SAN FRANCISCO (CBS SF) — California was once one of the best places in the country for doctors to live and practice medicine, but those days may be long gone.

A new study by the online financial gurus at Wallet Hub ranks the Golden State at #20 on 2016’s Best and Worst States for Doctors.

Source: WalletHub

According to researchers, the average young doctor leaves medical school with about $180,000 of debt. They hope the state rankings will serve as a guide to inform their decisions on where to set up practice. A wrong move could make or break their medical careers.

On its surface, California’s ranking seems ‘fair-to-middling’ but upon close examination it may be prescient of difficult days ahead for patients, and the potential for a critical physician labor shortage.

Here’s why. The ranking is based on two scores: Opportunity and Competition, and Medical Quality.

Sadly, California ranks in the bottom third of all states when it comes to ‘Opportunity and Competition,’ earning the number 31 spot on the list. Researchers calculated their findings based on things like annual wages, starting salaries, insured population, number of hospitals, and current and future competition. Mississippi ranked number 1; the District of Columbia was dead last at 51.

(Thinkstock)

(Thinkstock)

The criteria to determine ‘Medical Quality’ were punitive medical boards, malpractice payouts and the cost of malpractice liability insurance. In this category, California ranks at number 5. Minnesota has the best score and New York’s rank is the worst.

Back in 2004, a study at UC Berkeley titled Is There A Doctor In The House painted a rosy picture of the state when it came to patient/doctor ratios. Nonetheless, it warned that California could face a physician shortage in the future because the numbers of young doctors entering the market was not keeping apace with the rate of retiring physicians.

With the onset of the Affordable Care Act, and expansion Medi-Cal, it appears that future is now. The once Golden State for the medical profession is facing a real shortage of doctors. The Wallet Hub study drives home how difficult it will be to avert a crisis if young doctors find it just too costly and competitive to live here.

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