Once upon a time, it was the dream of most mothers that their sons grow up to be doctors. The late great comedian Alan King used to joke about a lullaby saying, "Rock-A-Bye Baby go to sleep honey, you'll be a doctor and make lots of money." That's all changed, especially in New Jersey.

A new Wallethub.com survey of the best and worst states for doctors gives New Jersey poor marks in many categories, including doctors salaries, which average about $160,000 per year. Factor in the high taxes, regulations, and insurance premiums and who'd want to practice medicine in New Jersey?

Dr. John Vitali, my brother-in-law, is one who would and when I asked him about this he said:

"It's been an ongoing issue for years. The northeast has the highest malpractice premiums.  Medicare reimbursement cuts always loom every year, but truly doesn't happen and commercial insurers will follow any decrease payments that Medicare does."

When it comes to earnings, Dr. Vitali says, "Newly graduated residents are paid about 20% less in New Jersey than the in the midwest and southern states." I asked him why that is and he said, "Basically, it's the law of supply and demand. Salaries are higher where there is more demand."

Dr. Vitali goes on to say, "New Jersey is the 27th state in highest pay, but has the 8th highest primary care physicians per 100,000 residents. Whereas compared to Alaska, where highest salary and 20th lowest  PCP per 100,000 residents. Take into consideration the cost of living in New Jersey, which is highest in the country, and doctors can't sustain medical practice due to lower insurance and Medicare reimbursement."

So what's a state to do? How about coming up with incentives to attract doctors to New Jersey, because the high cost of health care here is going to get even higher when there is no one to provide it.

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