Physicians in states with the highest pay often have the least competition: Where does your state rank?

Call it a matter of supply and demand. Physicians tend to have the highest pay in states with the lowest population of physicians. On the other hand, physicians generally earn less in states where there’s a higher concentration of competing physicians.

Of the 15 states where physicians have the highest wages, several have the fewest physicians per resident population: Alabama, Wyoming, Iowa, Nevada, and Indiana. Conversely, among the 15 states (or districts) with the lowest-paid physicians, some have the densest population of physicians: District of Columbia, New York, Pennsylvania, Maryland, Oregon, and New Jersey.

For this comparison, we obtained physician salary data from the Bureau of Labor Statistics’ May 2017 State Occupational Employment and Wage Estimates. Physician population data for each state came from the Association of American Medical Colleges (AAMC) 2017 State Physician Workforce Data Report.

This salary vs supply paradox is well worth considering, as the physician shortage is growing worse while physician salaries aren’t growing fast enough.

“We continue to project that physician demand will grow faster than supply, leading to a projected total physician shortfall of between 42,600 and 121,300 physicians by 2030,” predicted authors of a recent report, also from AAMC.

“We must start training more doctors now to meet the needs of our patients in the future,” said Darrell G. Kirch, MD, AAMC president and CEO.

The happiest physicians

Despite the trend toward higher salaries in states with fewer physicians (and vice versa), there are some notable exceptions. New Hampshire ranks number 10 among the most physician-populated states, yet it also tops the list of states with the highest physician salaries. Maine appears on both lists, too.

Several states are among those in which physicians are paid the least and have the lowest physician density: Arkansas, Oklahoma, Texas, Kansas, and Mississippi.

For comparison, a recent analysis by WalletHub found South Dakota to be the best state to practice medicine.

“There are, unquestionably, better and worse areas to work if you are looking to maximize your standard of living,” Howard P. Forman, MD, MBA, professor, Diagnostic Radiology, Public Health, Economics and Management, Yale University, New Haven, CT, told WalletHub. “But for some people, there is no dollar figure that would make living in North Dakota worthwhile. For others, there is no dollar figure that would get them to leave North Dakota.”

Dr. Forman added, “While there will always be pay disparities, all physicians are well paid, and the happiest physicians I know are not the best paid.”

15 highest-paying states

1. New Hampshire  $263,721
2. South Dakota  $248,119
3. Wisconsin  $247,743
4. Alabama  $245,818
5. North Dakota  $243,402
6. Alaska  $241,455
7. Wyoming  $240,742
8. Tennessee  $240,041
9. Iowa  $238,223
10. Nevada  $236,904
11. Colorado  $236,852
12. Indiana  $235,345
13. West Virginia  $235,287
14. Washington  $234,583
15. Maine  $232,527

15 states with lowest physician density

(number of active physicians per 100,000 residents)

51. Mississippi  186.1
50. Idaho  192.6
49. Wyoming  199.0
48. Nevada  200.1
47. Arkansas  203.7
46. Oklahoma  205.3
45. Utah  209.4
44. Iowa  211.4
43. Alabama  212.4
42. Kansas  219.4
41. Texas  219.4
40. Georgia  225.2
39. Indiana  226.5
38. South Carolina  227.1
37. Kentucky  228.9

15 lowest-paying states (or districts)

51. District of Columbia  $168,382
50. New York  $184,833
49. Michigan  $191,033
48. Arkansas  $195,894
47. Pennsylvania  $196,246
46. Maryland  $198,612
45. Oklahoma  $198,895
44. Missouri  $202,257
43. Nebraska  $204,078
42. Illinois  $206,942
41. Texas  $208,829
40. Kansas  $209,122
39. Oregon  $209,243
38. New Jersey  $209,991
37. Mississippi  $211,844

15 states (or districts) with highest physician density

(number of active physicians per 100,000 residents)

1. District of Columbia  866.3
2. Massachusetts  443.5
3. Maryland  377.8
4. New York  365.1
5. Vermont  357.5
6. Rhode Island  356.9
7. Connecticut  345.1
8. Maine  324.5
9. Pennsylvania  311.8
10. New Hampshire  308.1
11. Hawaii  304.5
12. New Jersey  294.9
13. Oregon  294.4
14. Minnesota  291.8
15. Ohio  289.5