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Guide to Practicing Medicine in Texas

Aside from a doctor’s salary in Texas, you may be wondering if you should open a practice in Texas or take a job offer from a medical center in the state. Texas is a beautiful state, one of the largest in the country in terms of population and size. It’s noted for its great weather, too. However, before deciding to work here, you need to have a better look at what working as a doctor in Texas will be like.

To help you, we have compiled some of the most important information for physicians to consider when trying to make a decision about whether or not to practice medicine in Texas.

Top reasons to practice medicine in Texas

There are a number of benefits to practicing medicine in Texas. Some of the most important reasons to do so include the following:

Diverse Populations

The state is noted for its diverse population. While there are many large medical centers doing cutting-edge research and procedures here, there are also many rural locations that need quality providers. For those who have a specific type of population they wish to serve, it is likely to find that here.

Low Taxes

Doctors who practice medicine in Texas will find that it can be affordable to do so. While doctor salary in Texas is high and competitive compared to the national level, it is also a state with low tax burdens. There is no income tax here for individuals, and that means significant savings. Other taxes in the state are also competitively low, making it an affordable place to start a practice.

Low Medical Malpractice Claims

Texas has lower medical malpractice claims compared to many other states. That’s a positive for doctors across the board. However, it does also have a cap on claims per claimant of $250,000, so that helps to keep medical malpractice insurance at an affordable level for doctors as well.

Low cost of living

The state’s cost of living, especially outside of the major cities, is affordable. That means you can enjoy the weather and the higher quality of life without having to pay what you would if you lived in California, New York, Washington, D.C., or Boston.

There are opportunities

There is a growing need for qualified doctors in the state, including in some of the most common fields. That creates an opportunity for doctors to find a way to build a career here. The low density of doctors can be a good thing for those who are entering a competitive area of medicine as well.

Read this: Experts Weigh in on the Future of Healthcare in the Next 30 Years

Top reasons NOT to practice in Texas

There could be some drawbacks to starting a medical career in Texas as well. Doctors may wish to consider the following factors before making their decision to start practicing here.

Stress factors

Reports indicate that many of the doctors in the state are stressed and face difficulties in operating a practice here. Many are more pessimistic than other doctors around the country.

It’s not home to the leading research locations

While there are many fantastic medical centers here, and many of them are conducting cutting-edge medicine, the state does not have the largest number of research-focused hospitals in the country. For those who are looking to lead programs like this, it may be harder to find those opportunities in Texas.

Number of Active Physicians in Texas

One of the key factors in making a decision about where to work could be a look at the number of doctors available in the state. Are there enough providers or too many?

Data from the Texas Medical Board shows that, in 2020, there were 6,288 physician applications received by the organization. It issued 4,862 licenses. By comparison, in 2011, the organization reported receiving 4,181 applications for licenses and issued 3,436.

There is a growing medical industry in the state. Over this period of time, from 2011 to 2020, the number of doctors applying for applications and receiving licenses has increased at a steady pace. That shows the demand for licensed professionals here.

Doctor Salary in Texas

For many people, the doctor salary in Texas is a big factor in determining whether or not to choose to start a practice in the state. While there are some details available to help you determine how much you can expect to earn, it is important to remember experience, position, and many other factors play a role in what you can expect.

Average Doctor Salary in Texas

The average overall salary for a doctor in Texas was $205,979, according to Salary.com information as of December 2022. Typically, the doctor salary in Texas ranges from $178,341 to $230,400.

Internal Medicine Doctor Salary in Texas

Those working in internal medicine can expect the average salary to be $230,105, according to Salary.com, as of December 2022. That range is typically between $207,325 and $261,498.

Family Medicine Doctor Salary in Texas

For those who wish to work in family medicine, the average doctor salary in Texas was $215,817, according to Salary.com information. They indicate that the range here is between $190,092 and $247,676.

Pediatric Doctor Salary in Texas

The pediatric doctor salary in Texas is, on average, $211,934 per year as of December 2022, according to Salary.com data. Those working in this field had an average salary range of $184,674 and $253,355.

Obstetrics/ Gynecology Doctor Salary in Texas

Salary.com information shows that those working in obstetrics or gynecology have an average salary of $299,966 in 2022. Those working in this field had a typical salary range of $260,239 and $360,966.

Anesthesiology Doctor Salary in Texas

For those who wish to work as an anesthesiologist, the average salary in Texas was $407,300 as of December 2022, according to Salary.com. These professionals had a typical salary range of $352,900 and $461,700.

Which Specialties Are in Need In Texas?

Data from the Physician Supply and Demand Projections report from the State of Texas sheds some light on some of the need for physicians in the state. The report indicates that, from 2018 to 2032, there will be an estimated shortage of all physicians across the state of 10,330 full-time providers. That number has grown from 6,218 in 2018.

The state also looks at which areas are most critically at risk in the state. While some areas will have a critical shortage that is much more significant than others, there are some fields where the shortages will be more significant across the board. This includes:

Psychiatry considered a critical shortage in all areas of the state except in Central Texas
Pediatrics is considered a critical shortage in all regions of the state except for Central Texas and the Gulf Coast.
Family medicine will have a critical shortage in all areas of the state except for the Panhandle, North Texas, South Texas, and Central Texas.

The report also provides insight into where these doctors will come from, noting that, according to medical school enrollment across the state’s medical education system, there will not be enough professionals available to meet the demand of the public.

Are there specialties that are not as in demand in Texas?

The same report sheds light on some areas where the supply of professionals is higher. For example, by 2032, the state expects to fully meet its needs for doctors in the areas of:

Allergy and Immunology
Anesthesiology
Colorectal surgery
Emergency medicine
Orthopedic surgery
Plastic surgery
Radiology
Rheumatology
Thoracic surgery

That does not mean there will not be openings in this field because doctors will retire and move to other areas. However, these positions may have somewhat less demand overall.

What Business Formation Is Best for a Solo Practitioner in Texas?

While this is very much an individual decision based on the unique needs of each person, there are some benefits to physicians in the state who develop a professional limited liability company or PLLC. For those who are setting up a medical practice in the state, a PLLC will provide some key benefits, including pass-through taxation, flexible management structures, and liability shielding. This could help a business owner to create a strong business model moving forward.

PLLCs are not expensive to set up. They do not require corporation oversight either. Yet, they do provide physicians with protection for their personal assets from claims made against them professionally. Speaking to a tax professional could also help physicians determine the tax implications of this or other business formation options, but most benefit from the pass-through taxation of a PLLC.

Ready to buy a home? Read this: How to Navigate Buying a Home in the Current Market

Continuing Medical Education for MDs and DOs

It is also important for physicians to think about what they can expect from continuing education requirements in the state. Nearly all states require them, but staying on top of your education should be a focal point of your decision to move to Texas to start a medical practice.

The Texas Medical Board shares that all physicians registering in the state will need to complete continuing medical education. That includes registering as a physician or a practitioner. This includes:

48 credits of continuing medical education every 24 months
At least half of those hours must be in the form of formal, Category 1 or 1A courses
Doctors must report at the time of registering with the Board for licensing if they have completed the required continuing education requirements
Those who are newly licensed do not have to meet the continuing medical education requirement the first time they register with the state

Of those hours, 24 of them must fall into one of formal education in category 1 or 1A, which may include:

Medical ethics and professional responsibility
Pain management and the prescription of opioids
Human trafficking

The 24 informal hours could be comprised of the following:

Information self-study
Attendance at hospital lectures
Grand rounds not approved for CME or case conferences

Want to try out working in Texas? Read this: What it takes to be a Traveling Physician

Texas State Taxes

When it comes to meeting financial obligations and growing a practice in the state, nearly all practices will need to fully understand the implication of state taxes in Texas. There are some core benefits to practicing medicine here, including the high doctor salary in Texas but also other key features.

Individual income tax

There is no individual income tax in Texas.

Corporate income tax

There is a corporate income tax in the state, but it does not have a gross receipt tax levy.

Sales tax

The state of Texas has a sales tax rate of 6.25%. The maximum local sales tax rate is 2%. The combined after state and local sales tax rate is 8.2%.

Property taxes

There is property tax paid in Texas. It is based on a percentage of owner-occupied housing value. Across the state, that is 1.66%. Per capita, this leads to state and local property tax collection of $2,098.

K-12 Schools in Texas

For doctors considering the move to Texas, one key factor to think about is the quality of education here. The state has a strong educational system, but there are some schools for students in K-12 that stand out in terms of their overall ability to provide a higher quality of education.

According to Niche, the following are some of the best schools in the state:

Best private high school: St. Mark’s School of Texas with a 9:1 student-teacher ratio in the Dallas-Fort Worth area
Best public high school: School for the Talented & Gifted in Dallas, with its student-teacher ratio of 18:1
Best private elementary school: The Awty International School in Houston, with its student-teacher ratio of 7:1
Best public elementary school: Imagine International Academy of North Texas with a 19:1 student-teacher ratio in McKinney.

Best Medical Schools in Texas

For those who are looking to complete their medical education, Texas has a number of exceptional medical schools that could prove to be the ideal place to learn and grow. Data from U.S. News & World Report indicates that the following are the top-rated medical schools in the state:

Baylor College of Medicine, especially its research program
The University of Texas Southwestern Medical Center, especially its research program
University of Texas Health Science Center – San Antonio
The University of Texas Health Science Center – Houston (McGovern)
Texas A&M University
University of North Texas Health Science Center
Sam Houston State University College of Osteopathic Medicine
Texas Christian University – Burnett School of Medicine
Texas Tech University Health Sciences Center – El Paso
University of Houston College of Medicine

Medical Malpractice Rates in Texas

The Texas Department of Insurance states that doctors in Texas will need to pay medical liability insurance. Also called medical malpractice insurance, it provides coverage for physicians for claims related to errors that stem from their medical practice. This type of insurance pays for costs associated with the defense against such claims and typically provides coverage for claims made for neglect and medical error up to the desired amount of coverage.

Most commonly, physicians in Texas will purchase coverage of $200,000 for each claim/ $600,000 Aggregate, as well as $500,000 /$1.5 million and $1 million/ $3 million in coverage. However, this differs by various factors.

Each carrier offering medical malpractice insurance sets the specific rates of coverage based on numerous factors. Most often, these are not readily made available. However, some insurance rates in Texas are lower than in other states, thanks in part to the placement of tort reform as well as caps on damage claims.

However, the following are some estimates based on profession and approximate claims made rates:

Anesthesiologist: $9,000
Internal medicine doctor: $8,000
General surgeon: $23,000
Obstetrics and gynecology major surgeons: $29,000
Orthopedic surgeon: $19,000
Radiology doctor: $9,000
Family practice, no surgery: $8,000

Costs will differ by location, insurance provider, and numerous other factors. It is possible to obtain quotes to compare policies evenly.

Medical claims in Texas

One of the key factors to keep in mind in Texas is that medical malpractice claims are nearly always capped at $250,000 per claimant. This is the lowest medical malpractice award payout per capita across the country. It directly impacts doctor salaries in Texas since less money must be put towards managing these costs.

However, some reports indicate that the average medical malpractice payout from 2009 to 2018 was $309,902. During that time, 12,414 cases were reported on average each year.

Related Reading: Medical Malpractice Payouts: What to Expect

Top Cities in Texas for Doctors to Live

If you’ve read through all of this data, you may be wondering where you can move in Texas and find the position you want and the career you are hoping to build. The state as a whole is made up of some areas that are very rural and other areas that are quite modern, urban centers. Positions for doctors exist throughout the state. However, these are some of the best cities for physicians in Texas.

#1: Austin, Texas

As the capital of the state, Austin is an excellent, modern city of about 980,000 residents. It has a higher cost of living than other cities in the state, but it also provides some great opportunities for doctors here. That includes numerous healthcare opportunities. Austin is home to St. David’s Medical Center, ranked #1 Large Community Hospital in the nation. There are also numerous opportunities here for doctors who are looking to build a strong practice since the city is growing. This, along with more affordable real estate than other areas and the non-existent state income tax, makes Austin rather affordable overall.

Austin is also noted for being a cultural hub, a foodie city, and a great place to explore the outdoors. It has McKinney Falls, Barton Springs, and Lady Bird Lake all to explore, not to mention a wide range of local parks and playgrounds.

austin

#2: Dallas, Texas

Dallas is the largest city in the state and offers doctors a wide range of potential career benefits. That includes having a population of 1.3 million in a very modern, positive city. It’s part of the Dallas-Fort Worth Metro area, which is home to 7.5 million people, providing ample opportunity for those looking to build a large practice.

The city is home to 41 colleges and universities, and there are numerous companies that call it home. Yet, as large as the metro area is, it still has beautiful, quiet neighborhoods with exceptionally good schools. That includes areas like Lakewood and Westlake.

UT Southwestern is perhaps the largest medical health center here, providing employment opportunities. However, there are others as well, including Texas Health Presbyterian Hospital, Methodist Dallas Medical Center, and Medical City Dallas Hospital, among others.

dallas

#3: Sugar Land, Texas

You may not have thought Sugar Land would be so high on the must-consider places to live, but it offers a wide range of benefits to physicians. The city is smaller, home to about 118,000 people. It’s located in the Southwestern portion of the state, just southwest of Houston. Here, the cost of living is more affordable than in Austin or Dallas. It is a far more racially diverse city, and there are also more culturally vibrant neighborhoods here. The city was named one of America’s best small cities in 2020.

There are a number of key reasons to consider living here, including noted high-quality public schools and luxury homes at a more competitive price. As for employment opportunities, Sugar Land Medical Center is the largest here, but United Memorial Medical Center is also available. As a suburb of Houston, that also opens the door to those possibilities as well.

Related Reading: Physician’s Top 10 Places to Live and Work

Making the Move to Texas

Texas is a vibrant state with a warm temperature and a lot of amenities. It is noted for its large park systems, incredible businesses and industry in general, and its passionate people. Those who are considering the move to Texas to start a medical practice will need to determine where in this large state they plan to move.

When it comes to doctor salary in Texas, the good news is that most physicians will find very competitive opportunities throughout the state, even in some of the smaller cities. That, along with a competitively high quality of life but lower cost of living, makes it one of the best states for physicians in most areas. With solid career opportunities thanks to a shortage of trained professionals, it may be easier to build a career here.

Still deciding where to go? Consult our Annual Physician Compensation Report to help with your decision.

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