Practice Medicine in Taiwan Part II: Salary & Work Culture, Immigration, Taxes

Taiwan is a tropical island country about the size of Maryland and is home to beautiful scenery, friendly people, and awesome food such as beef noodle soup and pork dumplings. It was also has one of the best healthcare systems in the world.  For US-trained physicians looking to practice in Taiwan, we previously described Taiwan’s Healthcare System, Medical Registration, and how to find a job. Here you will learn about the Salary & Work Culture, Immigration, and Taxes.

Salary & Work Culture

The average salary for an outpatient primary care physician is about 60,000 to 100,000 USD, which does not seem bad when the cost of living in Taiwan is about 1/3 the cost of living in the US. However, Taiwanese doctors need to work longer hours and see more patients compared to US physicians to earn this wage. It is common for busier doctors to see over 100 patients in a day. 

Taiwanese patients expect the doctor to address their urgent issues only, and often the appointment can be over in 5 minutes.  Given the low cost of doctor visits, abundance of mostly walk-in clinics in the urban areas, and minimal wait times, patients and physicians don’t feel the pressure to address every single health concern in one visit.  

Immigration

Prior to moving, you will need a job offer in hand and your employer will prepare the necessary documentation to apply for a work visa.  If your spouse has Taiwanese citizenship, you can apply for a resident visa that is valid for 1 to 3 years and can be renewed.

Taxes

If you are a US citizen living abroad, you may be eligible for the foreign earned income exclusion which can help to reduce your tax burden. On the other hand, if you are working for a US company, the Taiwanese government considers your income “foreign” as well, and won’t tax you until you earn over roughly 250K USD.  Of note, if you are a US citizen and doing telemedicine, you still need to pay the self-employment tax at roughly 15% from your foreign income if you are hired as an independent contractor. 

If you choose to work in Taiwan and see local patients, the tax rate will be 30% if you earn between the equivalent of 80K to 150K USD, and is capped at 40% if you earn over 150K.

Bottom Line

The Taiwanese healthcare system is great for patients but is not an easy system to work in for physicians.

With a lower cost of living and a favorable tax situation, it’s actually possible to work less (with minimal inbasket work!) and save more by doing telemedicine into the US, than by living and working in the US.  The key to achieving this is to have multiple state licenses, and finding a telemedicine company that allows physicians to work abroad with a decent compensation.  You can also start your own telemedicine business, but malpractice coverage and patient volume will be the biggest hurdle to overcome for it to be successful.

Most people I know, myself included, moved to Taiwan because of family ties.  Living in Taiwan, like other countries, has its own perks and downsides.  For me, seeing the exuberant smiles on our daughters’ faces everyday when they see their grandparents (and vice versa) has made this experience very rewarding.  

Anderson Tsai DO completed his internal medicine residency at Santa Clara Valley Medical Center in San Jose, and is currently a primary care physician living in Taiwan working with several telemedicine companies in the US and Taiwan. 

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