New York: Second Worst Place for Doctors

By Deborah Jeanne Sergeant

New York at ‘a competitive disadvantage in competing for the next generation of physicians’

Personal finance site WalletHub recently released its annual report on “Best & Worst States for Doctors.” The report uses 19 key metrics to compare the states, including average annual wage, number of hospitals per capita and the cost of liability insurance. 

New York ranked second to last.

Joseph Sellers, president of the Medical Society of the State of New York, has practiced with the Bassett Medical Group in Cooperstown for the past three decades. A lifelong New Yorker, Sellers grew up in Buffalo and attended college in Rochester. Though he attended medical school in Washington, DC, he returned to New York to complete his internal medicine and pediatrics residencies in Albany.

He believes that the physician shortage underscores many of the problems the state’s doctors face.

“Family, patient and community ties have kept me here, but across the state we are facing shortages of physicians as baby boomer doctors retire and newly trained physicians choose to locate to practice in friendlier states,” Sellers said. “The result of the well-earned reputation as a difficult state in which to practice medicine is putting New York at a competitive disadvantage in competing for the next generation of physicians.”

He lists as issues in New York:

Regulations. New York has “a highly regulated practice environment with government and insurers interfering in the physician-patient partnership as we work together to get folks the best health outcomes possible,” he said. “For example, there are more than 20 unique physician medical practice mandates in the law, each of which carry the risk of severe civil penalties and license sanction for failure to document compliance.”

Some antiquated mandates and regulations. These “remain on the books despite advances in medical knowledge. Business regulations and costs have made it nearly impossible for a new physician to start their own independent practice.”

High malpractice risk and insurance expenses. In New York, these are “far higher than any other state. Collectively, we pay twice the dollars but only have half the population of California here in New York.” He estimates that about two-thirds of the states have worked to mitigate these expenses, unlike New York.  

Merging health insurance companies. These business mergers cause companies to monopolize their areas of the state and “limit needed care for patients with prior authorizations, deductibles, co-pays, narrow practitioner networks and other hassles impacting both physician and patient,” Sellers said. He added that providers must hire more staff just to process required paperwork for insurers. 

Lower payments in Upstate. Sellers said this includes private and government payors. “The reimbursement from the state Medicaid program in New York is the fourth lowest in the USA as a percentage of federal Medicare payments,” Sellers said.

Closing hospitals. The effect limits “physicians’ and patients’ access to timely and local care and is likely contributing to the increasing disparities in health status and outcomes,” he said.

High taxes. “Taxes on income, property, purchases and anything else the government can think of to tax are much higher in New York than other states. When recruiting new physicians to join us in practice, we cannot compete with lower tax states.” While just one metric of quality of life, high taxes presents a financial challenge to newly minted doctors facing mountains of school loan debt.

For the full report, visit: wallethub.com/edu/best-and-worst-states-for-doctors/11376