Best areas to move for job post-residency?

[Perrotfish]

Are there places left in CA that don't cost million bucks to have a one bed room house (kind exaggerating but not much). .

I hear the prices in both Lemoore and Twentynine Palms are pretty reasonable

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[Winged Scapula]

I hear the prices in both Lemoore and Twentynine Palms are pretty reasonable

LOL...

My dad was stationed at NAS Lemoore so I"m pretty familiar with the area. In fact, my mother still lives near there and yes, you can get a home for much less than a million bucks.

 

[Burnted_out]

Wisconsin or Indiana near the illinois border...can reverse commute to a nice chicago suburb and not get killed on malpractice, etc.

This exactly. I will prob practice on IN and live in IL for next job. Best of both worlds. FYI - the more Republican the state the better the malpractice issues. Examples: IN and Tx. The more liberal and Dem the worse the malpractice issues . Examples: IL

 

[ThoracicGuy]

This exactly. I will prob practice on IN and live in IL for next job. Best of both worlds. FYI - the more Republican the state the better the malpractice issues. Examples: IN and Tx. The more liberal and Dem the worse the malpractice issues . Examples: IL

Why would you live in Illinois when you work in Indiana? You'll pay a higher state income tax rate in Illinois. You'll get a credit for Indiana tax paid, but the remaining amount will be due to Illinois. Plus housing costs will be higher along with costs of other stuff like groceries and shopping with the higher sales tax.

Better option is live and work in Indiana and visit Chicago whenever you like.

 

[Burnted_out]

Why would you live in Illinois when you work in Indiana? You'll pay a higher state income tax rate in Illinois. You'll get a credit for Indiana tax paid, but the remaining amount will be due to Illinois. Plus housing costs will be higher along with costs of other stuff like groceries and shopping with the higher sales tax.

Better option is live and work in Indiana and visit Chicago whenever you like.

I’m currently in IL, bought house here, family is here. I’m a Chicagoan at heart. Love the Chicago scene, always doing something either going to shows, restaurants, etc which IN does not offer. I will be doing interventional pain so prefer malpractice env of IN but again love Chicagoland.

 

[ThoracicGuy]

I’m currently in IL, bought house here, family is here. I’m a Chicagoan at heart. Love the Chicago scene, always doing something either going to shows, restaurants, etc which IN does not offer. I will be doing interventional pain so prefer malpractice env of IN but again love Chicagoland.

Sure, but if you have a job in NW Indiana, its not like going into Chicago would be that hard to do. But whatever floats your boat. You're paying a bunch for the privilege of living in Chicago...

 

[Burnted_out]

Sure, but if you have a job in NW Indiana, its not like going into Chicago would be that hard to do. But whatever floats your boat. You're paying a bunch for the privilege of living in Chicago...

I lived in NW Indiana for quite some time when I was younger and much prefer Chicago. NW Indiana certainly has some nicer parts, particularly if you have reasonable $ to buy housing, etc. but again not as nice as Chicago. I actually live in the burbs so not Chicago proper I guess so the taxes are quite reasonable. Chicago area is very saturated with doctors of all specialties - can't swing a dead cat without hitting a specialist of some sort. But I make a reasonable income, which will likely go higher with int. pain, have no debt other than mortgage, and husband makes a reasonable income so we are good financially speaking. I put a very high price on family and being close to my parents - even if it potentially costs me a few grand more here and there.

 

[rokshana]

This exactly. I will prob practice on IN and live in IL for next job. Best of both worlds. FYI - the more Republican the state the better the malpractice issues. Examples: IN and Tx. The more liberal and Dem the worse the malpractice issues . Examples: IL

So how do you explain Cali?

 

[ThoracicGuy]

I lived in NW Indiana for quite some time when I was younger and much prefer Chicago. NW Indiana certainly has some nicer parts, particularly if you have reasonable $ to buy housing, etc. but again not as nice as Chicago. I actually live in the burbs so not Chicago proper I guess so the taxes are quite reasonable. Chicago area is very saturated with doctors of all specialties - can't swing a dead cat without hitting a specialist of some sort. But I make a reasonable income, which will likely go higher with int. pain, have no debt other than mortgage, and husband makes a reasonable income so we are good financially speaking. I put a very high price on family and being close to my parents - even if it potentially costs me a few grand more here and there.

Chicago is a fun city, that's for sure. The traffic is horrible, though.

 

[Burnted_out]

Chicago is a fun city, that's for sure. The traffic is horrible, though.

Can’t disagree with you there!

 

[Burnted_out]

So how do you explain Cali?

What about Cali? Liberal, democrat and high malpractice with high payouts when something goes wrong. Don’t get me started on Cali. Won’t say anything else about it.

 

[rokshana]

What about Cali? Liberal, democrat and high malpractice with high payouts when something goes wrong. Don’t get me started on Cali. Won’t say anything else about it.

Really? My understanding is that Cali has somelowest medical liability in the country given tort reform decades ago and have some of the country’s lowest med mal... salaries and COL as well as taxes are crap ...

 

[Raryn]

So how do you explain Cali?

Tort reform happened in CA back in the 1970s, before it was quite the liberal powerhouse. Democrats still had a majority at that time, but MICRA passed less than a year after Reagan was governor.

What about Cali? Liberal, democrat and high malpractice with high payouts when something goes wrong. Don’t get me started on Cali. Won’t say anything else about it.

You're wrong. CA has one of the best malpractice environments in the country. Lower premiums than something like 45 other states. High payouts can only happen if you **** up royally on a very rich person (see John Ritter) because noneconomic damages are limited to a max of $250k.

 

[rokshana]

Tort reform happened in CA back in the 1970s, before it was quite the liberal powerhouse. Democrats still had a majority at that time, but MICRA passed less than a year after Reagan was governor.

You're wrong. CA has one of the best malpractice environments in the country. Lower premiums than something like 45 other states. High payouts can only happen if you **** up royally on a very rich person (see John Ritter) because noneconomic damages are limited to a max of $250k.

That’s what I thought

 

[Burnted_out]

Tort reform happened in CA back in the 1970s, before it was quite the liberal powerhouse. Democrats still had a majority at that time, but MICRA passed less than a year after Reagan was governor.

You're wrong. CA has one of the best malpractice environments in the country. Lower premiums than something like 45 other states. High payouts can only happen if you **** up royally on a very rich person (see John Ritter) because noneconomic damages are limited to a max of $250k.

Ok. Maybe I’m wrong on that aspect of CA and your theory that tier reform happened years ago before the liberal fruitcakes destroyed CA.
Bear with me on this then - if there is a tort reform as you say, why would that woman - Jahai Mcnath’s mother want to keep her alive in hopes of suing the pants off UCLA or whatever CA hospital the child had the operation at? If you have such a low cap going through all that craziness of keeping the brain dead corpse like that is beyond nuts. I’m sure she was promised millions by the fruitcake liberal lawyers.

 

[rokshana]

Ok. Maybe I’m wrong on that aspect of CA and your theory that tier reform happened years ago before the liberal fruitcakes destroyed CA.
Bear with me on this then - if there is a tort reform as you say, why would that woman - Jahai Mcnath’s mother want to keep her alive in hopes of suing the pants off UCLA or whatever CA hospital the child had the operation at? If you have such a low cap going through all that craziness of keeping the brain dead corpse like that is beyond nuts. I’m sure she was promised millions by the fruitcake liberal lawyers.

Seriously? You can’t get the facts straight to argue your point?
Uh, have you trained or practice in Cali?
IF there is tort reform? California is famous as a state with tort reform...it’s not fake news, it’s written law...take 2 seconds to google it...
And that case was in NoCal ...UCLA in LA... which is SoCal...it was in Oakland btw and that woman obviously could not deal with the death of her child to the point she moved her to the only state that allows for cardiac death and not brain death to determine death...and since the law in Cali doesn’t let you get more that 250k for non medical judgements at best she could have gotten that and cost of medical care

 

[qwerty89]

Ok. Maybe I’m wrong on that aspect of CA and your theory that tier reform happened years ago before the liberal fruitcakes destroyed CA.
Bear with me on this then - if there is a tort reform as you say, why would that woman - Jahai Mcnath’s mother want to keep her alive in hopes of suing the pants off UCLA or whatever CA hospital the child had the operation at? If you have such a low cap going through all that craziness of keeping the brain dead corpse like that is beyond nuts. I’m sure she was promised millions by the fruitcake liberal lawyers.

dat

logic

Also Jahi McMath type situations are more likely in the bible belt and with conservatives that believe all life is sacred because Jesus. You know like the entire Terry Schiavo situation which got conservative lawmakers involved.

 

[VA Hopeful Dr]

dat

logic

Also Jahi McMath type situations are more likely in the bible belt and with conservatives that believe all life is sacred because Jesus. You know like the entire Terry Schiavo situation which got conservative lawmakers involved.

You mean the notorious swing state of Florida?

The rest of the conservative South is not like that. I don't recall my state of South Carolina ever having a similar situation. It's actually often easier here because we can talk about letting someone go home to Jesus.

 

[Burnted_out]

You mean the notorious swing state of Florida?

The rest of the conservative South is not like that. I don't recall my state of South Carolina ever having a similar situation. It's actually often easier here because we can talk about letting someone go home to Jesus.

Going home to Jesus - Amen! I am a conservative and think the Jahai Mcnath situation was awful and horrifying so I would completely agree. that was a money grab for sure in my opinion, and I still don't understand - if $250k was all that could have been gotten in CA, why keep that poor child in that horrifying condition? I agree with VA Hopeful - us "conservatives" don't really believe in keeping brain dead people hooked up to machines. Now I gotta go to my "doctor/nurse" job.

 

[VA Hopeful Dr]

Going home to Jesus - Amen! I am a conservative and think the Jahai Mcnath situation was awful and horrifying so I would completely agree. that was a money grab for sure in my opinion, and I still don't understand - if $250k was all that could have been gotten in CA, why keep that poor child in that horrifying condition? I agree with VA Hopeful - us "conservatives" don't really believe in keeping brain dead people hooked up to machines. Now I gotta go to my "doctor/nurse" job.

I think part of it might be the difference between Protestants and Catholics. The latter group historically are much more against allowing someone to die than the former.

 

[Raryn]

Going home to Jesus - Amen! I am a conservative and think the Jahai Mcnath situation was awful and horrifying so I would completely agree. that was a money grab for sure in my opinion, and I still don't understand - if $250k was all that could have been gotten in CA, why keep that poor child in that horrifying condition? I agree with VA Hopeful - us "conservatives" don't really believe in keeping brain dead people hooked up to machines. Now I gotta go to my "doctor/nurse" job.

$250k for noneconomic damages, unlimited for economic damages - but the economic damages are limited to bona fide problems caused by the injury. The McNath situation was entirely due to religious sentiment and a family crazy from grief from what I can tell.

 

[evilbooyaa]

What about Cali? Liberal, democrat and high malpractice with high payouts when something goes wrong. Don’t get me started on Cali. Won’t say anything else about it.

Ok. Maybe I’m wrong on that aspect of CA and your theory that tier reform happened years ago before the liberal fruitcakes destroyed CA.
Bear with me on this then - if there is a tort reform as you say, why would that woman - Jahai Mcnath’s mother want to keep her alive in hopes of suing the pants off UCLA or whatever CA hospital the child had the operation at? If you have such a low cap going through all that craziness of keeping the brain dead corpse like that is beyond nuts. I’m sure she was promised millions by the fruitcake liberal lawyers.

You have an uncanny ability to be extremely strongly opinionated and confident in things that you have zero knowledge on and/or zero experience with.

 

[Obnoxious Dad]

I think part of it might be the difference between Protestants and Catholics. The latter group historically are much more against allowing someone to die than the former.

This statement about Catholics is untrue. Catholics do not believe that hopeless measures must be undertaken to preserve life. The problem for Catholics is measures taken to end life.

 

[Burnted_out]

You have an uncanny ability to be extremely strongly opinionated and confident in things that you have zero knowledge on and/or zero experience with.

Making global statements is just plain silly on your end. There is 0 question that CA is a bastion of liberal idiocy. They are the prime example of liberal fruitcakeness at its worst. Also I have a right to my opinion. Just like someone up there globally says that the southern belt tries to extend life unreasonably Bc if it’s conservative nature which is crap. We all have a right to our thoughts thank you very much.

 

[VA Hopeful Dr]

This statement about Catholics is untrue. Catholics do not believe that hopeless measures must be undertaken to preserve life. The problem for Catholics is measures taken to end life.

In theory that's true. In practice, that is less true.

 

[Obnoxious Dad]

Making global statements is just plain silly on your end. There is 0 question that CA is a bastion of liberal idiocy. They are the prime example of liberal fruitcakeness at its worst. Also I have a right to my opinion. Just like someone up there globally says that the southern belt tries to extend life unreasonably Bc if it’s conservative nature which is crap. We all have a right to our thoughts thank you very much.

If you want an example of the complete insanity of California's political class, see what they had in mind regarding the taxation of texting.
Text, Californians, text: State commission won't pursue tax on text messaging

The California PUC was going to begin taxing text messages. There was was a possibility that the tax would be retroactively applied over the last five years. The telecom companies would have been required to pay the retroactive tax rather than passing it on to consumers. The proposal was shelved because the Federal Communications Commission ruled that texting was an information service rather than a telecommunications service. The taxation of information services by states is narrowly circumscribed by federal law.

It isn't just the blatant inequity of this proposal that's mind boggling. It's the utter arrogance of those California politicians who believe that no matter what they do, people and companies will keep tolerating this kind of nonsense to be in or do business in California.

 

[Burnted_out]

If you want an example of the complete insanity of California's political class, see what they had in mind regarding the taxation of texting.
Text, Californians, text: State commission won't pursue tax on text messaging

The California PUC was going to begin taxing text messages. There was was a possibility that the tax would be retroactively applied over the last five years. The telecom companies would have been required to pay the retroactive tax rather than passing it on to consumers. The proposal was shelved because the Federal Communications Commission ruled that texting was an information service rather than a telecommunications service. The taxation of information services by states is narrowly circumscribed by federal law.

It isn't just the blatant inequity of this proposal that's mind boggling. It's the utter arrogance of those California politicians who believe that no matter what they do, people and companies will keep tolerating this kind of nonsense to be in or do business in California.

Ah California!

 

[letmeinwillya]

I appreciate the interest and conversation but let's get back to the subject and stay as objective as possible. I'm afraid the admin might close the thread and that would not be helpful for anyone.

So other than looking at the general cost of living, malpractice insurance should be considered. Duly noted.

On California, I've not lived there so can't say but based on online views and general perception, it seems lot of people move their because of nice weather year round and it appeals maybe more to the Northeast types who have endured some bad winters..

If malpractice insurance is a good and under control in CA, then that would be another positive.

Also non-compete agreements are non-enforceable in CA which is a huge positive: Understanding California's Ban on Non-Compete Agreements | HuffPost

How about states with no income taxes?

 

[Obnoxious Dad]

I appreciate the interest and conversation but let's get back to the subject and stay as objective as possible. I'm afraid the admin might close the thread and that would not be helpful for anyone.

How about states with no income taxes?

"Seven U.S. states forgo individual income taxes as of 2018: Alaska, Florida, Nevada, South Dakota, Texas, Washington and Wyoming. Residents of New Hampshire and Tennessee are also spared from handing over an extra chunk of their paycheck, though they do pay tax on dividends and income from investments."
Is Living In A State With No Income Tax Better Or Worse? | Bankrate.com

 

[letmeinwillya]

"Seven U.S. states forgo individual income taxes as of 2018: Alaska, Florida, Nevada, South Dakota, Texas, Washington and Wyoming. Residents of New Hampshire and Tennessee are also spared from handing over an extra chunk of their paycheck, though they do pay tax on dividends and income from investments."
Is Living In A State With No Income Tax Better Or Worse? | Bankrate.com

The article is wishy washy at times implying that net effect is somewhat negative in no-income tax states especially in terms of creating new jobs. I think the last paragraph from the link pretty much sums it up:

"If you think the government should stay out of the society-shaping business, or if you’re a higher-income earner, then you might very well be comfortable living in one of America’s nine no-income-tax states."

Looking at it from the perspective of a physician who will be earning decent amount, do these states bubble up to top in preferences? What're your thoughts?

 

[Old_Mil]

Texas and South Dakota are the best from a medicolegal standpoint. Florida, Washington, and Wyoming aren't as good.

 

[letmeinwillya]

Texas and South Dakota are the best from a medicolegal standpoint. Florida, Washington, and Wyoming aren't as good.

Where does MA stand? Also TX and SD, does it matter if one is working as an employee vs say running one's own practice? How's the business environment from taxation or general business friendliness in those states?

 

[Obnoxious Dad]

From a medical malpractice insurance rate perspective, Massachusetts is terrible.
How Much Does Medical Malpractice Insurance Cost?
From a state and local tax burden perspective Massachusetts is lousy
2018’s Tax Burden by State
If you noodle around the BLS website, you will see that the pay to physicians in Massachusetts is not bad.
Physicians and Surgeons : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics

 

[letmeinwillya]

From a medical malpractice insurance rate perspective, Massachusetts is terrible.
How Much Does Medical Malpractice Insurance Cost?
From a state and local tax burden perspective Massachusetts is lousy
2018’s Tax Burden by State
If you noodle around the BLS website, you will see that the pay to physicians in Massachusetts is not bad.
Physicians and Surgeons : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics

Thank you DAD! LOL!!

On a serious note, thank you for sharing those links. Very helpful!!

 

[Obnoxious Dad]

Thank you DAD! LOL!!

On a serious note, thank you for sharing those links. Very helpful!!

Please understand that the BLS data pertain to employed physicians and not solo physicians or partners in practices. I am pretty sure that the annual wage is based on a 40 hour work week. Because most docs work 50 hour weeks the salaries should be multiplied by 1.25,

 

[nimbus]

How about California? Are there places left in CA that don't cost million bucks to have a one bed room house (kind exaggerating but not much). Is the weather main attraction and if so are there areas within CA that are better than others? Like Sacramento I heard is more affordable than say Bay Area. Can one get a license fairly quickly in CA..
.

Some San Diego suburbs are still very affordable. Good schools, safe neighborhoods, newer 3-4br homes for around 500k. Not on the beach but easy to reach and much better weather than Sacramento and much better amenities than 29 palms.

 

[letmeinwillya]

Please understand that the BLS data pertain to employed physicians and not solo physicians or partners in practices. I am pretty sure that the annual wage is based on a 40 hour work week. Because most docs work 50 hour weeks the salaries should be multiplied by 1.25,

Thanks for clarification. At present, the employed physician data is relevant to my situation.

 

[letmeinwillya]

Some San Diego suburbs are still very affordable. Good schools, safe neighborhoods, newer 3-4br homes for around 500k. Not on the beach but easy to reach and much better weather than Sacramento and much better amenities than 29 palms.

3-4 br homes for $500k seems reasonable for CA especially if they are newer. Anything under a million for CA for desirable areas seems reasonable to me but this could be the case of seeing high prices for CA locations that anything in the $500k or less range starts to look reasonable! Would be looking for 4 beds!

Any particular neighborhood you have in mind? What's 29 Palms?

 

[nimbus]

3-4 br homes for $500k seems reasonable for CA especially if they are newer. Anything under a million for CA for desirable areas seems reasonable to me but this could be the case of seeing high prices for CA locations that anything in the $500k or less range starts to look reasonable! Would be looking for 4 beds!

Any particular neighborhood you have in mind? What's 29 Palms?

Mira Mesa and Chula Vista are a couple examples.

29 Palms is a town in the Mohave desert near Joshua Tree. It was mentioned earlier in the thread as an affordable place to live. I would not recommend raising a young family there, especially if like like city amenities.

 

[Naruhodo]

Friends teased us when we moved from NY to Salt Lake City, but lifestyle-wise it was a major upgrade. Physicians live comfortably (it's not bad even on PGY income), city amenities with accessible nature, very family friendly, good weather (snow tends to stay on the mountains and not in the valley), nice people, tolerant city with substantial LGBTQ and refugee populations, and good Mexican food. Considerations: air quality is poor for about 2 weeks a year (less of an issue in more affluent parts of town or in Park City) and more of your physician colleagues will be male than in other parts of the country.

 

[letmeinwillya]

What areas or states did you narrow down in your search and if you don't mind what led to your ultimate decision of moving where you are currently working? We (as a family) are considering TX, CA, NC maybe FL but haven't applied for license in any of those states. Currently on Long Island, NY and don't think it's a good fit for long term (have school going kids and property taxes and pays are not the best around here). Although schools here are excellent but the housing is expensive so looking for better alternatives...can move anywhere really but would schools, IT job opportunities (for spouse) and future medical job growth are a priority.

 

[letmeinwillya]

It's looking like Texas might be in our future. What's been you experience working there as hospitalist? Not sure if one area is better vs the other among Dallas, Houston, Austin, San Antonio...spouse is in IT and kids in the age bracket for all levels of schools except high school (pre, elementary, middle).

Was on some facebook group of hospitalist and someone was saying Dallas/Fort Worth area is saturated for hospitalist jobs and more applicants for any new job openings, any truth to that?

If I go for locums, wouldn't I have more freedom in terms of tipping my toes first before signing up a year long contract? Any suggestions for locum work in TX or in general? Thank you for your time!

 

[letmeinwillya]

Checking in for any any new responses. Would appreciate your thoughts on the topic. Thank for taking the time to respond.