Announcement

Collapse
No announcement yet.

Leaving a HCOL for a LCOL

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Zaphod
    replied



    Die hard New Yorker here. If you’re not from here and it’s not home I can see why you wouldn’t put up with the ridiculous rent for a shoebox at best, and lower physician salaries which effectively makes nyc almost a 50% pay cut for most docs. The city where nannies make more than residents.


    Post coming up on this but we are leaving NYC. Not exactly moving to LCOL, more like a MCOL but coming from NYC it all looks LCOL. We were doing fine in nyc since we have a dirt cheap condo mortgage. We are selling it and it’s unbelievable how much real estate goes for here. $1K/Sq ft….


    It wasn’t a proactive decision like the original post but was fortuitous in itself as fiancé got a job offer we couldn’t turn down. I myself got a nice pay increase and we are doubling our home size for a fraction of the cost in NYC.


    Click to expand...



    win, win, win,win, win.

    Leave a comment:


  • Miss Bonnie MD
    replied
    Die hard New Yorker here. If you’re not from here and it’s not home I can see why you wouldn’t put up with the ridiculous rent for a shoebox at best, and lower physician salaries which effectively makes nyc almost a 50% pay cut for most docs. The city where nannies make more than residents.

    Post coming up on this but we are leaving NYC. Not exactly moving to LCOL, more like a MCOL but coming from NYC it all looks LCOL. We were doing fine in nyc since we have a dirt cheap condo mortgage. We are selling it and it’s unbelievable how much real estate goes for here. $1K/Sq ft....

    It wasn’t a proactive decision like the original post but was fortuitous in itself as fiancé got a job offer we couldn’t turn down. I myself got a nice pay increase and we are doubling our home size for a fraction of the cost in NYC.

    Leave a comment:


  • Hatton
    replied





    look at houses that cost what you’re paying for your condo in your hometown

     


    Click to expand…



    What a terrible, terrible looking house.  I know the cost per square foot is favorable, but this looks like the sort of ham-fisted McMansion that would be featured on http://mcmansionhell.com .


    Click to expand...








    I’m not arguing that there aren’t tolerant, accepting places in this country that are LCOL. But I do think that some parts of the country feel like they wouldn’t be as welcoming to certain families. I know that this has affected my own family as we’ve decided where we would be willing to live.

     


    Click to expand…



    It may be true that some people will feel unwelcome in some communities, but that assumption is made far too often.


    In our community of < 20,000, our best friends are a caucasian and Indian couple (albeit American-born). At the hospital, I work with many immigrants from Asia and several from Africa. We have many Muslims in traditional garb as patients, and there is also a community of Mennonites. I have at least three local patients in black-white marriages.


    There is also a small university well-known for its engineering program, and there is similar diversity among the professors and students there.


    I’m white but my wife is Korean. The caucasian lady who lives next door organizes lunches (that last for three hours) for the six ladies on our street, including my wife and the young Chinese woman who moved in recently.


    My wife met a Korean woman at the local Starbucks who is married to a professor. That woman invited her to lunch with six other Korean women affiliated with the university. So far, she hasn’t been able to make their monthly lunches because of conflicting social engagements!


    ***


    The assumptions about tolerance result from unfamiliarity. I won’t go to the Carnival in Rio because of news reports of rampant crime. Meanwhile, plenty of Europeans probably won’t come to the US because of all the mass shootings they read about.


    Click to expand...



    I also enjoyed McMansion ************************.


    I also think that CM is right that an amazing amount of diversity exists in some small and medium sized towns.  I live in a medium sized town in Alabama.  I have seen patients from almost every country on the planet over the years.  I think you see a diverse population when a smaller town has a university or a military base.  My town has both.  My advice is to not rule out large areas of the country without at least visiting them.

    Leave a comment:


  • hightower
    replied
    @hank Thanks for posting that link to McMansion ************************! LOL! As an old house guy, that site makes me smile!

    Leave a comment:


  • adventure
    replied


    What a terrible, terrible looking house.  I know the cost per square foot is favorable, but this looks like the sort of ham-fisted McMansion that would be featured on http://mcmansionhell.com .
    Click to expand...



    I just died laughing. That's awesome. Thanks.

    Leave a comment:


  • Zaphod
    replied







    I’m not arguing that there aren’t tolerant, accepting places in this country that are LCOL. But I do think that some parts of the country feel like they wouldn’t be as welcoming to certain families. I know that this has affected my own family as we’ve decided where we would be willing to live.
    Click to expand…


    It may be true that some people will feel unwelcome in some communities, but that assumption is made far too often.

    In our community of < 20,000, our best friends are a caucasian and Indian couple (albeit American-born). At the hospital, I work with many immigrants from Asia and several from Africa. We have many Muslims in traditional garb as patients, and there is also a community of Mennonites. I have at least three local patients in black-white marriages.

    There is also a small university well-known for its engineering program, and there is similar diversity among the professors and students there.

    I’m white but my wife is Korean. The caucasian lady who lives next door organizes lunches (that last for three hours) for the six ladies on our street, including my wife and the young Chinese woman who moved in recently.

    My wife met a Korean woman at the local Starbucks who is married to a professor. That woman invited her to lunch with six other Korean women affiliated with the university. So far, she hasn’t been able to make their monthly lunches because of conflicting social engagements!

    ***

    The assumptions about tolerance result from unfamiliarity. I won’t go to the Carnival in Rio because of news reports of rampant crime. Meanwhile, plenty of Europeans probably won’t come to the US because of all the mass shootings they read about.
    Click to expand...


    Im sure it depends on where you live north, midwest, or south. It doesnt have to be aggressive and in your face to be unwelcoming. I moved from LA to the sticks for training, and the hyper religious in your face attitude was oppressive (was particularly prominent among my residency faculty). It didnt ruin my life or anything, but I definitely was happier and more comfortable when I left. I live in a very conservative area in Cali, but dont even notice it, not like residency where they basically cornered you and tried to bring you in the fold, and judged you for not going to their church etc...

    I can live almost anywhere, we're boring homebodies that dont need much and have found enjoyment everywhere we've been. However, there are noticeably better choices as well. Trick is to find the happy medium.

    Leave a comment:


  • CM
    replied




    I’m not arguing that there aren’t tolerant, accepting places in this country that are LCOL. But I do think that some parts of the country feel like they wouldn’t be as welcoming to certain families. I know that this has affected my own family as we’ve decided where we would be willing to live.
    Click to expand...


    .

    Leave a comment:


  • MPMD
    replied





    look at houses that cost what you’re paying for your condo in your hometown 
    Click to expand…


    What a terrible, terrible looking house.  I know the cost per square foot is favorable, but this looks like the sort of ham-fisted McMansion that would be featured on http://mcmansionhell.com .
    Click to expand...


    Ha, yeah, fair.

    Was just making a point about housing prices.

    Leave a comment:


  • HLM
    replied
    I think another thing to keep in mind about where people decide to live despite the cost is where they fit in and feel comfortable.

    Religious beliefs, race, political views, sexual orientation--these are issues that some people might not consider at all when they decide where they live because they might be able to "blend in" anywhere. But for others, their religion or race or sexual orientation or political views might not make them welcome in some LCOL places in this country. Some HCOL areas offer a diversity that is worth the cost for some.

    I'm not arguing that there aren't tolerant, accepting places in this country that are LCOL. But I do think that some parts of the country feel like they wouldn't be as welcoming to certain families. I know that this has affected my own family as we've decided where we would be willing to live.

    Leave a comment:


  • Hank
    replied


    look at houses that cost what you’re paying for your condo in your hometown
    Click to expand...


    What a terrible, terrible looking house.  I know the cost per square foot is favorable, but this looks like the sort of ham-fisted McMansion that would be featured on http://mcmansionhell.com .

    Leave a comment:


  • CM
    replied




    Lastly, I’m not convinced LCOL gives a better paycheck.  none of the doctor salary surveys are accurate.
    Click to expand...


    .

    Leave a comment:


  • drpepper
    replied
    If you think of yourself as a wage earner, you will be treated as such. If you think of yourself as a revenue creator, you will thrive whether you are in a LCOL or HCOL area.

    The truth is that there is more potential to make money in HCOL areas because of payer mix/patient density etc. It's just a matter of who is making the money and who is being taken advantage of.


    Leave a comment:


  • Kamban
    replied




    I’ve always been puzzled how LCOLAs are able to afford higher salaries for physicians. I understand it’s partially a function of supply and demand but how do practices in less affluent LCOLAs have a strong enough payor mix to pay high salaries.
    Click to expand...


    As Zaphod says, the HCOL areas know that you want to live there at any cost and hence they only offer you lower wages. Just like you get fixated with buying only "that car, that color, that accessory" and get screwed with paying MSRP.

    I went to SF in 1996 and they were offering less than half the pay they were offering in the South East. And they expected us to jump at the opportunity and thank them for the low wages :x . Yet at the same time the IT geeks were getting astronomical income.

    Thank God I saw that there were better opportunities in rest of USA.

    Leave a comment:


  • Zaphod
    replied





    I don’t think the OP needed to live “paycheck to paycheck” in his HCOLA even with 250K of med school debt. Still it seems like the right choice for many people to move to a LCOLA and benefit from geographic arbitrage.

    I’ve always been puzzled how LCOLAs are able to afford higher salaries for physicians. I understand it’s partially a function of supply and demand but how do practices in less affluent LCOLAs have a strong enough payor mix to pay high salaries.
    Click to expand...


    More likely the anomaly is the lower pay in HCOL areas. The money is certainly there, they just dont have to pay it to you. One of the biggest downsides in academic medicine is you have no idea how much money you're making the system, and they certainly dont tell you. They like to discuss the stuff you can see, the overhead you can appreciate etc...while leaving out facility fees, kick backs and the multiplying factors you may allow other specialties, etc...


    Leave a comment:


  • amphora
    replied
    I don't think the OP needed to live "paycheck to paycheck" in his HCOLA even with 250K of med school debt. Still it seems like the right choice for many people to move to a LCOLA and benefit from geographic arbitrage.

    I've always been puzzled how LCOLAs are able to afford higher salaries for physicians. I understand it's partially a function of supply and demand but how do practices in less affluent LCOLAs have a strong enough payor mix to pay high salaries.

    Leave a comment:

Working...
X