Connecticut’s own physicians have been direct about the causes when testifying before the state legislature, and the reasoning holds together as a specific, named set of structural problems rather than a vague sense that “things are hard everywhere.”

Malpractice burden. Health providers have described the state’s malpractice requirements as burdensome enough, combined with a high cost of living and a lack of financial incentives, to make Connecticut one of the least appealing states to begin practicing in. The Connecticut Urology Society’s president, Timothy Siegrist, put it in blunt personal terms in legislative testimony: “unless a candidate has family ties that compel them to return or remain in this state, it is nearly impossible to attract new physicians to Connecticut.” His own market illustrates the downstream effect directly: of five independent urology practices he interviewed with a decade ago, four — including his own — have since been absorbed into larger healthcare corporations, with the inability to recruit new physicians cited as the number one reason those practices couldn’t remain independent.

Reimbursement erosion. A 2025 op-ed from a University of Connecticut MD/PhD candidate and the chair of health policy for the state’s American College of Physicians chapter laid out the financial mechanics directly: Medicare reimburses hospitals at roughly 50% and physicians at roughly 70% of what private insurers pay, and Medicare physician payments have fallen 33% in inflation-adjusted terms since 2001. That’s not a Connecticut-specific federal policy, but its effect compounds with the state’s other cost pressures rather than offsetting them.

Cost of living against medical school debt. An editorial on the issue named the interaction plainly: physicians typically graduate deeply in debt, and Connecticut’s high cost of living means a larger share of an already-stretched salary has to go toward housing, functioning as a severe disincentive even for a comparatively high-earning profession.