%

• One hour north of Atlanta

Worst city: Miami

• High poverty

• High unemployment

• Very litigious state

• Average home price: $342,947

• State and local taxes: 9.2%

According to Medscape, “The Florida Justice Association estimates that there are more than 700 medical malpractice suits pending statewide. South Florida is known for being particularly litigious, and a recent ruling by the Florida Supreme Court, which rejected damage caps associated with medical malpractice wrongful death suits, intimates that it won’t get better anytime soon.”

Next: Southwest and South Central

Southwest and South Central

Best big city: San Antonio, TX

• Family-friendly environment

• Relatively low cost of living

• Tort reform and favorable malpractice environment

• Average home price: $188,710

• State and local taxes: 7.5%

• Home to Brooke Army Medical Center

Best small town: Tyler, TX

• Regional healthcare hub

• Good public school system

• Low property tax

• Average home price: $224,052

• State and local taxes: 7.5%

• Four local colleges

• Nicknamed “Rose Capital of the World”

Worst city: Albuquerque, NM

• High crime

• Above-average HMO penetration

• Lower compensation

• Average home price: $259,578

• State and local taxes: 8.6%

According to Medscape, “Breaking Bad cast a less-than-flattering spotlight on Albuquerque. The fictional TV series depicted some of the city’s real-life problems: drought, violence, poverty, and a crime rate well above the national average.” 

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