The 15 best, worst states for jobs

A new analysis finds states on opposite coasts most attractive for employment, while states in the South lag.

The 2022 ranking of the 50 states comes from Wallethub, which looked at two key dimensions: job market (60 points) and economic environment (40 points). The dimensions were evaluated using 35 metrics, including employment growth, worker protection scores, share of workers living in poverty, average length of work week in hours, average commute time and median annual income.

Below are the top 15 states and bottom 15 states. The complete ranking and scoring can be found here.

The best 

1. Washington: 69.65
2. Vermont: 69.46
3. New Hampshire: 66.27
4. Colorado: 65.38
5. Minnesota: 64.78
6. Rhode Island: 64.52
7. Massachusetts: 63.75
8. Virginia: 62.84
9. Connecticut: 62
10. New Jersey: 61.56
11. California: 60.90
12. South Dakota: 59.83
13. Utah: 59.71
14. Florida: 59.35
15. Illinois: 57.91

The worst 

36. New Mexico: 49.56
37. Indiana: 49.49
38. Wyoming: 49.36
39. Montana: 49.29
40. Georgia: 47.97
41. Ohio: 47.77
42. Alabama: 46.05
43. South Carolina: 46
44. Pennsylvania: 45.45
45. Oklahoma: 44.96
46. Arkansas: 42.99
47. Louisiana: 42.59
48. Mississippi: 39.64
49. Kentucky: 37.79
50. West Virginia: 35.45

Physicians pay cuts to take effect?

Physicians pay cuts to take effect!

Several provider groups say the Biden administration needs to reverse a proposed 4.5% pay cut to doctors for next year, noting the agency needs to consider additional financial pressures that practices are facing.

CMS proposed a 2023 conversion factor of $33.08 for each relative unit, which details how a doctor gets paid by Medicare. The conversion factor is a nearly 4.5% decline compared to the 2022 rate of $34.61.

The Medical Group Management Association urged CMS in comments to reach out to Congress and press for a positive update to the Medicare conversion factor.


As of now, the payment reductions “will have a detrimental impact on access to care for Medicare beneficiaries and financial sustainability for medical group practices,” the group’s comments said.

For over 30 years Integro has assisted candidates in the market with our popular “Questions To Ask Before You Sign” to assess opportunity stability and ability to withstand market stressors.  Reply today to request your free copy.

Questions to Ask Before You Sign!

Questions to Ask Before You Sign!

Surprises in a new opportunity are never a good thing. Of course, you want to know why they are hiring, how many physicians have left in the past 10 years and if you’re to take over from a retiring physician has that been formalized in writing.

Physicians who have been in practice tend to focus more on issues beyond income guarantee and more on operational aspects such as overhead, support personnel, referral patterns, how patients are assigned, and local medical politics.

If there are retirements in the future you’ll want to know what their exit policy is. Does the group have to “buy-out” a retiring colleague or just pay him their AR? Do they have what a retiring physician is entitled to codified in their partnership agreement? Many groups have run into issues because it was “understood” based on a discussions in years gone by or has never really been discussed at all!

Having a handle on what is expected from you outside of standard hours whether it’s self-marketing, business meetings, or paperwork is all part of the package.
To see all of our “Questions to Ask Before You Sign”, go to our Candidates page.

Location or Job?

There are two primary considerations when you are looking at opportunities.  Where is the job and what is the job?  Notice where the job is comes first and what is the job comes second.  But will you be happy living where you want to live if the job is not fulfilling.  You have spent most of your life developing a skill and expertise.  If the job you accept is frustrating & unfulfilling will you truly be happy?  The majority of physicians leave their job because of practice consideration not geographic considerations.  Consider compromising more on the geography to avoid becoming one of the 30%-40% who change jobs in the first 5 years.

Happy New Year!

Happy New Year 2022: As the world bids goodbye to a year to welcome another, people get together with their friends and families on New Year’s Eve to celebrate the joyous occasion with gifts, lavish feasts, parties and more.

New Year is celebrated around the globe with much enthusiasm, mainly because it is the beginning of a new year. It symbolizes happy beginnings, renewed energy and hope for a better year.

The past two years (2020 and 2021) have been challenging because of the Covid-19. Therefore, the hope for 2022 to be a great year is very much on everyone’s mind.

Here’s hoping that the new year brings us lots of new and exciting opportunities in our lives. This new year will be our year. Happy New Year!

What is the Purpose of an Interview?

From the applicant’s perspective it’s to determine if they like the opportunity, community, and culture of the practice.

The main purpose of a job interview is from an employer’s perspective to get an insight into a candidate’s personality, competencies, capabilities, and achievements.

In today’s world of physician shortages, it is easy for applicants to forget that they are being judged too.  Candidates who are attentive to how they are being perceived strengthen their position if they decide that the opportunity worth pursuing.  And benefit more professionally by being remembered fondly as paths cross down the road.

The purpose to the job interview for the applicant is to get an offer, in writing, so they can make the most informed and intelligent decision available to them.  Until an applicant has it in writting they really don’t have a decision to make or all the information required to make the best decision.

Salary Negotiations

In today’s Covid environment employers are risk averse and the steady rise of guarantees has stopped and is being reversed in many areas.
Many factors are involved in getting a desirable salary with a new job, but it’s important to negotiate the best salary right from the start. Only 57% of physicians feel they are fairly compensated for their work, according to Medscape’s Physician Compensation report.

Male physicians are more likely to negotiate for a higher salary than are women. Women physicians, when asked about their skill level with negotiating, reported a mixed range of skills; 28% of women said they were skillful or very skillful at negotiating for higher salary; 33% said they were neither skillful nor unskillful; and 39% said they were unskillful or very unskillful.

Besides salary, physicians may want to modify many other elements of an employment contract. Employers will sometimes accept a limited number of changes that will keep prospective employees happy, although it’s tougher in highly competitive markets to get them to agree to changes.

Why do you want to be a partner?

The idea of becoming a partner in a medical practice was once the dream of many young doctors. The advantages are many: a vote on practice issues, due process protections, the pride of ownership. But there are risks involved when medical practices offer partnership tracks, including the burden of extra administrative duties and a buy-in process that can lower initial salary payments and being legally tied to partners who’s goals may not align with yours over time.

Generally a group will not be able to calculate a specific amount of how much a buy-in will be in the future but they should be able to provide you with how the calculation will be made and an approximation based on current valuation.

If you’re interviewing with a medical practice that offers a partnership track, be sure to discuss the length of the buy-in period and how the process works.  Also discuss if someone leaves what the buy-out process is, especially if there are senior partners who are nearing retirement.  Before accepting any offer, consult your own legal and financial advisers to be sure your bases are covered.

Professionally Speaking, is This the Right Practice For Me?

  1. Is your practice providing you with the clinical volume you want?
  2. Are you provided the opportunity to fulfill your long term professional goals?
  3. Does your practice allow you to have enough time to provide adequate quality of life?
  4. Are you receiving adequate compensation for the work you do?
  5. Do you receive adequate support to maximize your productivity?
  6. Are you doing the amount of procedures or surgery you desire?
  7. Are your opinions regarding practice operations respected and acted upon?
  8. Do you respect your practice associates?
  9. Will the deficiencies of the practice change in a reasonable time frame?
  10. Would I make the same decision to practice where I’m at now if I had it to do over again
  11. If you answered “NO” to 3 or more of the above questions you should consider alternatives and act

Privacy is the “New” Hot Topic

Well not really new for Integro.  For over 30 years we have valued the long-term relationships we’ve developed with the physicians we assist in their career decisions.  We have never shared or sold our candidates data and do not place that data into one of many on-line databases that are the bane of individuals who are exploring opportunities.   Many of our clients were once those candidates who were once in the market.  They came to realize that our low-key, transparent approach is how they, as the hiring entity, want to be represented.  One of our Golden Rules is “If you help enough people make the decision that’s right for them, you will get your just rewards.”  It has served us well and believe it will continue to do so.