Date: December 8, 2015

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Session 35 – Social Structure and Experience – Where to Put a Practice Series



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Podcast 35 – Where to Put a Practice – Social Structure and Experience

This is Scott McDonald and Welcome to the Perfect Place to Put a Practice Podcast.

We have strung together several sessions to go over the priorities we want you to consider as you get an idea where you will want to practice.  No matter what one of your buddies says while you eat lunch, there is no single place that will work for everyone.  Heck, there is absolutely no place that will work for even a large chuck of your acquaintances.  That is because, the place that you choose to practice is highly individualized.  And in no way is this segment going to trump any others.  Let me illustrate:

My staff and I met to determine the biggest reasons why doctors want to relocate.  Even when they have a wonderful location and a successful practice, there are reasons they call to find a new site. This is a big one: A great deal of long-term unhappiness often results from dislocation of family.  To add to this complexity, we want you to consider: access to children from another marriage.

Parenting arrangements are decided by courts that often do not care about what is convenient for your work. And if you ever want to see your children again, you are going to have to take into account where they are located and what is reasonable in terms of location.  True, it does not mean that you will have to live in the same town as your former spouse but, then again, it may.  This may mean that you cannot have the success you would have if this were not an imperative.  It is just a fact of life.

Additionally, many of us have a sick or elderly parent we have to care for.  While it may be desirable for them to move to a new location with you, their healthcare situation may not allow it.  They may not be able to endure the weather where a new practice opportunity can be found.  The bottom-line is that we want you to start this process by asking yourself what real boundaries and limits exist on where you might practice.  

I am not saying this to be funny because we hear it all the time: I need my mother.  This can be for emotional reasons (having children really CAN be overwhelming.  Trust me, I have had five children and I can tell you that this is true) or even physical reasons including difficult pregnancies, children with disabilities, and myriad other factors.  But, then again, there are people who, for whatever reason, want to have their extended family around them.  Many others want to escape the ties of a family and this is also a reasonable factor in deciding where you want to go.  

There are other factors relating to social structure and your experiences that may also influence the places you want to live and practice. Please do not assume that the office site and the demographic character of a community will not have a significant impact upon several factors of your life. As an example, we want to recommend you consider places that are similar to the community where you grew up. It doesn’t mean that you have to “go home” to be happy or successful. But we have seen that the majority of professionals do best when they feel comfortable with their social environment. We have found many professionals are reluctant to even admit these because they may not seem “legitimate.”

Consider for a minute what it means to have a supportive religious community. We have found many SDA doctors who feel happiest when they can live near an SDA Academy. While not an absolute necessity, if it will support the way that you bring up your children, this can be important to you.  It may not be important to anyone else.  In one case, I was working with a wonderful, young (and successful) Muslim doctor who wanted to marry within his faith.  Unfortunately, the closest Mosque was several hours away and it bothered him very much to be separated from his faith community. If you are an active Muslim, being close to a Mosque is desirable for many reasons and it is legitimate to consider this.  

This concept extends to locations that make you feel comfortable even if they are far from your roots. If you grew up living near great fishing or in a university town or with 4 H and FFA, the impact of your experience and social structure will affect your happiness.  I did not grow up where raising livestock was a big deal.  But I am now in a community that has, as one of its most important annual events, the high school rodeo.  I have to confess that I do not enjoy the dusty, dirty, smelly press of people who are excited by the livestock judging.  But it would be foolish not to take into account that this is what many people love.

Obviously, this applies to people from urban areas as well. We have met very few doctors who can live and practice in Manhattan who were not born in New York. But if you have the “New York Bug,” you will have a hard time being really comfortable anywhere else.  They call it “The City” and they know what they mean when they say it.  By the way, Chicago and Los Angeles just don’t count with them.  I grew up in L.A. and freeway driving is second nature to me.  It drives some people crazy but if I have to breathe air I cannot see, it still makes me a little nervous.


It is rare to find a doctor who has never lived in Utah finding it a welcoming place to practice even if they are LDS.  Utah Mormons are not always like California Mormons.  Rather than make this complicated, let me suggest the following steps:


  1. Set your real boundaries for where you can and cannot live based upon your circumstance,
  2. Second, look for the familiar. Knowing what makes you feel at home is usually a good guide.
  3. Last, look for places of opportunity only after you have considered step one and two.

Next session we will go into housing type and overall lifestyle and how they will influence your practice location decision.

Thanks for listening to the Perfect Place to Put a Practice Podcast.  This is Scott McDonald and thanks for listening.


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