Which states are most physician friendly?

According to WalletHub's 2026 rankings, the most physician-friendly states overall are Montana, Indiana, and Louisiana.

Top Physician-Friendly States

• Montana: Ranks #1 nationally due to strong practice opportunities, competitive earning potential, and a favorable overall environment.
• Indiana: Features strong professional opportunities and a manageable cost of living relative to physician compensation.
• Louisiana: Scores high on overall professional opportunity and market demand metrics in recent evaluations.
• South Dakota & Iowa: Frequently top lists for high average salaries, low physician density, and substantial medical loan forgiveness programs.
• No-Income-Tax States (Texas, Florida, Tennessee): Highly rated by physicians on online platforms like Reddit for maximizing take-home pay and beneficial malpractice reform environments, though competition can vary by metro area.

Key Evaluation Factors

• Opportunity & Competition: Measured by average annual wages adjusted for cost of living, insured patient rates, and hospitals per capita.
• Medical Environment: Evaluated using malpractice liability climates, state medical board invasiveness regarding mental health disclosures, and overall clinician burnout rates.

Montana ranks as the best U.S. state for physicians to practice, according to the annual WalletHub study.

When evaluating the "best" state for doctors, studies look at factors like average salary, malpractice costs, hospital quality, and physician burnout. If you measure by overall patient health outcomes and clinical quality instead, different states come out on top.

Top States to Practice Medicine

• Montana: Ranked number one due to the nation's lowest physician burnout rates, high patient satisfaction (78% of patients rate hospitals a 9 or 10 out of 10), and strong average salaries ($400,000+ for surgeons and anesthesiologists).
• Indiana: Secured the second spot thanks to high starting salaries, low malpractice costs, and favorable medical boards.
• Louisiana: Ranked third for its high number of physicians per capita and strong average compensation.

States with the Best Overall Healthcare Quality

If you are looking for the states with the best overall healthcare systems and patient care rather than the best environment for the doctors themselves:

• Hawaii: Ranks #1 in overall healthcare quality and public health.
• Massachusetts: Ranks #2 in overall healthcare, featuring high physician density and exceptional clinical quality.
• Connecticut: Ranks #3 for overall healthcare and patient outcomes.

Montana is currently ranked as the best state for doctors, combining high average compensation, a low rate of physician burnout, and top-tier hospital systems.

Top States for Physicians

Recent analyses from sources like WalletHub's Best and Worst States for Doctors highlight several leading states based on opportunity, competition, and medical environment:

• Montana: Offers high earning potential (such as top salaries for anesthesiologists and surgeons) alongside low burnout rates.
• Indiana: Known for strong physician pay adjusted for cost of living, low malpractice premiums, and a favorable legal environment.
• Louisiana & South Dakota: Frequently rank high due to manageable living costs, solid compensation, and favorable practice environments.
• Wisconsin & Minnesota: Provide robust healthcare systems (like the Mayo Clinic presence in Minnesota) and high cost-of-living-adjusted wages.
• Texas: Features high physician pay, manageable taxes, and no state income tax, though competition can vary by region.

Key Factors to Consider

When deciding where to practice, look beyond overall state rankings and evaluate specific personal and professional needs:

• Compensation vs. Cost of Living: High gross salaries in expensive coastal states often have lower purchasing power than moderate salaries in the Midwest or South.
• Malpractice Environment: States with caps on non-economic damages or low average malpractice payout rates reduce professional financial risk.
• Burnout and Workload: Rural or underserved areas may offer high job availability and loan forgiveness, but can lead to heavy patient volumes and isolation.
• State Taxes: States with no state income tax (such as Texas, Tennessee, or Florida) can significantly impact net earnings.

Florida has the highest overall projected physician shortage in the United States, with an estimated gap of over 18,000 full-time equivalent positions.

Because "highest shortage" can be measured in different ways (total volume, per capita, or primary care needs), the top states vary depending on the metric used:

By Total Shortage Volume (Full-Time Equivalents)

• Florida: Projected to face the nation's largest absolute deficit (around -18,370 FTEs), driven heavily by a rapidly aging population and rapid growth.
• Texas: Faces the second-largest total shortage gap, projected to need over 12,700 additional physicians.
• California: Has the largest overall absolute demand and highest number of federally designated Health Professional Shortage Areas (HPSAs), with cumulative deficits expected to surpass 32,000 jobs over the decade.

By Per Capita Ratio (Shortage Relative to Population)

When measured by the shortage ratio per 100,000 residents, the most severely underserved states are:

• Mississippi: Carries the lowest primary care physician density and highest per-capita deficit rates.
• New Mexico: Suffers from a critical shortage ratio alongside an aging physician workforce.
• Louisiana: Ranks near the bottom for provider availability, with the vast majority of its parishes designated as shortage areas.

The most "PA-friendly" states for Physician Assistants—ranked by favorable practice laws, strong compensation, cost-of-living adjustments, and adoption of the PA Licensure Compact—include states like Vermont, Washington, Minnesota, and North Carolina.

Key Factors Defining PA-Friendliness

• Practice Environment: States with reduced administrative burdens, minimal chart review requirements, and optimized team-based or flexible practice laws (such as North Carolina or Alaska) rank high for daily working conditions.
• The PA Compact: States authorizing the PA Licensure Compact (like Minnesota, Washington, Colorado, Utah, and Wisconsin) make it much easier to practice across state lines or relocate smoothly.
• Compensation vs. Cost of Living: While coastal states like California, New York, and Connecticut offer high average wages, states like Texas, North Carolina, and Oklahoma provide exceptional real buying power when adjusted for regional cost of living.
• Top Overall Rankings: Outlined by industry analyses from resources like The PA Life and career trackers like Zippia, states such as Vermont, New York, Connecticut, and Minnesota consistently score near the top for job volume, salary, and supportive practice infrastructure.