Who say primary care physicians (PCP) feel like they are struggling is an understatement. Between constant changing government regulations (we’re looking at you MACRA), and the ever increasing pressure to please patients while battling electronic health records, it is no wonder burnout has become a constant topic of discussion amongst PCPs. With so many changing variables these days, it has become even more important to maintain a steady income. Knowing whether or not your salary is amongst the highest, or lowest, in the country comes in handy when attempting to combat these struggles. According to the Bureau of Labor Statistics (BLS), the mean annual wage for internal medicine physicians is $201,840. The top states with the most internists are Texas, California, Ohio, Florida and Massachusetts—but none of these states are among the top paying locations for internists and in fact, one is on the list of lowest-paying states, the BLS reports. Read on to find out which states the BLS says were the highest, and lowest, paying states for internal medicine this year. Top–paying states for internal medicine 5. North Carolina: $265,150 4. New Mexico: $266,550 3. Arkansas: $266,980 2. Alabama: $274,930 1. South Dakota: $275,760 Worst-paying states for internal medicine 5. Delaware: $188, 320 4. Hawaii: $185,670 3. Pennsylvania: $167,020 2. Texas: $153,940 1. Puerto Rico: $85,500 Source