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October 8, 2010

Avoid relocation shock

Avoid relocation shock
"One of my partners was really great,” says David DiMarco, M.D. “He helped us get the house we’re in now. He knew someone who was getting ready to sell because he lived in the same neighborhood."

You’ve accepted the position, and your family is excited about the move. Wouldn’t it be great if you could just snap your fingers and everything would magically fall into place? Unfortunately, it’s not quite that easy. However, there are things you can do to make your move a more seamless transition and minimize relocation shock.

If you’ve been working with a physician recruiter, search firm or real estate agent, chances are you’ve gotten answers to several questions prior to accepting the position, such as the best parts of town to live in for your family’s needs and where the best schools are.

Kathy Murray, the senior director of recruitment partnerships of Cejka Search Inc. in St. Louis, says that through the course of conversations between the physician and the recruiter, the recruiter should develop a summary of information about the physician candidate and the family’s needs so that the interview team can tailor the interview to meet some of those needs up front. An example might be school tours. Murray says, "If the new physician candidate’s child plays soccer, then the organization should set up a meeting with another family who has a child that plays soccer. Mutual interests are important. If those kinds of things happen over the course of the interview, things are pretty well set up when the physician arrives," she says.

Scout out your new community

Hopefully, you’ve had that kind of support and the opportunity to visit the community during the interview process. Whether that was the case or not, now that you’ve accepted the position, one of the most important steps you and your family can take prior to moving is to spend some time in the area. There may be time constraints, but if there’s any possible way, it’s a great investment.

J.P. Saleeby, MD
J.P. Saleeby, MD

J.P. Saleeby, MD, a general practitioner, has a medical concierge service called Carolina Mobile MD. He relocated to Bennettsville, S.C., from Savannah, Ga., about three years ago. He is in the process of moving 70 miles to Conway, S.C., later this year, partly because of changing hospital staffing, payer mix issues, and a greater opportunity to build his practice. But he’s also attracted by a wider variety of entertainment and social offerings in the new city. "Before committing to a new contract, it is definitely worthwhile to work a few shifts, weeks, or even months at the new facility, hospital or clinic. There is nothing more frustrating for a physician than to start a new job with great expectations and find out it was a mistake and life is miserable," Saleeby says.

J.P. Saleeby, MD, a general practitioner, pictured above with his wife, recommends the whole family get acquainted with the town. Kids should check out schools, parks and playgrounds, and other activities they find interesting. Be sure your family is committed to the move before you sign a contract.
J.P. Saleeby, MD, a general practitioner, pictured above with his wife, recommends the whole family get acquainted with the town. Kids should check out schools, parks and playgrounds, and other activities they find interesting. Be sure your family is committed to the move before you sign a contract.

Saleeby recommends the whole family get acquainted with the town and have the spouse commit to the move before you sign a contract. The kids should check out the new school, parks and playgrounds, and other activities they find interesting. "A great way to do this is to stay at a local B&B or a nice hotel in the new town and plan to spend a few days scouting about without working just to feel things out," Saleeby says."This also gives you a chance to pick up any subtle hints of trouble."

Philippa Kennealy, MD, is a family physician who left her own practice in 1996 to embark on an administrative career, first as the medical director and then the CEO of Santa Monica UCLA Medical Center. She currently is the president of The Entrepreneurial MD and resides in Santa Monica, Calif. Kennealy agrees that it’s important to spend at least four to five days in the new location prior to moving (use Google maps to check out neighborhoods online ahead of time by selecting actual satellite images). "Talk about any differences that you notice from your old home area. Ask your friends and acquaintances to make introductions to anyone in their network living in the new town or neighborhood," she says.

Hopefully, you and your family will have a pretty good idea in what area you’d like to live before you arrive. However, that’s not always the case so it’s important to use your recruiter,  physician contacts and real estate agent to help get the valuable information.

Scott Manning, the director of human resources and provider recruiting at District Medical Group (DMG) in Phoenix, Ariz., says, "Often, physicians new to the community like to move into the same neighborhood where there might be other members of their group."

David DiMarco, MD, is happy his colleagues were so helpful. DiMarco is a urologist

"We didn’t know what to expect the first winter in Oregon," says David DiMarco, MD. "We thought we’d made a mistake. It was just raining all the time."

"We didn’t know what to expect the first winter in Oregon," says David DiMarco, MD. "We thought we’d made a mistake. It was just raining all the time."

at Oregon Urology Institute in Springfield, Ore. His wife, Connie DiMarco, MD, specializes in female urogynecology at the same facility. David DiMarco says, "One of my partners was really great. He helped us get the house we’re in now. He knew someone who was getting ready to sell because he lived in the same neighborhood."

Use your resources

Regardless of where you decide to move, real estate agents can be a great reference to help you feel less like Dorothy waking up in Oz when you first arrive. Naseem El- Barbarawi, a real estate consultant with Keller Williams Gold Coast Realtors in Chicago, works with a lot of physicians and other professionals. According to El-Barbarawi, "Providing as much information about the neighborhood in advance is a plus. If the new homeowner is aware of the location and of all the ’basics,’ then they have a smoother transition," he says. Barbarawi says that having recommendations for grocers, butcher, dog walkers, lawn service and restaurants make that first few days and weeks less frustrating - especially for professionals who likely start work soon after the move. "We’ve been asked everything, so nothing is over the top for us," he says.

Rob Moneyhan of Greater Portland Real Estate in Portland, Ore., suggests Web searches and online resources are a good start for trying to find local services, but reviewers won’t always have the same perspective about good service. "People also are more inspired to write online reviews after a bad experience than a good one, so a general search doesn’t always lead to something you want to try," Moneyhan says. He recommends looking at the ads in community newspapers and then checking out the organization’s website or Facebook page. Another recommendation is to find businesses that already fit into your routines, the ones you see on your way to the grocery store, school or work.

Don’t forget to tap into the experience of your new neighbors. "Folks that have been in the community for years are helpful and they can be neighbors, co-workers, physician recruiters and community leaders," says Saleeby. "In my case, our immediate neighbors were very helpful when it came to finding a plumber, locksmith and lawn service. Also, they were helpful in keeping us out of the rough parts of town."

How to help the whole family make friends

If you and your spouse have children, then schools are going to play a huge role in where you choose to live or at least where you choose to send them. Generally speaking, the younger the children are, the easier it is for them to adapt. No doubt, pre-teens and teenagers can be more of a challenge. How do you make the kids feel more comfortable about starting a new school?

Sam Kong Kee is the director of admissions at Saint Louis School in Honolulu. Finding the right fit for the student and the school is one of Kong Kee’s primary responsibilities. He says, "If kids are involved with choir, drama or some other activity, then make sure there’s something familiar so that when they do move, there are other kids at their new school with the same interests." Within reason, involve your older children in school selection. "As kids get older, they play a bigger part in what school they want to attend. I think being a part of that process is really integral and beneficial in adapting to their new environment," Kong Kee says.

Kennealy agrees. "Kids need parents to listen to and acknowledge their concerns and fears. Set aside time to talk with kids about their feelings and avoid saying things like, ’It’s going to be fine - just you wait and see.’ " She recommends your family try to meet at least one school family before starting classes. Ask the school to suggest a "mentor" family with kids in the same grade and begin an e-mail and/or phone conversation before school starts.

Move a couple of weeks before school starts if possible and take the kids to the school and even the classrooms if you can. According to Kennealy, don’t be surprised if little ones develop tummy aches and headaches - these symptoms are often expressions of emotional distress. During the first few weeks, be willing to have one parent to take the kids to school and pick them up, and encourage them to invite new friends over after school or on the weekend.

You might also be wondering how to get your children involved in activities and connected with hobbies, clubs, teams and scouts. Moneyhan says talking to your neighbors might help you skip some steps. "My town has a seasonal parks and recreation catalog of activities that is both mailed out and listed online. I think most municipalities now are up with technology enough to do the same. These are often activities that your tax dollars help to support already, so it’s a great resource to search out."

Finding a place for your martial artist to continue her karate lessons is one thing, but Kennealy says you shouldn’t pressure your child to join clubs and activities right away. "Let them make new friends at school and discover what is popular with their new friends. Unless your kid is very shy, he or she will make acquaintances far more rapidly than you can imagine," Kennealy says.

Social contacts are important for everyone in the family. The sooner you make friends and meet people, the sooner everyone is going to feel more at home. Marci Jackson, the director of the physician and provider recruitment and retention department with Southwest Medical Associates in Las Vegas, says, "Quite often, clinics will have a welcome party that includes the families. If it’s a large, multi- specialty group, the department they are joining may be encouraged to have a welcome party. When I worked for Duluth Clinic in Minnesota, the department chair had a party in their home for any new physicians. They introduced them to the rest of the doctors in the department and the spouses and kids."

DiMarco mentions it wasn’t difficult for his family to make social contacts, maybe in part because both he and his wife met other physicians through their jobs. "Initially,  there were a lot of people who invited us to parties, and we also met other families through our kids’ schools," he says.

Saleeby recommends asking the hospital staff to introduce you to other professionals. "Co-workers are also helpful. If you are a member of a church or civil organization (Rotary Club, etc.), they are also helpful in networking," says Saleeby.

For many families, it’s important to find a place of worship, but finding the right fit can be tough. Again, the Internet and word of mouth are great sources. Jackson says, "We’ve had some physicians who have come from the Philippines and they have asked how large of a Filipino community we have here and if we have certain religious communities. We answered as much as we could for them and provided them with Internet links so they could research much of the information themselves."

Relocation: It’s not a walk in the park

Moving is a stressful event in the best of circumstances and it can take a toll on everyone in the family - particularly if someone did not want to move in the first place. Manning, the recruiter in Phoenix, says, "Relocation is never about the physician candidate. It’s about the whole package. If everybody doesn’t end up settling in and being happy, it won’t work."

There are psychological aspects of moving for both adults and kids. Not only is it stressful to settle into a new school, find a great hairdresser and a replacement for "our favorite restaurant," but leaving behind family and friends isn’t easy. To top it off, a spouse or the kids have particular difficulty in feeling like part of the new community. Murray at Cejka says, "A physician practice is pretty much the same wherever he or she goes. [The physician’s routine] doesn’t change, but for the family and spouse,  everything changes," she says. That degree of change can lead to reactions that vary from mild to severe and can even lead to depression or behavior problems.

Some anxiety, anger and sadness are normal for both adults and kids. It’s common to wonder at times if you made the right decision to move or chose the right school for the kids, especially if they don’t adjust well immediately.

For children, nervousness, acting out, somatic symptoms, refusing to go to school, tears, and shyness are all normal for the first few weeks or so, according to Kennealy. Prolonged anxiety, significant sleep disturbance, excessive anger, acting out at home, or marked withdrawal "may be signals of deeper emotional distress that may need professional guidance," she says.

Some physician families have been known to stay in a location for only six months or so and leave because someone in the family was unhappy. Although it’s vital to support family
members, you need support as well. According to Manning, "With doctors, even though they are highly sought after and highly employable,  it’s a much bigger upheaval than most other occupations," he says.

"Physicians have commitments - they go through hospital privileges, maybe have to get licensed in another state, in addition to uprooting your family and moving. You’re leaving patients you’ve established a rapport with and you might have employed a staff that will lose their livelihood if you leave," Manning says.

Don’t be shocked if, just like the kids, you find things about the new location you don’t like right away. Even if you’ve done your research and spent some time there, it still can be different when you’re actually living there day to day. Sometimes it’s hard to grasp the culture of certain places until you’ve arrived. Over time, there’s a very good chance you’ll adapt.

DiMarco agrees. "We didn’t know what to expect the first winter in Oregon. We thought we’d made a mistake. It was just raining all the time. We talked about switching jobs and moving to Arizona. I think what we experienced was common. Sometimes you get someplace and it’s not quite what you anticipated," he says. They stuck it out, and today the DiMarco family is quite happy in Eugene, Ore. So happy, in fact, that DiMarco’s mother relocated from Missouri to live next door.

Robert Bergamini, MD, of Cardinal’s Kid Cancer Center in St. Louis is board certified in both pediatrics and pediatric hematology/oncology. Bergamini has lived in St. Louis, for 30 years, but he is originally from the East Coast. "A lot of the issues I faced moving here are no longer issues. Blue Laws [which prevented stores from being open on Sundays] were still in effect, so the only way to shop for groceries on Sunday was to go to Walgreens. There were a couple of big shopping malls but nowhere near the malls there are today. It took me six months to find a bakery that was open on Sunday." Obviously for Bergamini, time, patience and sacrifice paid off in the long run.

Keep an open mind, have patience, and realize it may take some time to adapt. These are the keys to giving your new home a chance to work its magic on you and your family.

Marcia Travelstead is a Honolulu-based freelance writer and a regular contributor to PracticeLink Magazine.



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