should I bail on NYC?

[EmViv15]

I'm a couple years out of residency and work at a VERY busy academic center in NYC and am contemplating a move to the midatlantic area. My husband and I are in NY mainly b/c our families are here and its sort of a comfort zone where we both have grown up. The midatlantic region seems to have some nice living options, lower cost of living and still close enough to family to not have to take a plane. While I've been generally happy at my job, I sometimes feel I am shortchanging myself by forcing myself to practice in NYC. The volume feels unmanageable at times and sometimes I feel like our administrators cut corners and game the system when they work clinically just to prove to us that the volume IS manageable and we need to suck it up (thats a whole other post I guess). I guess sometimes my job just feels.... toxic
The pros of my hospital compared to others in the NYC area is that my ancillary care is wonderful and my patient population is awesome (at least, I think so). But perhaps my job is good relative to other NY jobs, and not good relative to the rest of the country. Who knows. I'm just wondering if its time to bail- either on my job or NYC all together.

Can anyone offer perspective on practicing in the mid-atlantic as compared to the NYC area? DC? Baltimore? Other sites in Maryland/Delaware? Philly? I am getting the sense that DC/Philly are probably not what I'm looking for

I'm craving nicer, less cramped facilities (ie, no patients on top of eachother in hallways), nurses/techs that will do more (eg, splinting, setting up stuff- not just placing IVs and giving meds), a lower cost of living, patients who are not overly entitled (regardless of socioeconomic status- I've worked with both rich and poor a-holes). But I still like being in an academic center. I don't need to live in a major city- we want to live in the 'burbs. I'd rather have good schools and maybe near a beach or something, but still with the option to make a day trip to a major city. Are there places I should be looking to find at least some of this?

Or is this itch to find a new job 2 years out normal and I should wait it out?

Feel free to PM me if thats easier
Thanks

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[DocEspana]

Im not even CLOSE to dealing with these job-related thoughts, and I can tell you that you work in NYC for the prestige, and only the prestige. This is true of nearly any field and NYC. Had plenty of attendings (EM and non-EM) tell me that they worked in NYC to get enough CV fodder to move to the suburbs of NJ or CT and get paid a king's ransom to run a quiet service later in life.

IDK about your job, but the pretty uniform characterization of NYC medical services is the pay is crap (comparatively to any other state or even upstate), the nurses have way too much power to do nothing, and the patient load is unreasonable 4 days out of 5. I'd say get out of NYC unless your game plan is similar to what the attendings I referenced above planned out (and accomplished). I can't see how its worth it if thats not your plan.

 

[EMedGrrl]

What about Upstate NY / New England?

 

[EmViv15]

What about Upstate NY / New England?

I'm hesitant about the weather. I think we'd rather move south than North

 

[Rendar5]

Trained in ny and left as soon as I could despite being a lifelong New Yorker. You're paying 23% extra taxes and getting half the pay. it's not even remotely worth it

 

[EmViv15]

Trained in ny and left as soon as I could despite being a lifelong New Yorker. You're paying 23% extra taxes and getting half the pay. it's not even remotely worth it

Did you only leave for $$ reasons or other reasons as well?

 

[JMC2010]

I have a severe bias but have you looked at NC? Specifically Durham/ Chapel Hill /Raleigh area. You've got several academic options, real estate will seem absurdly cheap to you, good public schools, warm weather, good pay, good malpractice environment.

 

[EMPassive15]

I completely understand! I am in a similar situation and wondering if I should bail as well. I love the city and our family is close by but is it really worth it? I am thinking of opting out.

 

[namethatsmell]

I have a severe bias but have you looked at NC? Specifically Durham/ Chapel Hill /Raleigh area. You've got several academic options, real estate will seem absurdly cheap to you, good public schools, warm weather, good pay, good malpractice environment.

I've always heard that this is a really tough area to break into (especially Raleigh)...have things changed?

 

[Birdstrike]

...4th of July fireworks on the rooftop deck, pizza at John's on Bleecker, gazing at Lady Liberty from the riverside, jogging home through the Village, pork buns at Noodle bar, jogging with my dog (RIP) past celebs on the Esplanade, Jazz in a basement club on a Saturday Night, playing with the kids in The Park...

Damn I miss that city sometimes.

 

[DocEspana]

...4th of July fireworks on the rooftop deck, pizza at John's on Bleecker, gazing at Lady Liberty from the riverside, jogging home through the Village, pork buns at Noodle bar, jogging with my dog (RIP) past celebs on the Esplanade, Jazz in a basement club on a Saturday Night, playing with the kids in The Park...

Damn I miss that city sometimes.

Thats why ive trained there as much as possible as long as possible. One day I will walk away from it because it will be the only logical (financial?) decision I can make. But until that point, I want to experience every unique positive it offers.

 

[EmViv15]

its pretty unfortunate that NYC has so much to offer but the medicine sucks. I'm glad I'm not just overthinking it. I would hate to move and regret it

 

[GeneralVeers]

Do yourself a favor and move to a low tax, high reimbursement state (TX, FL, SD, and to a lesser extent WA, NV, AK). The increased salary combined with the huge tax savings will pay for as many fancy trips to New York as you'd like in a year. If you figure that taxes alone will save you about $40K, you could do 4 weeklong trips a year to NY, stay at the best hotels, eat the best food, and still come out ahead.

 

[Rendar5]

Did you only leave for $$ reasons or other reasons as well?

Winter of 2011 reminded me how much I hate shoveling snow and being cold all the time. And my parents became snowbirds, so that helped. I still would've done it regardless of that though.
Think of it this way, if someone offered you $200,000-$300,000 annually to leave NYC,would you? that's the additional income, plus the yearly savings from reduced cost of living, plus not having to pay city tax and state tax. If you really love the area, move to Fort Lee or Edgewater, and grab a job in Northern Jersey. Works if you're a Manhattan type person, not so much if you want to be around the eastern boroughs. To me, I would take the bribe. For others it really is worth that much to stay there.

 

[Rendar5]

Bird you are a man after my own heart. I eat at johns every chance I'm back home. Took my wife there on our second date