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  • #16
    I've only visited NZ. It is very, very beautiful.
    Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

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    • #17
      Originally posted by STATscans View Post
      So sounds like people like the ‘medical climate’ in the US ALOT>>>. Despite all the negativity we hear - malpractice, forms, regulations, patient “satisfaction score”, declining reimbursement, etc..
      Any system is going to have downsides. I would rather live in my fancy doctor house next to world class recreation making as much money in an hour as I would in a day living in an underserved NZ location. I mean...money aside, I cannot imagine any rainbow/unicorn practice scenario where I would be happy in NZ if I am tied up in hospital 18 days/mo or whatever it is they want.

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      • #18
        Originally posted by STATscans View Post
        So sounds like people like the ‘medical climate’ in the US ALOT>>>. Despite all the negativity we hear - malpractice, forms, regulations, patient “satisfaction score”, declining reimbursement, etc..
        All the negativity you quoted were there in NHS in UK. Some like malpractice was a bit less but even that is highly variable in USA, with some places here even better than there. And I heard that the regulations have worsened with the multiple trust administrators adopting the same "patient satisfaction", "quality assurance and improvement" and other nonsensical measures like we do. Not that they are really measuring those parameters but using it to get the 5 star reviews so that the piggy bank NHS HQ can pay them more, and not penalize them. And other countries have inefficiencies, deficiencies, nepotism and corruption in the medical field that we would not put up with.

        What many yearn for when we say we want to move to NZ or OZ or England is that we want to not have all the negativeness you quoted in your post but thinking there will no negativeness on the other sides. It is not a bed of roses out there. There are trade offs and there is no utopia. As long as you accept it, it would be an adventure. And those countries are beautiful and different from what we have here.



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        • #19
          I've thought about moving it of NJ for financial reasons, as well as climate. Here you're paying sky high for bad weather. At least next door in Pennsylvania or Delaware it's similar weather for a fraction of the cost. Or Florida where you're paying but it's generally better weather.
          $1 saved = >$1 earned. ✓

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          • #20
            Originally posted by Cubicle View Post
            I've thought about moving it of NJ for financial reasons, as well as climate. Here you're paying sky high for bad weather. At least next door in Pennsylvania or Delaware it's similar weather for a fraction of the cost. Or Florida where you're paying but it's generally better weather.
            Yeah, I've always been fascinated by folks that live in miserable places and pay a premium to do so. But "miserable" is subjective, yes? My kid thinks I'm the craziest person on the planet for hating cucumbers...I think it is crazy that people actually pay money for the privilege of eating those disgusting things.

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            • #21
              Originally posted by G View Post

              Yeah, I've always been fascinated by folks that live in miserable places and pay a premium to do so. But "miserable" is subjective, yes? My kid thinks I'm the craziest person on the planet for hating cucumbers...I think it is crazy that people actually pay money for the privilege of eating those disgusting things.
              Not only do I love eating raw cucumbers I also love eating uncooked red full sized tomatoes. When patients bring those veggies to give away in our office because they have too much growing at home, I am the first who picks out the small cucumbers and juiciest tomatoes and snack on them. And my office staff think I am crazy for doing that.

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              • #22
                Originally posted by Forevalwayzz View Post
                I recently came across some post about New Zealand, started looking up the place, and the climate looks fantastic year round. I have never been to the country, but it’s now on my list to visit. A small part of me “wish” to move to a better tropical climate, not to retire, but live and work there (it’s really hot in TX). California and Hawaii fit the climate profile for places in the US, maybe even Key West. Anyone ever look into this or have done it? Any other country where you can still work as a physician with US license for similar compensation?
                I remember during med school or residency I had found a company that offered work in Australia for US docs to do primary care. I remember it paid 125k Aus dollars and could be done for a certain number of years. I was very interested in it but my wife didn’t want to be away from her family so it never happened.
                New Zealand weather is temperate I thought? Not tropical? Plus they are still on serious lock down last I checked. They are not allowing just anyone to come in.
                I personally would LOVE to move to Hawaii. I am certain I would be very happy living on Kauai or the big island. Would prefer a small house away from the towns with a little bit of land to garden year round. Would strongly consider teaching there as they have a desperate need for teachers. Might consider medicine there, maybe on the side. But again, my wife doesn’t want to be away from family. Maybe when we’re older and her parents aren't around anymore.

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                • #23
                  Originally posted by Kamban View Post

                  Not only do I love eating raw cucumbers I also love eating uncooked red full sized tomatoes. When patients bring those veggies to give away in our office because they have too much growing at home, I am the first who picks out the small cucumbers and juiciest tomatoes and snack on them. And my office staff think I am crazy for doing that.
                  I too also take the cucumbers. It is funny how much I love them but I despise pickles

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                  • #24
                    Originally posted by hightower View Post
                    it paid 125k Aus dollars
                    So 90-95k USD. Even with the extra benies and humane work hours, that is a tough sell. Especially if you have loans, anticipate moving back to the States at some point, retiring, etc.

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                    • #25
                      Originally posted by STATscans View Post
                      So sounds like people like the ‘medical climate’ in the US ALOT>>>. Despite all the negativity we hear - malpractice, forms, regulations, patient “satisfaction score”, declining reimbursement, etc..
                      I'm pretty sure what people like about the "medical climate in the US" is that it pays more (and maybe you're also taxed less). There are surely other considerations, but that's at least 90% of it. If one could make the same (or more) doing similar work abroad, I think it would be a more attractive option.

                      I've been working on my wife for years to leave here, but her main hang up is proximity to family. Canada is about as far as I can get her to go.

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                      • #26
                        Most discussions are colored by the 'There's no place like home' bias so I think that somewhere the is 'not home' would have to be pretty darn good, or one's version of 'home' has to be particularly nasty. Having worked in several countries I would say that each has some strong points and weak points. I would also suggest that the US is about as far from homogenous as one can get in terms of experiences. Income expectations would be high. Taxation is quite variable and I don't think that the US is the best place internationally with respect to taxes. And many places in the US would not be advantageous from an all in tax perspective. I suspect that even places that are perceived to be 'highly taxed' such as Canada that a significant number of MDs come out ahead. We also need to accept that as individuals, our values vary quite markedly. Some would be quite happy in places and situations that others would find unacceptable for various reasons.

                        When the question of staying in the US to work (and live of course) came up for us there were many possible positives but there were also some negatives (some of which where 'home' related things) and Canada won out. And this was when we were considering areas of the US that we found the most attractive (and having read discussions here for a few years, I know that some would not share our appraisal for various reasons). Subsequently, when the decision was made to relocate, the US was not the chosen destination for some of the not 'home' related reasons.

                        As Canadians, we are not constrained by forever being taxed by our motherland and I expect that this anchor weighs heavily on some. As well, as pointed out, the cost of education in the US seems like a very large negative in terms of mobility. I could see that it would be very difficult to sacrifice potential income when carrying this burden. Most of the places which have lower MD income also have markedly lower education costs and debt burden.

                        On a side note, I have long found the potential impact of medical education costs on people's decision to do work in international low resource settings distressing. This path can be very fulfilling but is very difficult to take if one had serious debt.

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                        • #27
                          Originally posted by Kamban View Post
                          I have lived ( not touristed or expated but actually lived) in India, England and USA. USA wins in all categories hands down. People who b and moan about USA don't know how good we have it here.

                          Having said that, it might not be a bad idea to go to these and other countries for a few months or year or two when you want a change, an itch that needs to be scratched or have a bit of wanderlust. These are best done who you have a decent FIRE or when you are reaching normal retirement and the coop is empty.

                          A PCP next door who used to refer to me did a 6 month assignment in NZ taking care of Maoris. He was 66, had SS and his kids were grown and settled. He did not have to take any exams to practice there and went with his wife. They provided accommodations. He liked it so much that when he came back to practice in his old combo of PCP /urgent care chain he quit after 6 months and went back to a 2 year assignment. Pay is decent but less than he was making here but he did not go for the pay. The Maoris liked him and he liked them. Even though it was expensive compared to South Carolina the pay was gravy since he already had a pension, 401K and SS.
                          I agree with you Kamban, but I was wondering what specifically (salary being the obvious one) you preferred about the US to the UK?

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                          • #28
                            Originally posted by Lithium View Post

                            I heard a rumor of a local psychiatrist (I think he still works at the academic center in town) who went to NZ. Supposedly he got stuck in a candy shop and the locals were livid with him, to the point that one even reportedly threatened him with violence, when he started cutting them off.

                            That is just what I heard second or third hand from my old colleagues. It could have been twisted or exaggerated, but it definitely quells a lot of my desire to commit to a long-term international assignment sight unseen.
                            I’ve been trying to figure out what a “candy shop” is. At first, I thought you meant he was very fat and got stuck in the door (seriously), but the rest of your comment didn’t make sense. Is a “candy shop” a pill pusher practice?
                            Our passion is protecting clients and others from predatory and ignorant advisors. Fox & Co CPAs, Fox & Co Wealth Mgmt. 270-247-6087

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                            • #29
                              Originally posted by jfoxcpacfp View Post

                              I’ve been trying to figure out what a “candy shop” is. At first, I thought you meant he was very fat and got stuck in the door (seriously), but the rest of your comment didn’t make sense. Is a “candy shop” a pill pusher practice?
                              Correctomundo!

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                              • #30
                                Originally posted by snowcanyon View Post

                                I agree with you Kamban, but I was wondering what specifically (salary being the obvious one) you preferred about the US to the UK?
                                Longish story


                                I went to England to get that itch of seeing what the rest of the world looked like and a bit of wanderlust out of the way, having done my MBBS and MD ( equivalent of residency) in one location in India, for 10 years, post high school. That was the time to do it, young and single. India and England are commonwealth countries and at that time I did not need a visa to go there. US had a bit of catch -22 situation - you needed a visa to come in for interviews for residency slots but the embassy would not give a visa unless you already had a residency slot confirmed. I had an option to go to France but that is story for another day.

                                UK was fun. I passed and got diplomas from the Royal college of Physicians of England ( and Ireland too, since it was just a ferry ride away and Dublin is pretty). But England at that time had a pyramidal system where there were like 10 interns and residents ( called House Officers and Senior house officers) , then cut to 5 fellowships people ( called registrars) followed by called 3 senior registrars, 2 research registrars and finally the king - one consultant. As you climb the side the sides of the pyramid you slip and slide and become family physicians, a NP like position called clinical specialist or be a permanent locum consultant after senior registrar but never having a tenured position. Or being unemployed. If you paid 4 years of social security equivalent you were guaranteed a permanent immigrant status in UK. But without a proper job what is the point of having it. There were consultant positions available in geriatrics and psychogeriatricis but I had no interest in being one of those. Nor in being a glorified NP.

                                I was all set on returning to India when I came to US on a tourist visa. My friend who had come one year earlier took to me to his hospital in inner Bronx where no US graduate would dare do residency due to its war zone like nature. The chief and program director asked my friend who I was and when he introduced me, the guy gave me a residency spot right then, out of match. A 2nd year position skipping internship, more for teaching interns than learning medicine, since I could have taken the boards on day 1 and passed it with all my previous training. I took it so that I can do oncology fellowship and then return home but after finishing it I had opportunities to work in physician deprived area for 2 years and get a green card. In the meantime, India had changed so much in the 8 years and I might have had to make a serious adjustment to settle there. I took the easy way out and here I am in the South USA, 27 years later. ( these are all mid-late 80s and early 90's time frame and things have changed a lot since then in the UK and Bronx).

                                Income really did not influence my decision since I was frugal, had savings and no med school debt and no interest in high end homes or cars. In USA, once you do your residency you are settled. Unlike UK where you are stressed for 10+ years, wondering if you will ever become a consultant. US has better weather and you can move freely within it unlike UK where you are struck to one consultant position in one hospital for life. I find people nicer here than the "superficial niceness" among the British. You earn more and get to keep a bit more. The children are treated as American unlike UK where they are always immigrant even if you were born there. Tourist visits seeing Buckingham palace, London Bridge and Stonehenge does not give a true picture of what it was to live like a physician there.

                                I know some might disagree with me but that was what I experience there and here.

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