Married couple (IT and healthcare), should they move to TX?

[iamanewuser]

Thank you for sharing your experience. Software Dev and BioMed sounds like a great combo! I'm a regular Java dev. so can blend in easily Have been looking at fully remote options online and see quite a few of them so that could be another option.

Originally Posted by grad_student200

I work in both healthcare and IT and love Texas. It has a booming economy and great housing options. I worked for a year in San Antonio and Austin. It was awesome. I am from rural AZ but went to undergraduate college in the cold midwest. I have worked for years in Colorado and Florida. That year in Texas always stands out as a great one.

Central Texas is not nearly as humid as Florida. It is also not as humid as the midwest in the summer. Even Northern Michigan or Northern Indiana in the summer gets more humid than Central Texas. The most humid heat I have ever experienced is in Florida in the aftermath of a summer tropical storm or hurricane. Austin and San Antonio are not nearly as humid as the FL Panhandle after a hurricane in hot August.

But Austin and San Antonio are more humid than Phoenix. The most humid part of Texas to me is the area near Houston. Beaumont, TX is pretty much like Louisiana - very humid. Houston may likely be too humid for you (albeit it is great for IT and healthcare). But Austin, San Antonio and Dallas may be a good fit. I am a biomedical engineer and software engineer with a background in public health.

If you want the classic four seasons, then Denver would be a better choice. But their housing is expensive and IT jobs are vulnerable during recessions. The 2001-2002 recession in Denver was horrible for IT, but it has since bounced back high for the time being. Denver is not as cold as the midwest and not as hot as Texas or Phoenix. It is a dry mile high city with moderate snow in the winter and moderate summer heat with access to the Rocky Mountain trails and ski bases.

Another option is Albuquerque but their job market is small. Phoenix is probably too dry and hot. But I am used to it and love it here. Best wishes.

[iamanewuser]

My wife has started the licensing process but not yet licensed. Yes, we had the same concern that recruiters/medical groups won't consider someone who's not licensed yet. If the recruiters are hiring for way out in future then they consider residents who are fresh out of residency and not yet licensed, meaning they get them to sign the contract and start date is dependent on the timing of getting licensed!

Also learning that medical groups hire physicians in TX and not the actual hospitals!

About the physician market, I hear the same thing about popular areas of TX too. I've heard about Dallas are that it's quite saturated but then again I think it would be true for most places where lot of folsk want to move to.

For us, thinking that one hour commute from the main cities would be acceptable. So live in suburbs but commute to the medical job (hoping wife can get part time so she can travel say three days in a week or some light schedule like that.

Originally Posted by Texas Ag 93

Is the physician already licensed in Texas? If not, start that process right away if you are seriously considering this state. The process will, indeed, take 6 months, and for that reason, health systems and practices will strongly prefer someone already licensed here.

Re: the above suggestion of Denver- it's a great city, we loved it, but due to its high desirability, the physician market is very oversaturated for many specialties. I know that from experience having moved back to TX from Denver in 2012 where my husband was in practice.

[hellpaso]

Originally Posted by iamanewuser

Also learning that medical groups hire physicians in TX and not the actual hospitals!


For us, thinking that one hour commute from the main cities would be acceptable. So live in suburbs but commute to the medical job (hoping wife can get part time so she can travel say three days in a week or some light schedule like that.

Something else to keep in mind, is that it’s not necessary to work in the TMC. Particularly if your wife is not involved in a research position (those jobs are also located in Galveston at UTMB and throughout the area, btw), there’s really little reason to actually practice in the medical center.

Even if your wife is a hospitalist, there are plenty of positions in the ‘burbs. There are at least a dozen or more hospitals in my small area (Clear Lake) I’m an RN, and none of the physicians I know and work with ever go into the TMC for anything.

You are correct in that most physicians are employed by groups, not hospitals. One group I work with frequently has over 50 docs in their group.

[Texas Ag 93]

Originally Posted by hellpaso

Even if your wife is a hospitalist, there are plenty of positions in the ‘burbs. There are at least a dozen or more hospitals in my small area (Clear Lake) I’m an RN, and none of the physicians I know and work with ever go into the TMC for anything.

You are correct in that most physicians are employed by groups, not hospitals. One group I work with frequently has over 50 docs in their group.

I think there are a fair number of physicians who will see patients in both the Med Center and suburban locations, but usually, they only do that if they need two locations to get the volume they need. Like you, I can't think of anybody who has adequate volume in the suburbs that goes into the Med Center. I think that's my husband's worse nightmare.....that they ask him to go up to the Med Center once a week. They would have to make it very much worth his while.

Regarding the group employment thing, it definitely seems like most private practice physicians practice in large multi-specialty groups, as opposed to alone or with just 1-2 other partners. However, I think the suburban hospitals are bringing more and more formerly private practice docs into their fold and making them hospital employees (or more appropriately, employees of the Practice Plan, which is essentially the same thing).

[hellpaso]

Originally Posted by Texas Ag 93

Regarding the group employment thing, it definitely seems like most private practice physicians practice in large multi-specialty groups, as opposed to alone or with just 1-2 other partners. However, I think the suburban hospitals are bringing more and more formerly private practice docs into their fold and making them hospital employees (or more appropriately, employees of the Practice Plan, which is essentially the same thing).

True. My husband has been retired (anesthesiologist) since we moved here, but he pretty much always practiced at a facility that contracted his group, and didn't have to go to other facilities.

[iamanewuser]

Thank you for chiming in. Yes, I'm getting the sense that unless one has a reason to go to TMC for work due to particular type of job (say needing research or academic support/work, it's not a must. Good to know that there're quite a few hospitals in the 'burbs. Do you know any good medical groups that I could contact to see what job openings they may have for a hospitalist or nocturnist? You may PM me if you prefer.

Originally Posted by hellpaso

Something else to keep in mind, is that it’s not necessary to work in the TMC. Particularly if your wife is not involved in a research position (those jobs are also located in Galveston at UTMB and throughout the area, btw), there’s really little reason to actually practice in the medical center.

Even if your wife is a hospitalist, there are plenty of positions in the ‘burbs. There are at least a dozen or more hospitals in my small area (Clear Lake) I’m an RN, and none of the physicians I know and work with ever go into the TMC for anything.

You are correct in that most physicians are employed by groups, not hospitals. One group I work with frequently has over 50 docs in their group.

[iamanewuser]

Thank you for sharing your perspective and I agree with your assessment! So this group thing, is pretty much a nuisance and TX hospitals seem to have formed their entities that employ physicians..am I understanding this right? So it doesn't change much then ..

I was thinking that hospitals HAD to go through private groups to "employ" physicians and as someone looking for jobs should look for these private medical groups (Sound Physicians, Apogee Hospitalist etc) and no use looking at the hospital's websites directly. Or I have it wrong?

Originally Posted by Texas Ag 93

I think there are a fair number of physicians who will see patients in both the Med Center and suburban locations, but usually, they only do that if they need two locations to get the volume they need. Like you, I can't think of anybody who has adequate volume in the suburbs that goes into the Med Center. I think that's my husband's worse nightmare.....that they ask him to go up to the Med Center once a week. They would have to make it very much worth his while.

Regarding the group employment thing, it definitely seems like most private practice physicians practice in large multi-specialty groups, as opposed to alone or with just 1-2 other partners. However, I think the suburban hospitals are bringing more and more formerly private practice docs into their fold and making them hospital employees (or more appropriately, employees of the Practice Plan, which is essentially the same thing).

[Texas Ag 93]

Originally Posted by iamanewuser

Thank you for sharing your perspective and I agree with your assessment! So this group thing, is pretty much a nuisance and TX hospitals seem to have formed their entities that employ physicians..am I understanding this right? So it doesn't change much then ..

I was thinking that hospitals HAD to go through private groups to "employ" physicians and as someone looking for jobs should look for these private medical groups (Sound Physicians, Apogee Hospitalist etc) and no use looking at the hospital's websites directly. Or I have it wrong?

Yes and No. Health Systems can (and increasingly, do) employ physicians. But, to avoid the legal issues that disallow the "corporate practice of medicine", they have separate legal entities that function as their employer where only the physicians (or maybe midlevel providers) fall under that "employer" umbrella. What you are referring to above in bold is what hellpaso was describing (I think)- private, profit driven companies, often national or regional in scope, that employ physicians. Many, if not most, hospitals today have to use them to provide physician coverage for specialties that are often shift work or where the doc can work offsite, like EM, Anesthesiology, Radiology etc). This is the scenario that often leads to the stories you hear about patients who go to an ER that is in their insurance network, but receive care from a physician that works for one of these groups, and then they get stuck with a big bill. Personally, I think such things shouldn't be allowed, and so do an increasing number of states, it seems, but that's a different topic for discussion.

[iamanewuser]

Got it, thank you for explaining it. So then it would be beneficial to contact the "employer" entity of a given hospital to work directly with them as opposed to working through the for-profit groups. The thinking is a job is advertised through recruiters and posted on the main hospital website as well, going directly to hospital would save the hospital money by hiring the person directly vs if the person was introduced to hospital through the recruiter.

Another scenario is where some of these private hospitalist groups exclusively provide hospitalists for a gien hospital. I've seen those in NY where if you go to hospital's website and look for hospitalist openings, they would explicitly direct you to third party private group and there would't be any choice except to go through the designated vendor/hospitalist group.

I hope it makes sense.

Originally Posted by Texas Ag 93

Yes and No. Health Systems can (and increasingly, do) employ physicians. But, to avoid the legal issues that disallow the "corporate practice of medicine", they have separate legal entities that function as their employer where only the physicians (or maybe midlevel providers) fall under that "employer" umbrella. What you are referring to above in bold is what hellpaso was describing (I think)- private, profit driven companies, often national or regional in scope, that employ physicians. Many, if not most, hospitals today have to use them to provide physician coverage for specialties that are often shift work or where the doc can work offsite, like EM, Anesthesiology, Radiology etc). This is the scenario that often leads to the stories you hear about patients who go to an ER that is in their insurance network, but receive care from a physician that works for one of these groups, and then they get stuck with a big bill. Personally, I think such things shouldn't be allowed, and so do an increasing number of states, it seems, but that's a different topic for discussion.