Physicians nearing retirement are not always looking for a full stop. Many want a softer landing: a few clinic days a week, seasonal coverage, locums, telehealth-adjacent work, chart review, or volunteer care in a state that does not make licensure, taxes, or cost of living feel like a second full-time job. Based on current Interstate Medical Licensure Compact participation, state-board post-retirement pathways, Census demographic and health care-market data, and Bureau of Economic Analysis price-parity data, these are the strongest first-pass picks right now. 

1. Florida — a strong contender because it has no personal state income tax, 21.8% of residents are 65 and older, and it participates in the Interstate Medical Licensure Compact. Florida also offers limited-license pathways for certain post-retirement practice, including volunteer and, in some cases, compensated work. A key trade-off is cost: Florida’s 2024 regional price parity was 103.6, above the national average.

2. Tennessee — a strong soft-landing state: it has no personal income tax, below-average price levels, participates in the IMLC, and offers a volunteer medical license for uncompensated care for physicians seeking a narrower second chapter. Its health care sector is smaller than Florida’s or Texas’s but remains substantial, particularly in markets like Nashville.

3. Texas — stands out for optionality: it has no personal income tax, participates in the IMLC, and has one of the largest health care markets in the country (about $250 billion in health care and social assistance receipts). This supports part-time, locums, and multi-state work without shrinking opportunities. One nuance: Texas’s retired license status eliminates fees and CME requirements but does not permit clinical practice, so physicians who plan to keep working—even at reduced hours—must maintain a full active license.

4. North Carolina — checks many key boxes: it participates in the IMLC, the Board offers a volunteer license for retired physicians providing uncompensated care, price levels are below the U.S. average, and the state has a large health care sector. It is not as tax-light as Florida or Tennessee, but it is a strong all-around transition state.

5. Arizona — remains one of the more natural retirement states for physicians who want to stay partially active. Nearly one in five residents are aged 65 and older, the state has a sizable health care sector, and it participates in the IMLC. The Arizona Medical Board supports continued practice through standard licensure, locum tenens opportunities, volunteer pathways, and inactive-status options, though most part-time work is done under a full active license rather than specialized limited licenses.

6. Georgia — is a strong under-the-radar option for physicians who want access to a major metro health care market without Florida-level pricing. It has below-average price levels, participates in the IMLC, and has a large health care sector. The state also offers a retirement income exclusion beginning at age 62 (capped, with higher limits at age 65+), which can reduce—but not eliminate—state income taxes in retirement.

7. Idaho — makes the list by pairing a relatively affordable cost profile with full IMLC participation and strong population growth. Its health care market is smaller, so the appeal is less about high locums volume and more about preserving flexibility in a lower-cost, lower-friction environment.

8. Nevada — the appeal is straightforward: it has no personal income tax, participates in the IMLC, and has a growing retiree-age population. Its health care market is smaller than top-tier states, but Las Vegas and Reno provide more part-time and locums optionality than many states of similar size, in part due to ongoing provider shortages.

9. Maine — is the oldest state in this group, with about 23.5% of residents aged 65 and older, making it appealing for physicians who want to scale back while remaining clinically active. It participates in the IMLC, and its cost of living is modestly lower than neighboring New Hampshire’s, though not dramatically so. The trade-offs are a smaller health care market and less favorable overall tax treatment.

10. New Hampshire — earns the last spot because of its strong tax and licensing profile: no broad-based income tax, IMLC participation, and relatively streamlined licensure processes. What keeps it from ranking higher is cost; its 2024 regional price parity was 105.4, among the highest in this short list.

South Carolina — is a notable near-miss on retiree lifestyle: about 19.7% of residents are aged 65 and older, its cost of living is below the national average, and the state offers retirement income deductions while exempting Social Security from taxation. While it now participates in the IMLC, it falls just outside this list due to a smaller health care market and somewhat more limited part-time/locums optionality compared with higher-ranked states.

Colorado — was the opposite kind of near-miss: a strong health care market and clear lifestyle appeal, but with a cost profile above the national average and materially higher than most of the final 10.

Sources: Interstate Medical Licensure Compact, U.S. Census Bureau QuickFacts, U.S. Bureau of Economic Analysis, Federation of State Medical Boards, State Medical Boards, State Revenue Departments