After earning his M.D, Dr. Burton moved to Springfield, Ohio to open his own medical practice. He married Hattie B. Taylor in 1893. 

Shortly after he began practicing medicine, Dr. Burton was commissioned as Assistant Surgeon of the Ninth Battalion Infantry, Ohio National Guard where he organized a regiment of the State Militia to defend the state of Ohio during the Spanish-American war.

In 1897, Dr. Burton invited other African American physicians to create the Ohio Mutual Medical Association, and he later served on the National Medical Association.

Burton is credited with being the first African American physician in Springfield, and operated several businesses. He was and the first African American in Springfield to open a drugstore and own/operate a newspaper, the Loyal Legion of Honor. His business ventures included a shoe store and a hotel and health resort in Michigan.

Dr. Thomas W. Burton died on March 23, 1939, at age 78 and is interred in the NW Section of Ferncliff Cemetery.