Research Shows Top 10 States And Top 25 Cities To Practice Insurance-Free Medicine

Are you curious if your state or city made one of the lists? Keep in mind, we’re having a great time practicing direct care here in Wichita, KS, and get this–we didn’t make either one! On top of that, not all of these states are eligible to dispense prescriptions (New York, Montana, Texas, and Utah prohibit it). In our experience, the real value in running a direct practice comes from offering wholesale prescription discounts. Over time the savings add up, especially for patients with chronic conditions (diabetes, thyroid disease, asthma, migraines, etc.) where it becomes cheaper to subscribe to your clinic and stop using insurance to pay for prescriptions.

Given these facts, we’re not treating this as the ultimatum for who or where one should or shouldn’t open a direct care clinic. However, the research brings up some good reminders. According to Dr. Chris Ewin, Founder and physician at 121MD in Fort Worth, TX:

“Direct practices should be successful in most cities and states where there is an inadequate supply of primary care physicians.” He adds, “… Most important, a physician needs to have social skills to sell him/herself and their new practice model to their patients and their community.”

Great call. If there’s a dearth of doctors, then the added demand, coupled with all the red tape will give you a comparative advantage. This will help you articulate how much you can do for a patient at a fraction of the potential cost. And that second point is true as well. Direct care is a commitment to the patient, and to your blossoming practice. It’s a reasonable, full-time commitment with more autonomy but less bureaucratic headaches, and with more responsibility but also more satisfaction. However, solid communication skills will be invaluable to getting your clinic off the ground.

But enough of that, here are the Top 10 Best States To Start A Career in Concierge Medicine or Direct Primary Care in 2013-2014 ( * indicate a state where prescription dispensing is not allowed ):

1. Utah *
2. California
3. Texas *
4. Florida
5. Washington State
6. New York *
7. Colorado
8. Georgia
9. Tennessee
10. North Carolina

And the Top 25 Best Cities To Start A Career in Concierge Medicine or Direct Primary Care in 2013-2014:

1. Salt Lake City, UT *
2. Provo, UT *
3. Los Angeles, CA
4. San Francisco, CA
5. Dallas/Fort Worth, TX *
6. San Antonio, TX *
7. Miami, FL
8. Fort Lauderdale, FL
9. Seattle, WA
10. New York, NY *
11. Denver, CO
12. Colorado Springs, CO
13. Atlanta, GA
14. Nashville, TN
15. Charlotte, NC
16. Chicago, IL
17. Montgomery, AL
18. Birmingham, AL
19. Lincoln, NE
20. Omaha, NE
21. Minneapolis, MN
22. Columbus, OH
23. Boise, ID
24. Nashua, NH
25. Philadelphia, PA

Check out Concierge Medicine Today’s press release that highlights the research methodology and some industry reactions as well.