Feasibility of long distance travel for work

[dphy83]

I am exploring out of town options in order to work in a clinical area that more interests me. I'm pretty happy with where I live, however, there are limited job opportunities in the area of practice that I am seeking. I have been exploring locations out of town, and I am wondering if anyone has any experience working in locations several hours from home?

I have an offer for an interview in a city that is a 5 hour drive away. Is it realistic and sustainable to live where I am and work in such a location if I can get the employer to schedule my shifts in a row so that I can just drive there, stay and work my shifts, then return home (or a similar situation where I fly somewhere, work my shifts, and return home)?

[AbeTheBabe]

I mean it's possible, but there's a lot of variables. Firstly, you would have to get paid a lot more to make up for the fact you'd have to either rent a second apartment in the city to be able to stay there. You would ideally work 3 12s in this scenario so you have more time at home. However, 12 hour shifts are more often variable and not fixed like a regular 8-5.

[Lightspeed]

For physicians, maybe. I know a few that do (and a few that have to). For non physician providers? Barring unique exceptions, I’d say it’s not worth it for me. Your travel and accommodations would swallow up too much of your income unless you were super frugal. I knew laborers in oil that were in that kind of arrangement making around what most PAs make(or less), but they were miserable, and they were bad with money. There are all sorts of variables, and exceptions (resort towns, providers who own trailers they live in, crashing at a relative’s), so I’d hate to make a blanket statement.

So maybe some big money boom towns would be worth doing that in, but mostly only if you can stand the dual life that comes with that, because you’ll be spending a good chunk of your week there watching Netflix at night and killing time until you go back to where you really want to be, which is home. To me, that’s not living, but some folks like the oil rig, or the tar sands, or the tourist traps, or the rural countryside, or the national park, or the diplomatic compound. I like to come home every day and work on my projects and invest my time at home in my community that I enjoy. That’s why I work. But maybe you are in the countryside and need to commute to support that lifestyle. Then it might be the small price to pay to live like you want. 

To many unknowns for much useful advice.

[ohiovolffemtp]

What you're talking about is exactly what I do for a living.  I do solo overnight coverage at an ED in a critical access hospital.  The doc covers 12 hours during the day, I cover 12 hours at night - also responding to calls from the in-patient unit.  I do call the doc in for codes and thrombolytics and a very few other things.  I drive about 4 hours each way and do a series of shifts, 2-7, usually 4-5, in a row.  Housing is provided and I bring food from home.  Since I drive, I don't get mileage but the docs, PA's, and NP's that fly in get airfare, rental car, and a motel room for the night before their shift if needed.  Great job, great work environment, great pay.  I'm actually not spending any more hours driving than at my old job that was an hour each way per shift.

This is my employer's business model, so it's a great fit.

[Reality Check 2]

I personally cannot imagine it. Years ago I drove 1.5 hours to work a 12 hr ER over night shift and then 1.5 hrs back in horrible Texas traffic. I was useless to anyone for about the next day. Never knew if it was night or day and couldn't keep up with my family that all lived during daylight hours. I missed out on so much. 

I am a homebody with kids and pets and would not want to be away. My kids need consistency in parenting. I wouldn't want to miss school plays, soccer games, etc. So, it wouldn't work for me.

Having been in all these years, I really stress life quality. Work to live, not live to work.

What are the consequences of being that far away? What will be missed? Is it important? Who will it affect? 

Where do you want to be in a year, five years, etc.

Not a decision to take lightly.

Hope it works out for you.

 

[EMEDPA]

all 3 of my clinical jobs are at least 60 miles from home and the farthest is 115 miles away. I bought a small condo near the one 115 miles away and commute to the others. it is worth it for better quality jobs outside the big city. 

[cinntsp]

Rural places will often have some sort of housing arrangements for the providers because people are willing to work there consistently, but not necessarily live there.  One CAH I work at has two call rooms(shower, fridge, etc) and two apartments for the ER and hospitalist providers.  Another place has apartments because it's a heck of a lot cheaper than paying for hotels for everyone.  If you're interested in working somewhere a bit far and they don't have something like that, sell yourself hard and include travel expenses(i.e. hotel) as part of your negotiation.  Another option would be to do locums work.  Travel is paid, though contracts can reach an end point.

[EMEDPA]

I have call rooms at 2 of my 3 rural jobs and a condo across the street from the hospital at the other. 

[dphy83]

Thanks everyone for the input. The job would be for the CT ICU at a large academic center so I would imagine I have zero negotiation power as far as travel or lodging reimbursement. They would have no trouble finding someone else to take the position, I'm sure, since it's in a large city. 

I hear he sentiment on missing out on things in life, which is one of the reasons I moved back to my current location - to be closer to family and friends - so extended time away would stink. But I think, clinically, the job would be beneficial as far as professional growth and job satisfaction. That tradeoff is where I am stuck. I am having a hard time getting into critical care in my local area. Didnt think the transition from the ED would be so difficult (even with an EM residency) but I've had no luck thus far.

With being taxed four times on the income from the new job (federal, state of residence, state of employment, city of employment income tax) I'd probably be left with peanuts. Just want to make a sound, reasonable decision and not an emotional one because it's a job I think id love.

Thanks again, everyone.

[SedRate]

Like some of the others said, you need to figure out what you want and if it's feasible. But, be sure to evaluate the compensation and benefits (financial, professional, fulfillment, etc) to make sure it all makes up for the additional living expenses and travel time.

I am actually in a similar situation. I have accepted a new position 3 hours away. Unfortunately, the shifts are not 12's and cannot be stacked, so I will have to live there for it to make sense. The field is also not easy to get into, but it pays much more with better benefits and cheaper COL. I do have a spouse and so we will have to drive back and forth to visit. Now I'm sure the driving will get old, so it may not be a long-term gig, but it'll get my foot in the door and help us meet our goals. My spouse can also work remotely part of the time so they will stay with me some of the days and then at their work-sponsored condo the other days. As a side note, our goal is financial independence sooner rather than later, so the plan is to rent our primary residence out while living cheaply in my secondary residence. My poor spouse will be a little bit of a gypsy, but they're on board so what the hell. So as you can see, there are many factors at play here, so evaluate your situation to see if it'll work for you. 

[ohiovolffemtp]

Fortunately, I'm in the grandparenting stage of life.  In my prior FT job I worked 15:30-01:30 and seldom got out before 03:00.  While I did get home before my wife left for work I left before she got home.  We had lots of days when we were in the same house only for a few sleeping hours.  We're actually seeing each other more when we are simultaneously awake with my new job than my old one.  I do lose most of the day I travel home, because I get off work, shower, and then drive home.  I pretty much hit the recliner until bedtime, but the next day I'm pretty much back on daytime schedule.

[dfw6er]

I did it for 2.5 years.  Lived in the DFW area, took a job in Huntsville (north of Houston) to have my loans repaid by NHSC.  I found a studio for $485/month and basically worked every Mon-Wed 12 hr shifts, then drove home.  (3 hr commute)....between the salary the rural health clinic paid and the check the NHSC cut me, it definitely made financial sense.  But it's time away from friends/family.   OTOH, if you're a real go-getter, you can pick up another job on your days off and pay down bills/loans pronto.

[dphy83]

It's mostly about job satisfaction for me, at this point. I'm really wanting critical care, but I'm not finding it in my area. I'm not wanting to permanently relocate either, as I just moved to this area specifically to be by friends and family. Im in EM currently, so taking a critical care job is almost definitely going to result in a pay cut, but I would plan on continuing to work EM on the side. With the location of the job that I have a chance of getting (Chicago), financially it probably wouldnt make sense considering considering additional state and city income taxe, travel, lodging. Frustrating.

Thanks again to everyone for your input. I think I knew it wasnt a great option for me but was just really wanting this job that i needed to hear others' thoughts.

[mikespa12]

14 hours ago, dphy83 said:

It's mostly about job satisfaction for me, at this point. I'm really wanting critical care, but I'm not finding it in my area. I'm not wanting to permanently relocate either, as I just moved to this area specifically to be by friends and family. Im in EM currently, so taking a critical care job is almost definitely going to result in a pay cut, but I would plan on continuing to work EM on the side. With the location of the job that I have a chance of getting (Chicago), financially it probably wouldnt make sense considering considering additional state and city income taxe, travel, lodging. Frustrating.

Thanks again to everyone for your input. I think I knew it wasnt a great option for me but was just really wanting this job that i needed to hear others' thoughts.

I disagree with the paycut. You can make a great living in critical care ie: neuro critical care, ct surgery critical care and etc. 

 

However, 5 hours of drive may seem a bit tooo much even if its weekly. Max really should be two hours...

[Lightspeed]

On 8/29/2019 at 10:03 PM, dphy83 said:

It's mostly about job satisfaction for me, at this point. I'm really wanting critical care, but I'm not finding it in my area. I'm not wanting to permanently relocate either, as I just moved to this area specifically to be by friends and family. Im in EM currently, so taking a critical care job is almost definitely going to result in a pay cut, but I would plan on continuing to work EM on the side. With the location of the job that I have a chance of getting (Chicago), financially it probably wouldnt make sense considering considering additional state and city income taxe, travel, lodging. Frustrating.

Thanks again to everyone for your input. I think I knew it wasnt a great option for me but was just really wanting this job that i needed to hear others' thoughts.

It might not be a great option for many of us, but lots of folks might be up for the adventure. My priorities are family, time, money, and job satisfaction. I can knock out the last one pretty easy by having a job that makes the first three easy to manage. But it might be that the first three aren’t in the picture to compete with the last one for you. Plenty of folks have unconventional commutes. The conservative approach suits many of us well. Does it suit you?