Choosing where to practice has many factors for physicians. What are the employment opportunities like? Will your spouse be able to find a job in his or her chosen field? Is the area a match for your interests outside of work? And, for many physicians: Is the area family-friendly?
In Danville, Pennsylvania, children can grow up playing in lush, green forests. The small town of Columbia, Missouri, offers scores of entertainment options (and a highly educated populace), because the city is also home to the University of Missouri. Gainesville, Florida, residents often raise their kids to be "Gators," and the local passion for the University of Florida sports teams creates a strong sense of community. And Naperville, Illinois, is so charming that one physician who was born and raised there moved back after deciding "Naperthrill" trumped the tropical island of Antigua, where he was studying.
Columbia, Missouri, is nestled in the center of Missouri, and is a hub for sports, education and medicine. The University of Missouri Health System, commonly referred to as MU Health, is an academic health system that treats patients from around the state and is a supportive employer for physicians who want to break new ground in their fields.
Laine Young-Walker, M.D., knew she wanted to be a physician since she was 8 years old. But she still faced uncertainty: how, exactly, would she make this happen? "I come from inner-city Kansas City in a household where no one had gone to college. I knew what I wanted to do, but I didn’t have a roadmap. I didn’t have people in my life who were doctors," says Young-Walker.
Nevertheless, things came together. "I was put in Catholic school from the beginning. I had counselors who really helped me understand what to do and get to the next level," says Young-Walker. As a high school student, she spent time shadowing in an OB/GYN office and had very early ideas about specializing.
At the University of Missouri, Young-Walker found a second home. As she worked on her undergraduate degree, she entered a pipeline that would prepare her for medical school admissions. "The University of Missouri had a summer program for pre-meds. You have a research mentor; you do some research and you have MCAT prep. You get to know the school better," says Young-Walker. "I was a counselor second year. I had relationships and contacts and experiences with the medical school that were positive. MU was the only medical school I applied to. Thank God I got in."
Young-Walker built her entire medical career at MU. From med school and residency to her work as a child psychiatrist, she is deeply loyal to MU. MU Health Care operates five hospitals, including the Missouri Orthopedic Institute, the Missouri Psychiatric Center, and the Women’s and Children’s Hospital. University Hospital is the flagship hospital. Across the five hospitals, they have 602 beds. In addition, MU Health operates 50 outpatient clinics. MU Health Care employs 7,000 people, approximately 700 of whom are physicians.
It’s clear why Young-Walker planted roots in Columbia - there are scores of reasons to stay. Says Megan McConachie of the Columbia Convention and Visitors Bureau, "We have so many amenities and things to do that you’d expect to find in a much larger city. The University of Missouri creates a great opportunity for us to enjoy a pretty cosmopolitan small city, but still with that low cost of living. It has the best of all worlds." Columbia’s downtown area is an attraction in and of itself with bars and restaurants that satisfy an area with lots of foodies.
The population of Columbia is more than 120,000. Something unique about Columbia is the number of journalists who live there, because of the University of Missouri’s elite journalism school. "It’s a media rich environment, and it’s definitely one of the hallmarks of the city," says McConachie.
"We’re a city with all four seasons. We have a very distinct spring, summer, fall, winter. Our summers are warm and pretty humid. Our winters are generally not too harsh. We get a few snows but nothing too crazy." McConachie says that occasionally the area experiences bitterly cold winters, but those are the exception to the rule.
"Another great thing about Columbia is that it is right in the center of the state. If you need to, you can get to Kansas City or to St. Louis in about two hours," says McConachie.
But Young-Walker has anchored in Columbia, where she has had the support of the University of Missouri Health System to build two programs to reach and treat children who need psychological treatment but are unlikely to receive it.
Says Young-Walker, "I was able to create a program unique to this area where a child psychiatrist will go to a school with a nurse and do an evaluation, and then have three follow-up visits. While the child is waiting in between visits, she’s being treated and managed. She’s more stable, as opposed to going untreated and then being taken to the hospital or going to the ER when there’s an emergency. I’ve been able to focus on prevention and early intervention."
The second program that Young-Walker created elevates the knowledge that pediatricians and family medicine practitioners have about child psychology.
"The Missouri Child Psychology Access Project focuses on creating relationships between child psychologists and family care doctors," Young-Walker says. "Our program provides doctors with immediate telephone support and linkage and referral resources to get kids into cognitive behavioral therapy. We help doctors refer their patients to a provider who can provide services."
Young-Walker has also created an online educational tool to educate family medicine practitioners on child psychology. Next year, the program will go state-wide.
This is especially interesting because Young-Walker had always pictured herself in a clinical setting and saw patients for years before training her focus on public health. She has advice for students and physicians in the early stages of their careers: "It’s important to accept the fact that your vision may not be the end vision. If all of us are in this for the right reasons, allow things to happen that you’re not used to, in a way that will change things and help others. I spent a lot of time resisting the opportunities for change in my career."
Now, Young-Walker is in a place where she finds her work deeply impactful and motivating, even if it is not what she originally had in mind.
Physicians who yearn for a rural lifestyle or giving their children an upbringing in the great outdoors have the unique opportunity to live in a remote area and still build a career with cutting-edge health systems.
Michelle Cornacchia, M.D., had early ideas about her career. "I wanted to be a teacher for a long time," she says. At the College of New Jersey, she started to pivot: "I thought it would be really cool if I could have a career where I help people feel better." She started looking into careers in health care, and she volunteered at local hospitals and clinics. She was accepted at the Robert Wood Johnson Medical School (now part of Rutgers University, New Jersey’s flagship public university).
She was initially thinking pediatrics, but she was also intrigued by internal medicine. "So ultimately, I did a combined internal medicine and pediatrics program," she says. Cornacchia carved out a unique specialty: she works with adults with complex medical needs that originate in childhood, such as autism, muscular dystrophy and other disabilities.
Cornacchia knew that there weren’t a lot of clinics for adults with developmental disabilities. Thus, she was excited to join Geisinger’s comprehensive care clinic in Danville.
Geisinger Medical Center is a 500-bed Level I trauma center and teaching hospital with over 50 residency and fellowship programs. The clinic is a patient-centered medical home for individuals with intellectual and development disabilities. The clinic has a multidisciplinary team with a care manager who triages, a health assistant who coordinates, pharmacists, and of course, several internal medicine physicians and specialists.
"We’re able to look at the big picture for our patients. If they need multiple specialists and medication from different specialists, our pharmacist makes sure there are no adverse effects from the interaction. It’s a primary care place, but it’s a place that patients can get the comprehensive care that they need."
Cornacchia has high praise for Geisinger as both an employer and as a steward of health care. Cornacchia recalls that when she was a resident elsewhere, she saw patients in 20-minute slots. At Geisinger, she has an hour with each patient. "There is a lot of good by allowing us that extended time. Our patient population is so thankful. I’ll have mothers who bring their children in for a first appointment, and they start frantically going through their children’s medical history in a very short time," says Cornacchia. This is because patients often expect their time with physicians to be limited.
"Geisinger has moved away from fee-for-service to value-based care," says Matthew McKinney, director of talent management for Geisinger. "The experience our patients receive, as well as the health and well-being of the communities we serve, come first. Providers’ performance is not strictly related to seeing X number of patients or performing X number of procedures. That has really resonated with the providers we recruit," says McKinney.
Geisinger attracts physicians with its cutting-edge technology. The health system has had electronic health records since 1996; Geisinger was one of Epic’s first clients. "We were one of the first health care organizations in the country to begin using electronic health records. We have more than 20 years of patient data that has allowed us to deploy a lot of evidence-based best practices," says McKinney. In fact, "we have two research centers - one clinical and one outcomes research. We have the largest biobank in the world; we do human DNA sequencing and are able to notify patients if they may have a genetic predisposition. That’s something we offer all Geisinger patients through primary care, specialty care and even online."
"You wouldn’t think in Danville that there would be amazing access to technology, research, data and educational opportunities for our employees and providers," says McKinney.
About 20 minutes from Danville is Lewisburg, another area health care hub and home to Evangelical Community Hospital - a fiscally strong community hospital that has retained its independence and is growing.
"Evangelical is currently undertaking the largest construction project in its history," says Elyse Stefanowicz, provider recruiter and retention coordinator for Evangelical. That project includes the construction of a four-story, nearly 112,000-square-foot addition slated to be finished in August 2020. It will create modern, single-occupancy rooms and private bathrooms.
Also on Evangelical’s list is adopting the Epic electronic medical record platform, a transition that will be complete in summer 2021 and result in a single, fully integrated information technology system.
Evangelical is currently recruiting in anesthesia, cardiology (both invasive and non-invasive), critical care medicine, family medicine, gastroenterology, general neurology and obstetrics and gynecology.
"It is a perfect place to raise a family and practice medicine," says Stefanowicz of Lewisburg and the Greater Susquehanna Valley. "The small community feel of Lewisburg includes great shopping, fantastic dining, and the renowned Bucknell University, which provides arts and entertainment to the community."
Cornacchia says the patient population is overall easygoing and grateful. "Quality of life is really fantastic, and the patient population is nice. Living in a rural area, it’s more laid back. It’s OK to breathe. It’s okay to take the time to enjoy the simple things, to take a walk, to spend time outside."
McKinney echoes the sentiment that there is a high quality of life, especially for families with kids. He says, "It’s small-town living. The people in the community are very friendly and engaging. There are great school systems. When you factor in how wonderful the people are and the educational opportunities that exist for our providers’ children of all ages, it’s really a great place to live."
Naperville is a suburb of Chicago, 30 minutes west of the city. While there are scores of health systems and hospitals with facilities in Chicago, physicians who practice in Naperville have the advantage of potentially accelerating their careers by practicing in a smaller market. Not to mention, Naperville is an ideal place to raise a family, where community is king, but big city culture is an hour’s drive away.
Amish Doshi, M.D., is another physician who knew in childhood, growing up in Naperville, that he wanted to be a doctor. "A second-grade school assignment asked us to complete the following sentence: ’When I grow up, I will be a…’ and I wrote ’a doctor!’ Even as a 7-year-old, I knew I wanted to be a part of health care. My passion was solidified through my undergraduate studies, work and volunteer experiences."
Doshi graduated from the University of Michigan before setting off to medical school in Antigua. Says Doshi, "Although a vacation destination for many, my regular date night with the books meant days at the beach were few and far between. After completing my rotations in various health care systems across the states, I completed two years of research with the University of Michigan in diabetes, before undergoing my training in internal medicine at St. Joseph Mercy Oakland Hospital in Michigan."
After residency, Doshi left Michigan to return to his hometown of Naperville, Illinois, to join Edward-Elmhurst Health.
Edward-Elmhurst Health includes three hospitals - Edward Hospital, Elmhurst Hospital and Linden Oaks Behavioral Health (a mental health hospital) - and an extensive ambulatory care network for residents of the west and southwest suburbs of Chicago. Edward Hospital has 354 beds, and Edward-Elmhurst Health has approximately 60 outpatient locations in the Chicago suburbs.
Says Keith Hartenberger, system director of public relations for Edward-Elmhurst Health, "The system has annual revenues of more than $1.3 billion; more than 60 locations across a service area of 1.7 million residents; nearly 8,500 employees, including 1,900 nurses with 2,000 physicians on staff; plus 1,300 volunteers."
Doshi says that Edward-Elmhurst Health is well-regarded by the community, and it contributes to Naperville’s strong sense of community. He says, "Edward Medical Group has a warm community feel that helps patients and family members feel assured during their times of need. I believe it is Edward’s deep involvement with the community that has created this trust and achieved an intimate role in the well-being of the members of the local and neighboring communities."
Hartenberger says that physicians at Edward Hospital appreciate being part of a physician-led organization and the positive culture, with a "focus on physician well-being and leadership."
Then, there is the excitement outside of work. Says Doshi, "I grew up in Naperville, which is better known as ’Naperthrill’ to some. I wanted to give my family the same great experience I had. Naperville has an unrivaled combination of education, entertainment and outdoor recreation. …To add to the excitement, Naperville also has several fairs and festivals throughout the year. Last year, I was even lucky enough to see Pitbull and to meet [Aerosmith lead singer] Steven Tyler!"
Doshi and his wife, Christine Elyse, have a baby son named Shyam. Doshi says, "We enjoy the simple things like taking a walk around the miles of local forest preserves and nature centers. We are excited to bring him to the local swimming pool in the summer. We also frequent the various restaurants in the area. Being that it is so very family-friendly and kid-friendly, Shyam is beginning to love his regular stroller stroll through the thriving streets of downtown Naperville."
Gainesville is all about the Gators. This is not to say that alligators are an omnipresent threat - rather, the community is wildly supportive of the University of Florida Gators. The University of Florida is Gainesville’s largest employer. UF Health, the university’s health system and teaching hospital, is the area’s second-largest, with approximately 12,000 employees. There’s a unique trend among medical students and medical residents: once they come to Gainesville and become part of UF Health, they tend to stay. This speaks volumes to UF Health as a quality employer, and Gainesville as a place to build a life and raise a family.
When Julia Close, M.D., was a child in elementary school, she was fascinated to learn how the heart pumps blood around the body. She knew then that she wanted to be a physician. She says, "Later I remained interested as I came to realize that doctors can provide comfort and cure, all while being on the cutting-edge of science."
"I attended medical school at the University of Florida in Gainesville, and I never left!" Close says. She was drawn to oncology for many reasons. She wanted to care for patients along a continuum, and she was interested in learning about the growing number of effective and less toxic therapies for cancer patients.
"What made me most want to be an oncologist was when I attended my mother’s first appointment with her oncologist while I was a second-year medical student. Her doctor sat with her and explained chemotherapy with patience, knowledge and grace. It was such a relief to my family. I hope I provide the same to my patients and their families," says Close. Thankfully, Close’s mother is now a 20-year survivor of breast cancer and still sees the same oncologist - a testament to the longevity of the relationships that oncologists can build with their patients.
Close completed her residency in internal medicine and her fellowship in hematology/oncology all at the University of Florida. Close says that UF Health is an especially supportive place to train and practice. "There is a reason why so many of us attended medical school here and never left. As a trainee, I noticed attending physicians were approachable and units worked as a team. UF Health has great nurses, pharmacists, therapists, techs. They have great, knowledgeable staff whose opinions and input are valuable. This allows us to take great care of patients," says Close.
UF Health Shands Hospital is a teaching hospital, and the anchor of the University of Florida Health System (commonly referred to as UF Health). The hospital is a Level I trauma center licensed for 961 beds and 241 ICU beds. UF Health Shands Hospital is also home to the University of Florida Health Science Center: the umbrella organization for the University of Florida’s medical, dental, nursing, pharmacy and public health schools.
Says Elizabeth Reyes, the marketing coordinator for Visit Gainesville, "The Gainesville region is very family-friendly, with numerous parks, splash pads, public pools, museums, a children’s theater, trails, farmer’s markets, and free activities such as the downtown Free Fridays Concert Series that runs from May to October. There are also many educational programs and activities for every type of interest." She says that Gainesville is a college town that "hits way above its weight. Meaning, you can still find southern hospitality here and an easy lifestyle, but also with all the modern conveniences that you might expect from larger cities."
Close agrees Gainesville has a little bit of everything. Says Close, "There is so much I like about Gainesville. What could be better than living in a college town, in a state without snow, but in a region with seasons? My family likes being outside year-round. We play a lot of sports, and while I’m not very fast, I enjoy running our trails. We have great restaurants and access to arts, but I can live on enough land to have ducks, chickens and a stocked pond."
Then, of course, there is University of Florida sports. "The University of Florida football, basketball and other sports events create great opportunities for entertainment and community activities," says Reyes.
Close agrees, "My kids were born at UF and are Gators through and through. Taking them to all sorts of sports on campus and feeling the camaraderie is something I hope they look back on as an important part of growing up."