Leaving good job for new location

[lakeswim]

I'm three years out of training - took the first job offered to me, and it's pretty good. I work at a big managed care system in NorCal, and for the most part I like the complexity of my patients, the patient load, and the benefits, which are excellent. I also work 0.6 FTE which is critical for me because my husband travels a lot for his job and I have two kids under 3.

We are considering a cross-country move to be closer to family, but I am worried about leaving my job. Honestly I just don't have anything to compare it to, which is part of the worry. I'm in Derm, and I hate the thought of doing skin checks all day or hustling for money by doing unnecessary procedures. I'm salaried right now, I see mostly complex med-derm or peds patients, and I do some excisions (no cosmetics).

I guess what I'm asking is, does a similar job exist elsewhere? Should I consider locums? With two young kids I would prefer to stay part-time, or even half-time. I just don't want to be bored out of my mind - deep down I feel like doing the high-volume, high-RVU Derm thing would drive me out of medicine within about a week. It's just not for me. Maybe academics?

Any insights would be appreciated.

[CordMcNally]

There are a lot of different jobs out there. I would start applying and interviewing in the area you are looking in and that will give you the information you're looking for.

[jfoxcpacfp]

Yes, there is hope beyond CA! From personal experience, I know many deems who give their job a high rating and who are not in CA. Care to share what state(s) you are considering a move to?

[GUtiger]

I'm three years out of training - took the first job offered to me, and it's pretty good. I work at a big managed care system in NorCal, and for the most part I like the complexity of my patients, the patient load, and the benefits, which are excellent. I also work 0.6 FTE which is critical for me because my husband travels a lot for his job and I have two kids under 3.

We are considering a cross-country move to be closer to family, but I am worried about leaving my job. Honestly I just don't have anything to compare it to, which is part of the worry. I'm in Derm, and I hate the thought of doing skin checks all day or hustling for money by doing unnecessary procedures. I'm salaried right now, I see mostly complex med-derm or peds patients, and I do some excisions (no cosmetics).

I guess what I'm asking is, does a similar job exist elsewhere? Should I consider locums? With two young kids I would prefer to stay part-time, or even half-time. I just don't want to be bored out of my mind - deep down I feel like doing the high-volume, high-RVU Derm thing would drive me out of medicine within about a week. It's just not for me. Maybe academics?

Any insights would be appreciated.

I would find it hard to believe that the job you're in is a unicorn that exists nowhere else. You'd do well to contact the large healthcare systems in the target area and see what they have available. I think you're less likely to find what you're looking for in the academic realm than in the private sector. An academic position will require typically at least two of three development areas: clinical, teaching, research. I don't think most academic centers (unless you're in a satellite location) will be looking for less than full-time. You can certainly look at locums, but that may end up requiring taking work fairly far from home, which doesn't sound like what you're looking for.

[lakeswim]

Yes, there is hope beyond CA! From personal experience, I know many deems who give their job a high rating and who are not in CA. Care to share what state(s) you are considering a move to?

It would be PA/NJ/NY and possibly VA.

I will admit I'm not good at networking and don't have a lot of confidence in general. I didn't really apply to jobs out of residency - this one was simply offered to me. I don't think it's a unicorn job by any means, but I see maybe 20 fairly complex patients a day and prefer that over 40 easy ones. I feel like that is maybe harder to find in Derm?

How can I apply to and interview for jobs without alerting my current boss of the potential move?

[MoneyMoth]

kaiser has a division in VA i believe

[loeffy]

I can understand the hesitancy to leave a good setup, but the pull of family is strong and understandable as well. I've come to realize that there are good employed doctor jobs out there and plenty not so good ones. While not quite a unicorn, a good job should be held in high regard, personally I'd take less money for a good job. In your case, I'd consider starting the job hunt process, looking around and feeling things out, and really look closely at the job and see if it'll be a good fit. If the people there are good, reliable, trustworthy and will give you what they say. Politics of the system. If there's been a lot of turnover. Etc.

[Drsan1]

You can definitely find another great job. You have to ask the right questions when interviewing. If you know you want a non RVU salaried position look for that...part time...look for that. As physicians we are the ones with the talent and skill. Employers need us. It’s ok to turn jobs down and look for what you want. Since your target area is so broad you should def be able to find something suitable for you. If you area was limited to say one city...you may have to take what you can get to be in your desired city. Now your an experienced doc looking which tends to hold more weight for some. Good Luck.

[wideopenspaces]

I would find it hard to believe that the job you're in is a unicorn that exists nowhere else. You'd do well to contact the large healthcare systems in the target area and see what they have available. I think you're less likely to find what you're looking for in the academic realm than in the private sector. An academic position will require typically at least two of three development areas: clinical, teaching, research. I don't think most academic centers (unless you're in a satellite location) will be looking for less than full-time. You can certainly look at locums, but that may end up requiring taking work fairly far from home, which doesn't sound like what you're looking for.

In my area, an academic center is the only employer who allowed part time. I was 0.25 fte. I did also teach residents as I enjoy teaching.

OP, there are certainly other good jobs out there. You sound like you want to do the hard work others might not be interested in so I think you're a catch. Negotiate what is most important to you. The right employer will have no issue with that. I think I'd steer clear of locums right now, unless you could find something one weekend a month or something, just given how much you are juggling right now.

[lakeswim]

Thank you all for the helpful advice. It is much appreciated. Is there a job search strategy that you would recommend? Should I just start emailing practices or academics centers with a general inquiry? Or use a recruiter? I went to a large residency program with a robust network, but I'm reluctant to go that route since one of the dermatologists in my office is very closely affiliated with my residency program and I'm trying to keep this under the radar for now.

Also, in general, is it frowned upon to contact people who have left the practice? I feel like that was one thing I really should have done before I took my current job (there was a lot of turnover before I came on).

[Lithium]

Thank you all for the helpful advice. It is much appreciated. Is there a job search strategy that you would recommend? Should I just start emailing practices or academics centers with a general inquiry? Or use a recruiter? I went to a large residency program with a robust network, but I'm reluctant to go that route since one of the dermatologists in my office is very closely affiliated with my residency program and I'm trying to keep this under the radar for now.

Also, in general, is it frowned upon to contact people who have left the practice? I feel like that was one thing I really should have done before I took my current job (there was a lot of turnover before I came on).

I think there is very little risk in informal networking with colleagues from residency. Why would anyone rat you out? That's probably where I would start.

Also, let them frown away. Obviously, like you said, you want to hear what the ex-doctors say. But a practice's reaction to that request is probably just as informative. It's like dating someone who blames all his problems on his exes.