Best Places to Practice in the US?

[greentealeaves]

What are the best placees to practice medical dermatology in the US? Is the key metric to focus on dermatologists per capita or is there a better metric to get a sense of competitive dynamics? Are reimbursements basically equivalent no matter where you are in the US (not adjusted for cost of living)? Is there any database where you can get a better sense of dermatologists per capita on a very granular level such as by city or zip code?

Thank you in advance for the help!

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[asmallchild]

What are the best placees to practice medical dermatology in the US? Is the key metric to focus on dermatologists per capita or is there a better metric to get a sense of competitive dynamics? Are reimbursements basically equivalent no matter where you are in the US (not adjusted for cost of living)? Is there any database where you can get a better sense of dermatologists per capita on a very granular level such as by city or zip code?

Thank you in advance for the help!

It would be interesting to see how everything shakes out after COVID-19.

But in general, if you are practicing medical dermatology, there will be a need for your services almost anywhere.

I would pick the place where you want to live and take it from there. That is one of the perks of pursuing dermatology (and in particularly, medical dermatology) as your career should blend into where you want to live and how you want to live as opposed to dictating where you must be (e.g. some other specialties with tighter job markets)

In general, reimbursements are lower in higher COL areas I have found.

 

[greentealeaves]

Thank you for the input. Are reimbursements lower in high COL areas due to lower insurance payouts or Medicare payouts or due to higher overhead?

It would be surprising to me if Medicare or an insurance company paid a lower amount for a given procedure in NYC vs. South Dakota.

It would be interesting to see how everything shakes out after COVID-19.

But in general, if you are practicing medical dermatology, there will be a need for your services almost anywhere.

I would pick the place where you want to live and take it from there. That is one of the perks of pursuing dermatology (and in particularly, medical dermatology) as your career should blend into where you want to live and how you want to live as opposed to dictating where you must be (e.g. some other specialties with tighter job markets)

In general, reimbursements are lower in higher COL areas I have found.

 

[asmallchild]

Thank you for the input. Are reimbursements lower in high COL areas due to lower insurance payouts or Medicare payouts or due to higher overhead?

It would be surprising to me if Medicare or an insurance company paid a lower amount for a given procedure in NYC vs. South Dakota.

I probably should have been clearer.

I think there are variances in terms of how much reimbursement comes from the insurance companies for the same procedure performed in different locations, I am unclear as to how much a variance.

The bigger difference is in the compensation package that is offered to you if you are looking at an employee position. As you mentioned, higher overhead in HCOL areas (which tend to be more "desirable") means that potential employers do not have to be as generous in terms of their offer.

Admittedly it has been a while since I went on a job hunt but my most unpleasant interviewing experiences typically arose from the most "desirable" cities. These were typically predatory practices who churned through first year attendings because there was always a new graduate ready to take the outgoing first year's place.