By Deborah Jeanne Sergeant
The personal finance website WalletHub recently released its report on 2018’s Best & Worst States for Doctors. New York came in third from last, meaning only Rhode Island and New Jersey are worse states in which to practice. South Dakota, Nebraska, Idaho, Iowa and Minnesota ranked as the top five best states.
The report included 16 key metrics, which includes average annual physician wages to the quality of the public hospital system.
For doctors practicing in New York, the outlook is grim.
In the following categories, the Empire State rated:
• 49th — Average annual wage of physicians (adjusted for cost of living)
• 42nd — Average monthly starting salary of physicians (adjusted for cost of living)
• 51st — Hospitals per capita
• 16th — Insured population rate
• 28th — Projected percent of population aged 65 & older by 2030
• 46th — Projected physicians per capita by 2024
• 49th — Malpractice award payout amount per capita
• 50th — Annual malpractice liability insurance rate
Physician Leila Kirdani practices at Quality of Life Medicine in Rochester and New Hartford. Kirdarni practiced in traditional family medicine for 15 years. Her offices don’t accept insurance but operate on a fee-for-service business model to eliminate the red tape and allow providers to practice in a more patient-centered fashion.
She said that the insurance company mandates since the Affordable Care Act have made it “ridiculously complicated to see patients.” For her, so much is being demanded of doctors. “It’s not about the relationship with the patients, which is what a lot of doctors and people value. It’s about documentation.”
For example, if a doctor doesn’t check off every box and include the required wording in each area of the chart, he doesn’t receive reimbursement for the visit — which can be paltry to begin with compared to the doctor’s operating overhead.
“Rochester has one of the lowest reimbursement rates for primaries,” Kirdani said. “It gets down to bean counting. Are you checking off all the right boxes? It’s not about patient satisfaction.”
Instead of focusing on patients, doctors’ noses are buried in laptops as they fire off questions and tap in patients’ responses, she said.
Barbara Greenwald, executive director of the New York State Osteopathic Medical Society, said that the high rate of medical malpractice suits in New York has complicated the delivery of medical care. As a result, doctors must pay high premiums for medical malpractice insurance to protect themselves.
She said that her organization and the Medical Society of the State of New York has been lobbying for a cap on emotional damage claims.
“We don’t get very far,” she said. “Lawyers are more apt to go into politics than doctors.”
She said that doctors in Downstate New York struggle to make enough money to afford the high cost of living in the city, since insurance reimbursements are so low. Here in Upstate, health organizations struggle to attract enough care providers to meet the needs.
“To draw docs to sparsely populated areas, you need to enhance the infrastructure,” Greenwald said. “It’s a more complex problem. To attract physicians, they’ll want amenities and a hospital nearby. Some doctors are going back to making house calls. It should be ‘prescriber prevails’ instead of the insurance company deciding on cost.”
To read the entire report, visit https://wallethub.com/edu/best-and-worst-states-for-doctors/11376.