practicing medicine in Texas...
practicing medicine in Texas...
Hi folks. I'm a 35yo physician in California. I wanted to ask some local Texan docs to see what the job opportunities are like. I don't have a big attachment to my current location, San Diego and have loved my trip to Austin but have heard great things about other places in Texas as well. I'm board certified in FM but do mostly urgent care here. Base pay at my current employer before taxes is 250k but I make about 350k with my extra shifts.
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Re: practicing medicine in Texas...
that is absolutely impossible EVERYONE knows that due to greedy malpractice lawyers and chintzy insurance companies impoverished MDs are living in their cars, dumpster diving for dinner and discouraging young people from studying medicine.
Hey, my mother told me to learn how to cook and marry a doctor. Thanks mom .
Hey, my mother told me to learn how to cook and marry a doctor. Thanks mom .
Re: practicing medicine in Texas...
shoot that's what my mom told me! she said go marry yourself a nice girl doctor but first learn how to cook and get a real doctor job, not this family medicine crap, what are you? a nurse?
Re: practicing medicine in Texas...
Hi FRx. I'm a doc living in Dallas. I went to med school in Houston and did my residency & fellowship in Dallas. Other big Texas cities to consider besides Austin include Dallas, Houston, San Antonio, and Fort Worth. I'm originally from Dallas and have always been comfortable here, and that's why I returned here to practice. Houston is even bigger, and I would say it's even more cosmopolitan than Dallas, though too crowded for me. San Antonio is smaller than Dallas & Houston, but it has more hill country (and more grass) than the other two. Its culture is also very different; it has a strong Latin/Hispanic flavor. Fort Worth is small, too, but possibly the best city to live in; not too crowded, but still has all the restaurants, bars, shopping of a larger city. Visit Sundance Square in Fort Worth. You'll love it.
Maximum efficiency, minimum effort
Re: practicing medicine in Texas...
There are way too many Doc-in-a-Boxes in my area in Texas. They are becoming more prevalent than Starbucks. Sometimes they are across the street from each other. One day I expect to have 4 of them at the same intersection --- one on each corner. So I think one should do some market research on this. I suppose starting your research at Bogleheads is fine.
Re: practicing medicine in Texas...
This thread is now in the Personal Finance (Not Investing) forum (employment decision).
Re: practicing medicine in Texas...
I am not a doctor but there seems several new medical center/hospitals opening up every year around the state, including suburban areas around most major cities. Scott and White opened a huge facility in College Station. Heard that A@M is in the process of expanding their medical school. There appears to be ample opportunities. Good luck and how dee!
Re: practicing medicine in Texas...
i would keep in mind that getting a texas medical lic takes a little more time than most states and requires the jurs prud test.
Re: practicing medicine in Texas...
thanks for that heads up. I had never even heard of it before.
Re: practicing medicine in Texas...
Texas has the most common sense malpractice reform in the country. I would consider practicing there for this reason alone.
Re: practicing medicine in Texas...
+1 ( I am not from texas)DireWolf wrote:Texas has the most common sense malpractice reform in the country. I would consider practicing there for this reason alone.
Ram
Re: practicing medicine in Texas...
I'm not a doc (but am a professional) - A few other things to note re: living and working in Texas:
- No state income tax - property taxes are relatively high, but you're still likely to come out WAY ahead.
- Housing prices are generally reasonable, even in the big Texas cities and their suburbs. Austin, which you mentioned (which is not the city in which I live) is probably more expensive than most places in Texas, but reasonable as compared to California.
- May not be relevant for you, but school systems in big Texas cities generally are poor. Most doctors and other professionals with children either live in suburbs with strong school systems or send their kids to private schools (there are many excellent private schools in the main Texas cities).
- Major Texas cities have great restaurants and lots of other things to do. You won't be deprived (by any means) from a cultural or lifestyle standpoint.
A doctor will be able to make a good living in any area of the country. The key is making good financial decisions and ending up financially secure down the road. I highly recommend the blog of a well-known poster here who also is a practicing emergency physician (he posts as Emergdoc). His blog, "The White Coat Investor", can be found at http://whitecoatinvestor.com/. He also has written a recent book focused on investing and financial matters for docs.
- No state income tax - property taxes are relatively high, but you're still likely to come out WAY ahead.
- Housing prices are generally reasonable, even in the big Texas cities and their suburbs. Austin, which you mentioned (which is not the city in which I live) is probably more expensive than most places in Texas, but reasonable as compared to California.
- May not be relevant for you, but school systems in big Texas cities generally are poor. Most doctors and other professionals with children either live in suburbs with strong school systems or send their kids to private schools (there are many excellent private schools in the main Texas cities).
- Major Texas cities have great restaurants and lots of other things to do. You won't be deprived (by any means) from a cultural or lifestyle standpoint.
A doctor will be able to make a good living in any area of the country. The key is making good financial decisions and ending up financially secure down the road. I highly recommend the blog of a well-known poster here who also is a practicing emergency physician (he posts as Emergdoc). His blog, "The White Coat Investor", can be found at http://whitecoatinvestor.com/. He also has written a recent book focused on investing and financial matters for docs.
Re: practicing medicine in Texas...
Both the book and the blog are in the wiki.DFAMAN wrote:...I highly recommend the blog of a well-known poster here who also is a practicing emergency physician (he posts as Emergdoc). His blog, "The White Coat Investor", can be found at http://whitecoatinvestor.com/. He also has written a recent book focused on investing and financial matters for docs.
Biography, which includes the blog: Jim Dahle
The book: The White Coat Investor
Re: practicing medicine in Texas...
I'm actually halfway through the book. Have been reading the blog a lot, great material.
I've heard from others that practicing in Texas is a good experience. I am not planning on any children.
I am currently renting and could rent forever and be totally happy but of course if the math makes sense I would be happy to purchase.
I've heard from others that practicing in Texas is a good experience. I am not planning on any children.
I am currently renting and could rent forever and be totally happy but of course if the math makes sense I would be happy to purchase.
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Re: practicing medicine in Texas...
Nothing so respectable. I'm a law professor (emeritus) But I've taught Health care risk management, worked in medical ethics and been a visiting faculty member in a medical school. I think I have 60 citations in Medline. I did lots of work with medical devices and FDA.FRx wrote:shoot that's what my mom told me! she said go marry yourself a nice girl doctor but first learn how to cook and get a real doctor job, not this family medicine crap, what are you? a nurse?
Most of my work is in mathematical models used in risk regulation and public health and safety.
So my wife's usual line is "why does a doctor marry a lawyer?"
To treat him like he really deserves!
Re: practicing medicine in Texas...
I wasn't familiar with the juris test so I looked it up to see what it involved. Here are some examples of the questions that it can draw from:
Aiding Suicide
AIDS and HIV Infection
Anatomical Gifts
Business Organizations
Central Complaint System
Confidentiality, Discovery and Medical Turpitude
Criminal Checks
Death Certificates
Deceptive Advertising
Definition of "Health-Care Entity"
Definition of Death
Drug Law
Federal Health Care Quality Improvement
Healing Arts Identification Act
Hospital Law
Identification of Health Care Professionals
Inquests and Autopsies
Medicaid Reporting Requirement
Medical Malpractice Liability
Miscellaneous Statutes
Newborns
Relationships with other Health-Care Providers
Reporting Requirements
Reproductive Issues
Voluntary and Court-Ordered Mental Health Services
Withdrawal of Treatment from Terminally Ill Patients
Workers' Compensation
As always, there is cme available to study for the questons.
http://www.texasjurisprudenceprep.com/
10 cme credits.
I am sure that there will be many doc in a boxes hiring, the population of texas is growing and is a quite popular retirement state. ( number 10 on the Forbes list).
Mike
Aiding Suicide
AIDS and HIV Infection
Anatomical Gifts
Business Organizations
Central Complaint System
Confidentiality, Discovery and Medical Turpitude
Criminal Checks
Death Certificates
Deceptive Advertising
Definition of "Health-Care Entity"
Definition of Death
Drug Law
Federal Health Care Quality Improvement
Healing Arts Identification Act
Hospital Law
Identification of Health Care Professionals
Inquests and Autopsies
Medicaid Reporting Requirement
Medical Malpractice Liability
Miscellaneous Statutes
Newborns
Relationships with other Health-Care Providers
Reporting Requirements
Reproductive Issues
Voluntary and Court-Ordered Mental Health Services
Withdrawal of Treatment from Terminally Ill Patients
Workers' Compensation
As always, there is cme available to study for the questons.
http://www.texasjurisprudenceprep.com/
10 cme credits.
I am sure that there will be many doc in a boxes hiring, the population of texas is growing and is a quite popular retirement state. ( number 10 on the Forbes list).
Mike
Re: practicing medicine in Texas...
Medscape recently came out with a report for salaries . This may apply somewhat to the UC docs too, so if you are a medscape member you might check it out. Looks like Texas was a little higher than Ca as per salary. If you are not a member, it is free to join. The report talks about Emergency Medicine and Family Practice specifically.
http://www.medscape.com/features/slides ... _specol#24
mike
http://www.medscape.com/features/slides ... _specol#24
mike
Re: practicing medicine in Texas...
I am a surgeon who just moved to Texas in the last few months. I used to practice in New England. Since I am new to the state, I can't give the OP much advice regarding Texas.
Questions to the OP, what are your motivations to make a move? Not liking your current job? Wishes to make more money and possibly keep more of your after tax income? I am sure that you know Texas is tort reform state and therefore you are less than likely to get sued. No state income tax. I found property tax is similar to that of NE. If you have children, you may have to spend the saving from no state income tax on private school tuition.
I don't know much about the average income of FP/Urgent care docs. But it seems to be me that 350k a year is an excellent income for urgent care. Maybe you work like a dog to get the extra 100k over your base I know of surgeons who make less than 350k in many parts of the country. I doubt that you will make that much more in Texas. You can always make a few phone calls to recruiters to see what kind of opportunities are available.
Don't worry about the Tx licensing process. It does take a little longer than some states and more hurdles to jump through but I am sure it's a lot easier and quicker than getting a CA medical license.
Questions to the OP, what are your motivations to make a move? Not liking your current job? Wishes to make more money and possibly keep more of your after tax income? I am sure that you know Texas is tort reform state and therefore you are less than likely to get sued. No state income tax. I found property tax is similar to that of NE. If you have children, you may have to spend the saving from no state income tax on private school tuition.
I don't know much about the average income of FP/Urgent care docs. But it seems to be me that 350k a year is an excellent income for urgent care. Maybe you work like a dog to get the extra 100k over your base I know of surgeons who make less than 350k in many parts of the country. I doubt that you will make that much more in Texas. You can always make a few phone calls to recruiters to see what kind of opportunities are available.
Don't worry about the Tx licensing process. It does take a little longer than some states and more hurdles to jump through but I am sure it's a lot easier and quicker than getting a CA medical license.
Re: practicing medicine in Texas...
You cost of living should be significantly lower in TX, regardless of the city, than it is in San Diego. Your state income taxes go to $0 and if you rent your property taxes are great here in TX too. The Malpractice Laws here are much better and sensible than Ca also. Your pay should be similar, potentially a little lower, but when COL and taxes are taken into account you will almost certainly come out ahead and have less malpractice liability as well.
If you have no overwhelming attachment to CA or San Diego, I would definitely explore your options here and use the Job hunt to check out the cities you might want to live.
If you have no overwhelming attachment to CA or San Diego, I would definitely explore your options here and use the Job hunt to check out the cities you might want to live.
Re: practicing medicine in Texas...
thanks for the reply.hmw wrote:I am a surgeon who just moved to Texas in the last few months. I used to practice in New England. Since I am new to the state, I can't give the OP much advice regarding Texas.
Questions to the OP, what are your motivations to make a move? Not liking your current job? Wishes to make more money and possibly keep more of your after tax income? I am sure that you know Texas is tort reform state and therefore you are less than likely to get sued. No state income tax. I found property tax is similar to that of NE. If you have children, you may have to spend the saving from no state income tax on private school tuition.
I don't know much about the average income of FP/Urgent care docs. But it seems to be me that 350k a year is an excellent income for urgent care. Maybe you work like a dog to get the extra 100k over your base I know of surgeons who make less than 350k in many parts of the country. I doubt that you will make that much more in Texas. You can always make a few phone calls to recruiters to see what kind of opportunities are available.
Don't worry about the Tx licensing process. It does take a little longer than some states and more hurdles to jump through but I am sure it's a lot easier and quicker than getting a CA medical license.
I am not looking to make more. I'm just wanting to practice somewhere with less state tax and lower cost of living.
I love, love, love what I do. It's like the best fit for me. I'm like a family medicine doctor on steroids. So the urgent care thing is perfect for me.
As for my hours, I'm at about 55 hours average last year to make the 350k that I made. Not terrible by any means but more than my FM peers I suppose.
I'm not planning on kids, so no worries there.
I don't mind San Diego but nothing really that makes me attached.
I surfed a lot when I moved here but now I bike a lot so it's ok not being by the ocean.
Re: practicing medicine in Texas...
that's encouraging. thanks.vesalius wrote:You cost of living should be significantly lower in TX, regardless of the city, than it is in San Diego. Your state income taxes go to $0 and if you rent your property taxes are great here in TX too. The Malpractice Laws here are much better and sensible than Ca also. Your pay should be similar, potentially a little lower, but when COL and taxes are taken into account you will almost certainly come out ahead and have less malpractice liability as well.
If you have no overwhelming attachment to CA or San Diego, I would definitely explore your options here and use the Job hunt to check out the cities you might want to live.
like other poster mentioned, I should look into some recruiters and see what they have to offer.
- goodenyou
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Re: practicing medicine in Texas...
18 years and counting. Won't leave anytime soon. Came from NY via Illinois. No way going back. Texas has been VERY good to me.
"Ignorance more frequently begets confidence than does knowledge" |
“At 50, everyone has the face he deserves”
Re: practicing medicine in Texas...
does anyone have any recommendations as far medical groups that are more reputable than others to apply for?
Re: practicing medicine in Texas...
Texas is too hot for me, sorry. I went to south Texas to visit a couple of clinics a few times a couple of years ago, I liked the place and the people but the weather is just unbearably hot.
"The two most important days in someone's life are the day that they are born and the day they discover why." -John Maxwell
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Re: practicing medicine in Texas...
I am a physician in Dallas and just a couple of years older than you. I'm not sure I would leave San Diego if it were me. I've lived in Texas most of my life and I'm not overly impressed in all honesty. I've actually considered moving to the west coast.
You make a very nice salary for CA. You could probably match it in Texas but I would be surprised if you make much more in UC. You are doing very well salary wise IMO.
Cost of living is cheaper but in the best areas of big cities it still can be pricey. And if you aren't planning on kids, your salary on the west coast should go pretty far I would imagine.
As another poster mentioned, all the major cities in TX have a very different feel to them. If you are serious about the move I would spend several days in each of the major cities in order to get an idea of which one you prefer, if you haven't already. If you are single I would rule out FW and San Antonio. Austin, Dallas, and Houston are much better places for a mid 30's single professional. If you are married or otherwise attached San Antonio and FW are good options as well as the othes. Fort Worth is just 30 minutes from Dallas but the two cities are extremely different and each has their own merits.
Feel free to PM me if you have any more specific questions.
You make a very nice salary for CA. You could probably match it in Texas but I would be surprised if you make much more in UC. You are doing very well salary wise IMO.
Cost of living is cheaper but in the best areas of big cities it still can be pricey. And if you aren't planning on kids, your salary on the west coast should go pretty far I would imagine.
As another poster mentioned, all the major cities in TX have a very different feel to them. If you are serious about the move I would spend several days in each of the major cities in order to get an idea of which one you prefer, if you haven't already. If you are single I would rule out FW and San Antonio. Austin, Dallas, and Houston are much better places for a mid 30's single professional. If you are married or otherwise attached San Antonio and FW are good options as well as the othes. Fort Worth is just 30 minutes from Dallas but the two cities are extremely different and each has their own merits.
Feel free to PM me if you have any more specific questions.
- White Coat Investor
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Re: practicing medicine in Texas...
I think moving from California to Texas is an excellent FINANCIAL move. Personally, I wouldn't live or practice in either state. California is a toxic wasteland financially for docs. I was in Los Altos this week, and noted that a 1500 sq foot home on a small lot on the busiest street in town was on sale for $1.5 Million. Add in the high cost of living, relatively poor reimbursement (although yours not too bad) and the state taxes and you come out way behind. Texas generally fixes all of these issues, plus has a nice malpractice climate.
However, I wouldn't live in Texas either because I don't want to live there. Utah is quite a bit more expensive than Texas (although far less than California), but worth it to me. Some people say the same thing about The Bay Area, I'm sure. To each their own. But if living in Texas is just as appealing to you as San Diego, then yeah, you should move.
However, I wouldn't live in Texas either because I don't want to live there. Utah is quite a bit more expensive than Texas (although far less than California), but worth it to me. Some people say the same thing about The Bay Area, I'm sure. To each their own. But if living in Texas is just as appealing to you as San Diego, then yeah, you should move.
1) Invest you must 2) Time is your friend 3) Impulse is your enemy |
4) Basic arithmetic works 5) Stick to simplicity 6) Stay the course
Re: practicing medicine in Texas...
besides Utah what other states do you like for practicing medicine?EmergDoc wrote:I think moving from California to Texas is an excellent FINANCIAL move. Personally, I wouldn't live or practice in either state. California is a toxic wasteland financially for docs. I was in Los Altos this week, and noted that a 1500 sq foot home on a small lot on the busiest street in town was on sale for $1.5 Million. Add in the high cost of living, relatively poor reimbursement (although yours not too bad) and the state taxes and you come out way behind. Texas generally fixes all of these issues, plus has a nice malpractice climate.
However, I wouldn't live in Texas either because I don't want to live there. Utah is quite a bit more expensive than Texas (although far less than California), but worth it to me. Some people say the same thing about The Bay Area, I'm sure. To each their own. But if living in Texas is just as appealing to you as San Diego, then yeah, you should move.
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Re: practicing medicine in Texas...
I'm a physician and not sure you are asking the right questions for moving. I don't think EVERY decision in one's life should be based on what is the best financially. If it was half of us would not have married who we did or has as many kids as we did or...FRx wrote:besides Utah what other states do you like for practicing medicine?
If you want to relocate decide why. If you like Austin what makes you think you will like other parts of Texas??
You income in S.D. is quite high for the amount of hours you work in urgent care. If you are not happy with that or the area you have to start a deeper level of questioning why. When you get the answer to that question making the decision on where to move will be a lot easier. I will guarantee if you search you soul the answer has nothing to do with "California taxes are too high."
Good luck.
"The stock market [fluctuation], therefore, is noise. A giant distraction from the business of investing.” |
-Jack Bogle
Re: practicing medicine in Texas...
It's a very valid question. There are a lot of factors. I love what I do, at least for now and the income is great. I'm living in a state where I pay $825/mo for a 210sqft studio. Air quality is subpar. It attracts a lot of people who kind of want the California glamour. Before this I was in Los Angeles and I can say San Diego is better but certainly not much cheaper. There are few moonlighting opportunities. There is Sharp/Kaiser/Scripps, I'd have to essentially work for one of these places. And paying 9% tax on top of my federal is hard to swallow. But you are right, it's more than dollars and cents. I think a new place to work out might be interesting since I'm single, no family around. I grew up in Germany so I'm a bit more used to the slow life, biking everywhere and enjoying the scenery.
Re: practicing medicine in Texas...
Frx, if you are looking for a place with lower COL, and lower income taxes, I would look more widely than restricting yourself to a single state. There are lots of other things to consider such as job satisfaction which Is going to be more specific to the job itself. Washington state has no income tax and lower cost of living than CA. If you don't mind the rain in the winter, you may like it. I am in Texas now but if I had a similar job in WA, I would pick WA myself because of family ties and prettier scenery.
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Re: practicing medicine in Texas...
Are these actual doctors or PAs and Nurse Practitioners? Seems to me (just my experience and the comments from others) the Family Practitioner is going the way of the buggy whip. I'm seeing all these mega corp clinics coming in buying the local docs out and staffing them with PAs. My current doctor also said that is the way he sees the family practice going...livesoft wrote:There are way too many Doc-in-a-Boxes in my area in Texas. They are becoming more prevalent than Starbucks. Sometimes they are across the street from each other. One day I expect to have 4 of them at the same intersection --- one on each corner. So I think one should do some market research on this. I suppose starting your research at Bogleheads is fine.
Re: practicing medicine in Texas...
These are actual docs who own these boxes and staff them. But I concede that some must be corporate owned and staffed by PAs and nurses.
Amusingly, the Pakastani docs don't like the Indian docs and vice versa, so they are never in geographic proximity to each other.
I have seen the best stitchwork in one of these places, much better than in the hospital e.r.
Amusingly, the Pakastani docs don't like the Indian docs and vice versa, so they are never in geographic proximity to each other.
I have seen the best stitchwork in one of these places, much better than in the hospital e.r.
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Re: practicing medicine in Texas...
210 square feet? Isn't that a 15x15 foot room? Surely you typed that wrong. That's a jail cell.FRx wrote:It's a very valid question. There are a lot of factors. I love what I do, at least for now and the income is great. I'm living in a state where I pay $825/mo for a 210sqft studio. Air quality is subpar. It attracts a lot of people who kind of want the California glamour. Before this I was in Los Angeles and I can say San Diego is better but certainly not much cheaper. There are few moonlighting opportunities. There is Sharp/Kaiser/Scripps, I'd have to essentially work for one of these places. And paying 9% tax on top of my federal is hard to swallow. But you are right, it's more than dollars and cents. I think a new place to work out might be interesting since I'm single, no family around. I grew up in Germany so I'm a bit more used to the slow life, biking everywhere and enjoying the scenery.
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Re: practicing medicine in Texas...
I just looked on zillow, and there are half a dozen places near me in Orange County, ten miles from the beach, that run 650k-700k for 2200 s.f. All of CA is not Los Altos.EmergDoc wrote:I think moving from California to Texas is an excellent FINANCIAL move. Personally, I wouldn't live or practice in either state. California is a toxic wasteland financially for docs. I was in Los Altos this week, and noted that a 1500 sq foot home on a small lot on the busiest street in town was on sale for $1.5 Million. Add in the high cost of living, relatively poor reimbursement (although yours not too bad) and the state taxes and you come out way behind. Texas generally fixes all of these issues, plus has a nice malpractice climate.
However, I wouldn't live in Texas either because I don't want to live there. Utah is quite a bit more expensive than Texas (although far less than California), but worth it to me. Some people say the same thing about The Bay Area, I'm sure. To each their own. But if living in Texas is just as appealing to you as San Diego, then yeah, you should move.
- goodenyou
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Re: practicing medicine in Texas...
I chose Texas for a great opportunity. It was great from an entrepreneurial standpoint, practice standpoint and ease of life standpoint. It has allowed me to be able to retire 10 years earlier than I would have in other places. I have spent a lot of time with my kids and traveled a ton. Thankfully, I can sit back and watch this profession unravel before my eyes. I no longer have to worry that I have to be in an accumulation phase of my life during these changes. I loved it 20 years ago, I do not now. I have the luxury of doing what I want and plan to retire a lot sooner than I expected. That was what the opportunity in Texas offered. In the current medical economic climate, I would not choose to come here now. I would look for an opportunity that would get me out ASAP.
"Ignorance more frequently begets confidence than does knowledge" |
“At 50, everyone has the face he deserves”
Re: practicing medicine in Texas...
yea, 210sqft. no AC. no kitchen. I mean it's a cool historic building but still...toofache32 wrote:210 square feet? Isn't that a 15x15 foot room? Surely you typed that wrong. That's a jail cell.FRx wrote:It's a very valid question. There are a lot of factors. I love what I do, at least for now and the income is great. I'm living in a state where I pay $825/mo for a 210sqft studio. Air quality is subpar. It attracts a lot of people who kind of want the California glamour. Before this I was in Los Angeles and I can say San Diego is better but certainly not much cheaper. There are few moonlighting opportunities. There is Sharp/Kaiser/Scripps, I'd have to essentially work for one of these places. And paying 9% tax on top of my federal is hard to swallow. But you are right, it's more than dollars and cents. I think a new place to work out might be interesting since I'm single, no family around. I grew up in Germany so I'm a bit more used to the slow life, biking everywhere and enjoying the scenery.
- bertie wooster
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Re: practicing medicine in Texas...
You make 350k and live in a 210 sq ft studio??? I'm all about living below one's means - but that strikes me as absurd.
- White Coat Investor
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Re: practicing medicine in Texas...
I don't think Utah is particularly good. Maybe a little better than average. Indiana and Texas are pretty high up there. California and the Northeast are at the bottom in my book.FRx wrote:besides Utah what other states do you like for practicing medicine?EmergDoc wrote:I think moving from California to Texas is an excellent FINANCIAL move. Personally, I wouldn't live or practice in either state. California is a toxic wasteland financially for docs. I was in Los Altos this week, and noted that a 1500 sq foot home on a small lot on the busiest street in town was on sale for $1.5 Million. Add in the high cost of living, relatively poor reimbursement (although yours not too bad) and the state taxes and you come out way behind. Texas generally fixes all of these issues, plus has a nice malpractice climate.
However, I wouldn't live in Texas either because I don't want to live there. Utah is quite a bit more expensive than Texas (although far less than California), but worth it to me. Some people say the same thing about The Bay Area, I'm sure. To each their own. But if living in Texas is just as appealing to you as San Diego, then yeah, you should move.
You truly have no geographic preference for where you want to live? I see the financial aspects as just one small part of a decision like this. I'm not here for the medicine. I'm here for the mountains.
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4) Basic arithmetic works 5) Stick to simplicity 6) Stay the course
- White Coat Investor
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Re: practicing medicine in Texas...
True, but you can get 4000+ square feet for half that in Utah, which is above the national average. Even Orange County is at least 4 times as expensive as the national average. (I've lived for a month in Orange County and another month in Northern California and visit both frequently. My ranting isn't just idle speculation from Zillow surfing.) Visiting California and looking at real estate prices must feel similar to a Guatemalan coming to the US and realizing there is no way he will ever be able to buy a home on what he is making.jackholloway wrote:I just looked on zillow, and there are half a dozen places near me in Orange County, ten miles from the beach, that run 650k-700k for 2200 s.f. All of CA is not Los Altos.EmergDoc wrote:I think moving from California to Texas is an excellent FINANCIAL move. Personally, I wouldn't live or practice in either state. California is a toxic wasteland financially for docs. I was in Los Altos this week, and noted that a 1500 sq foot home on a small lot on the busiest street in town was on sale for $1.5 Million. Add in the high cost of living, relatively poor reimbursement (although yours not too bad) and the state taxes and you come out way behind. Texas generally fixes all of these issues, plus has a nice malpractice climate.
However, I wouldn't live in Texas either because I don't want to live there. Utah is quite a bit more expensive than Texas (although far less than California), but worth it to me. Some people say the same thing about The Bay Area, I'm sure. To each their own. But if living in Texas is just as appealing to you as San Diego, then yeah, you should move.
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Re: practicing medicine in Texas...
I really don't have a preference. I think down the road I could see myself living somewhere perhaps in Europe where I grew up. But right now I would want to move to a state that is the most inviting to my profession in the sense that it allows me a high income, puts me at a little lower risk of getting sued, and of course is less taxing on my income. And having cheaper rent/home prices is a plus.
So if Texas matches that I can deal with the heat etc.
So if Texas matches that I can deal with the heat etc.
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Re: practicing medicine in Texas...
Even with New Hampshire's lack of both sales tax and income tax?EmergDoc wrote: California and the Northeast are at the bottom in my book.
I have to assume that being in Utah that you aren't scared of snow.
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Re: practicing medicine in Texas...
If you decide to check things out in Texas, be sure to look closely at Fort Worth. Politically, it's the polar opposite of Austin. I only mention that because you said you loved your trip to Austin, and it would be a big mistake to assume that FW or any of the other large urban areas would be like Austin in that respect. BTW, the discussion of politics is off limits, here.
Before retiring in 2004, I worked in the Fort Worth healthcare scene for over 4 decades, as an OR tech, then as an OR nurse and, finally, as a healthcare attorney representing a large hospital system and, on occasion, its resident physicians and other healthcare providers. It was always my opinion that FW would be a great place to practice medicine, and I know that so many of the physicians I knew and worked with felt that way. There are numerous hospital systems, and countless clinics and "walk up" emergency centers in the DFW metroplex. The economic growth there is actually quite remarkable, and that includes the healthcare industry. I recently read that Fort Worth is the best city in the nation for landing a job.
The cultural scene will surprise you. FW is, after all, still called Cowtown. In its day, it was one of the big cattle drive destinations, remnants of that era still on FW's North Side and still bringing in visitors and their money like crazy. Head up that way, eat "the dinner" at Joe T's and partake of their remarkable margaritas. The art museums are truly excellent. The institutions of higher learning abound. There are many quite good to excellent restaurants. IMO, FW has the best Mexican food in the state, hands down. The downtown area is a model of urban reinvention, a vibrant destination for those seeking good food and entertainment, with many young professionals moving downtown. Housing is reasonably priced, IMO. Though there is much construction at present, the traffic is still the easiest to contend with of all the large Texas cities.
Do remember that Texas is a far cry from California in too many respects to cover here. Good luck!
Before retiring in 2004, I worked in the Fort Worth healthcare scene for over 4 decades, as an OR tech, then as an OR nurse and, finally, as a healthcare attorney representing a large hospital system and, on occasion, its resident physicians and other healthcare providers. It was always my opinion that FW would be a great place to practice medicine, and I know that so many of the physicians I knew and worked with felt that way. There are numerous hospital systems, and countless clinics and "walk up" emergency centers in the DFW metroplex. The economic growth there is actually quite remarkable, and that includes the healthcare industry. I recently read that Fort Worth is the best city in the nation for landing a job.
The cultural scene will surprise you. FW is, after all, still called Cowtown. In its day, it was one of the big cattle drive destinations, remnants of that era still on FW's North Side and still bringing in visitors and their money like crazy. Head up that way, eat "the dinner" at Joe T's and partake of their remarkable margaritas. The art museums are truly excellent. The institutions of higher learning abound. There are many quite good to excellent restaurants. IMO, FW has the best Mexican food in the state, hands down. The downtown area is a model of urban reinvention, a vibrant destination for those seeking good food and entertainment, with many young professionals moving downtown. Housing is reasonably priced, IMO. Though there is much construction at present, the traffic is still the easiest to contend with of all the large Texas cities.
Do remember that Texas is a far cry from California in too many respects to cover here. Good luck!
Re: practicing medicine in Texas...
this is a really helpful bit of information, really appreciate it.Austintatious wrote:If you decide to check things out in Texas, be sure to look closely at Fort Worth. Politically, it's the polar opposite of Austin. I only mention that because you said you loved your trip to Austin, and it would be a big mistake to assume that FW or any of the other large urban areas would be like Austin in that respect. BTW, the discussion of politics is off limits, here.
Before retiring in 2004, I worked in the Fort Worth healthcare scene for over 4 decades, as an OR tech, then as an OR nurse and, finally, as a healthcare attorney representing a large hospital system and, on occasion, its resident physicians and other healthcare providers. It was always my opinion that FW would be a great place to practice medicine, and I know that so many of the physicians I knew and worked with felt that way. There are numerous hospital systems, and countless clinics and "walk up" emergency centers in the DFW metroplex. The economic growth there is actually quite remarkable, and that includes the healthcare industry. I recently read that Fort Worth is the best city in the nation for landing a job.
The cultural scene will surprise you. FW is, after all, still called Cowtown. In its day, it was one of the big cattle drive destinations, remnants of that era still on FW's North Side and still bringing in visitors and their money like crazy. Head up that way, eat "the dinner" at Joe T's and partake of their remarkable margaritas. The art museums are truly excellent. The institutions of higher learning abound. There are many quite good to excellent restaurants. IMO, FW has the best Mexican food in the state, hands down. The downtown area is a model of urban reinvention, a vibrant destination for those seeking good food and entertainment, with many young professionals moving downtown. Housing is reasonably priced, IMO. Though there is much construction at present, the traffic is still the easiest to contend with of all the large Texas cities.
Do remember that Texas is a far cry from California in too many respects to cover here. Good luck!
I love getting a local's perspective, so that's always a plus. I'll definitely check it out. Sounds like a great long weekend trip to take.
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Re: practicing medicine in Texas...
FRx, sorry, I intended to include this link in my post, and just forgot.
http://www.dfwhc.org/
It's the DFW Hospital Council website. Yours may not be a hospital-based practice, but it'll give you some idea of the number of hospital systems and individual facilities in and surrounding the DFW area.
http://www.dfwhc.org/
It's the DFW Hospital Council website. Yours may not be a hospital-based practice, but it'll give you some idea of the number of hospital systems and individual facilities in and surrounding the DFW area.
Re: practicing medicine in Texas...
Since you are from California, you will fit in and like Austin.
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Re: practicing medicine in Texas...
Keep Austin WeirdSnapShots wrote:Since you are from California, you will fit in and like Austin.
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Re: practicing medicine in Texas...
you'd be happy to know there is nothing normal about me, I'm sure I'd fit right in.
It's hard passing up those food trucks!
It's hard passing up those food trucks!
Re: practicing medicine in Texas...
I think they generally are poor in big cities across the country....school systems in big Texas cities generally are poor.
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Re: practicing medicine in Texas...
The fact that 1 in 4 people in Texas are uninsured, the highest uninsured rate in the nation, might be a consideration. Texas is not expanding Medicaid so the insured rate may not be expected to improve much in the near future. If your interest is in urgent care, you would likely be seeing a lot of the uninsured.
Re: practicing medicine in Texas...
Jack -
Unlike EDs, urgent care is cash-on-the-barrelhead beacuse it's not subject to EMTALA. Likely make more money from uninsured than insured on a per-patient basis (no market power, unlike the insurer).
But for emergency departments, the combination of decreased DSH payments and the surprise ability and willingness of states to turn down large quantities of Medicaid funds for the expansion may be a big problem.
Unlike EDs, urgent care is cash-on-the-barrelhead beacuse it's not subject to EMTALA. Likely make more money from uninsured than insured on a per-patient basis (no market power, unlike the insurer).
But for emergency departments, the combination of decreased DSH payments and the surprise ability and willingness of states to turn down large quantities of Medicaid funds for the expansion may be a big problem.