Real Estate for Physicians: Location, Location, Location, Location

As I head out once again on a snowy December Sunday, I have mixed feelings.

On one hand, even though it’s entirely not his fault, the good orthopedic doctor called me back to the hospital right as I pulled the car into my garage, having just left the hospital, and I’ve decided to be upset with him. But, really, I’m just perturbed at the situation, because it’s 9:25 a.m. and I’m going back to the hospital for the third time today.

On the other hand, for the umpteenth time this year, I remind myself how lucky smart I am to have a home so close to the hospital.

 

Location, Location, Location, Location

 

Why the fourth location? If you, like me, are a physician who takes “home” call, or have any type of position that requires more than five round trips to work in a normal week, location should play a more vital role in your housing choice.

You’ve probably heard the three-location mantra as it applies to what matters in real estate. You may not know that in the fictional and quite funny world of professional therapist Dr. Katz, his buddy Stanley actually coined that phrase, although his original catchphrase used the word four times. I think the phrase with the four locations applies best to doctors and others who make frequent trips to work.

The Benefits of Living Close to Work

 

Living near the hospital improves my life in many ways. Take this particular Sunday as an example. I was called in for labor epidurals at 0515 and 0830, then back again for a third time at 0925 for an orthopedic procedure. Before we finished, there was rumor of a hip fracture. We came back to fix that in the afternoon.

If, like my partners, I lived about 20 minutes away, I would be spending around two and a half hours driving back and forth for four procedures on a Sunday. With a six minute round trip I’ve got, I’ve spent 24 minutes total, a savings of 2 hours to spend as I please.

 

yellow maple family picture

i’d rather be outside with these two

 

Alternatively, I could choose to stay at the hospital. Well, that’s no fun, especially when I’ve got a family living life without me just down the road. If I lived further away, though, I might stay longer at the hospital to find out whether those rumors turn out to be true, or to see how soon the other laboring patient will reach her breaking point and request my services. If the rumored case doesn’t materialize, or the woman chooses to tough it out, I’ve wasted even more time at the hospital.

Quite frequently, our surgeons will do add-on cases after a weekday clinic, and the page for the case usually goes out between 1700 and 1800. If the day’s last scheduled patient leaves the recovery room at 1630, I’m heading home. There’s a good chance I’ll have dinner with my family at 1700 before having to go back — and if I don’t make it home, that’s another day I won’t see my boys at all. If I lived further away, I’d probably end up staying at the hospital, eating cafeteria food alone in the office.

When I’m home and on call, I have much more freedom than I would if I wasn’t so close. With a 20-minute tether, I’ve got plenty of leeway. If I’ve just started eating, I can finish my meal. If I’m sound asleep (and it’s not a stat case), I’ve got time to brush my teeth and take a shower. I can be sweating on the treadmill or soaking in the hot tub and still make it in to the hospital in plenty of time. Living further away, I would be much more limited in how I conduct myself while on call — which is how I spend 20% of my life, or 1,752 hours per year (but who’s counting?). Call is more tolerable when you’ve got 15 minutes to be on your way, instead of two.

 

A Short Commute Keeps Me Healthier

 

I can ride my bike to work, and I do about half the year. If were hardcore, I could do it year round. But frankly, I’m kinda soft, and my commute includes a trip across a high bridge with a narrow sidewalk that can be a little harrowing in good weather. In the winter, the sidewalk narrows with the buildup of snow and ice, and there’s nothing between that skinny sidewalk and the cars cruising past at 40 mph.

 

bike by marina

 

But I do harness pedal power about six months of the year, saving on gasoline and increasing my daily exercise. Living within a mile of the hospital, I can easily walk it when necessary.

Hypothetically, if I were to lock my keys in the car as I arrive still somewhat somnolent in the wee hours, I could just walk home rather than call a service or my wife to come pick me up. OK, that’s not a hypothetical situation, but an actual situation that I’ve found myself in. Twice. It’s a brisk twelve minute walk.

In the midst of a blizzard, it might take me a little while, but I can get there in snowshoes. It wouldn’t be the first time I commuted by snowshoe. Location matters when doing locum tenens work, too. Several years ago, I spent a week in a luxury townhome across a frozen lake from the hospital where I was working. I opted for the “as-the-crow-flies” route, snowshoeing directly across the ice to and from work every day. That trek was an invigorating way to wake up in the morning.

 

frozen lake ice house

 

Being able to get to work without a motorized vehicle makes it easier to get by when one of our two vehicles in the shop for brake work or deer-versus-front-quarter-panel work. We don’t need a rental car replacement. Even better, we’re within a mile of the mechanic and body shop, so I’ve been able to drop off the car and walk home.

 

In summary, living close to the hospital is great for these reasons:

  • Less time commuting = more time at home.
  • Less money spent commuting = more money in my pocket.
  • I can always leave the hospital, even if I only have 30 to 60 minutes.
  • Locked keys in car only inconveniences me.
  • I have much more freedom at home when on call.
  • Time to brush my teeth = no morning breath.
  • Time for my shower = good for everyone.
  • I get more exercise.
  • We can get by with one car when necessary.

 

Location Isn’t Everything

 

I know. I know. Your hospital is in a bad neighborhood. The schools are better two towns over. Your specialty doesn’t get called back much. There’s nothing in the hospital near your price range. You love your commute.

There are some valid reasons to live further away. There are reasons that I might consider less valid, but it’s your money and your life.

I have certainly spent time in hospitals that didn’t have the greatest housing within a mile or two. You may want to live on a hobby farm, or have acreage for motocross trails. Understand that if you have a job like mine, you won’t be milking cows or catching air on your call shifts. Living on the outskirts, you’ll have to stop reading mid-sentence when the pager goes off. If you lived closer, you could finish the story (children’s book) or chapter (grown-up book) before going to work.

The school issue is a big one for those of us with kids in public schools, We all want to give our children the best opportunities, but I think we tend to put a little too much emphasis on ensuring we live in only the best school districts in the neighborhoods slated for the best elementary or middle schools.

I recognize that there can be major differences between the best and “worst” schools, but I also know that the have-nots also produce doctors and lawyers and such. It’s also true that the school district lines can be redrawn, and the school you were slated for can change. I wouldn’t pay a large premium for a home based school zoning, knowing that the borders can and do move.

 

The Value of Time

 

Time is money and money is time.

If you never take home call, you won’t be going back and forth nearly as much as I do, but there will still be a routine commute every workday, and you may find yourself going back for department or committee meetings in the evenings or on your days off. If you believe that your time is valuable (it is), minimizing your commute is valuable, too. Less time in traffic means less stress and more time at home.

What is a shorter commute worth? Consider three physicians. One drives 5 minutes each way to work, the second lives 25 minutes away, and the third needs a solid 45 minutes. The round trips are 10 minutes, 50 minutes, and 90 minutes.

Let’s assume each commutes 240 times per year. It could be less or a lot more, but it’s a good place to start, and makes the math easy. Our first physician spends 2,400 minutes, or 40 hours commuting. That’s one standard work week commuting over the course of a year.

The second physician, living 25 minutes away, spends 12,000 minutes = 200 hours in the car, or five standard work weeks.  Our third physician, living way out in the suburbs, is in the car for 2,160 hours, or nine 40-hour work weeks.

In terms of time, living 5 minutes and not 45 minutes away from work gives you an extra 320 hours to play with every year (or an additional 8 weeks of “vacation”), and more money to spend or save, as you’ll be putting about 10,000 fewer miles on your car. Over the last year, I put about 3,000 miles on my car, and I can account for over 2,000 in five road trips. I don’t know exactly how many miles can be attributed to commuting, but it would be measured in the dozens or low hundreds, not in the thousands.

 

How close do you live to your primary workplace? Was location a primary consideration when you shopped for a home? Would you do things differently if given another chance?

 


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46 comments

  • orthoMD

    I am a surgeon, on-call 1:3, and made the decision to live as close to the hospital as possible for the reasons you outlined. I am less than 10 minutes away so it doesn’t seem as bad when I am called in a second or third time. I did make sure to find a private location, however. I did not want to be so close that people would be able to look at my car in the driveway and know the odd time that I get to go home for lunch in the middle of the day or leave early!

    • Wise choice, orthoMD. I’m not familiar with the concept of a “lunch break” but I’ll bet you’re glad you can actually make it home and back in that time frame.

      I had one locums gig and was given a hotel 17 miles from the hospital. After putting on over 100 miles the first day on call (and feeling stressed and rushed each time I was called), I requested a hotel much closer. The call burden feels more relaxed when you’re nearby.

      Cheers!
      -PoF

  • We sold our first house to move closer to work. At the time it was either move or my wife would quit work as she hated our over 1 hr commute that much. It actually started as 30 mins but then the state decided the route was a good location for a ten year construction project. It just goes to show there are some things you can’t account for. We now live 4 mins from work via multiple back road routes. It’s not viable by bike due to the types of roads (no shoulder blind corner average traffic) but the shorter commute has been a major stress reliever.

  • As a non physician who also works long and unpredictable hours I totally subscribe to this philosophy. I have never lived in the suburbs because I’d rather spend the extra hour with my family than in my car. I do the urban version of PoFs snowshoe commute. I Citibike through Central Park to get to my office.

  • PoF,

    I completely agree! When I was in medical school, I was so foolish as to choose to live 45 minutes from the hospital so that I could afford to buy a house (yet another mistake). That commute was a killer and caused me to miss out on a lot of family time. When I was on surgery, my wife would often have to come and drive the hour and a half to bring me home because I was unsafe to drive after call.

    In reaction to this, when I found out my home call in my current job was q2, I bought a home half a mile from the hospital. I walk or ride my bike to commute most days. My record for placing a PICC line on call is 18 minutes. When I told some IR friends, they thought I was pretty slow until I told them that time was from leaving my garage to walking back into my house!

    NwaV

    • That’s a record that might stand indefinitely! If everything goes smoothly, I can usually be back from a labor epidural about 45 minutes after I leave the house. That’s pretty similar to the commute alone for some docs.

      In college and medical school, I walked and biked everywhere until MS3 year, when we had to drive around to different hospitals. I couldn’t imagine living 45 minutes away. You clearly learned your lesson.

      Cheers!
      -PoF

  • ER guy

    This is a great example of what is important. I have partners that live over an hour away and commute a total of 40 hrs per month!!! That’s insane!!!!

    I teach a number of students and I always have a financial lecture I give to them every month. Living close to work is always included in that discussion. It is so important for overall well being.

    • Yes, that qualifies as insane. Psych consult insane.

      • Zaphod

        Totally agree. I college I lived across the street from work and always walked. Med school was tougher due to location but still 15 mins or so (depending on rotation much longer). Residency I should have been closer but still 15 mins. Fellowship across the street.

        In practice Im now almost 10 mins out. House and practice linked by bike path, sometimes I ride and sometimes I even run home (cant do it to as I’d be disgusting).

        Though I do not take call nor work a full week, you never, NEVER, get commuting time back. Its about the most worthless time you can be spending, so there better be some very good reasons to do an awful commute.

      • Very cool – I’ve never had much of a commute, either. Always lived near campus, near hospital, near wherever I need to be. Our second home was even super close to our main home before we had to move.

        Cheers!
        -PoF

  • When we bought our house a few months ago location was key. We passed on living in the better school district with slightly cheaper housing to live close to work. Now my commute is 3 miles (granted I live up a mountain) and it makes my life so much better. Being close allows me the ability to go home and come back without much trouble, whether it is for call or if I need to run a mid-day errand.

    Another crucial decision on housing. If you can avoid railroad tracks on your way to work, then do it. My last job was 6 miles from work but there were train tracks. At least once a week I would get caught waiting for the train to pass. This easily added 10-20 minutes of commute time which can be quiet frustrating when trying to get home after a long day.

    A third consideration is the direction of the commute. If you can set it up where in the mornings you are driving West (away from the rising son) and in the afternoons driving East, then you will not have to deal with the glare of the son in your eyes. Seems like a minor point but one that will make the commute much easier.

    • I would never have considered the sunshine aspect of the commute. Of course, it’s usually dark when I go to work and quite often when I get home.

      The tracks one is a good one, though. That was definitely an issue at my last job. Now, I live on the right side of the tracks. I’ve also dealt with a lift-bridge issue another place I lived, but it never affected my commute.

      Good tips, EJ!

      • S.G.

        If you follow property values absent a feature (eg. ocean/lake front). NE parts of a city tend to be more expensive than SW due to the sun and commute.

  • mike

    With a 1.2 mile commute , I still have my 1991 Acura Legend and it still drives great . Probably saved over 100K easily by not having to buy new cars !!!!

  • Some people like filling up the car at the gas station. 😉

    As we know, long commutes promote heart disease too. Many docs I know cover multiple offices and hospitals (some a hundred miles away), so some of them justify buying a nicer home even if it’s further away from the in-town hospital.

    I think that many people are aware of the pain of commute (I hear people complain about it at work), but for whatever reason (homes near the hospital are all crackhouses, school selection…etc) there is at least a 30 minute commute for most people.

    Hey, at least you were able to bill for coming in for those epidurals and a hip!

    • On that last comment, we’re salaried with the potential for a pooled production bonus, so I don’t see much benefit for that work. At least I made a couple laboring ladies much more comfortable. Somebody benefits!

      When I worked locums, I loved getting called back. Time truly is money when you’re paid by the hour, and its reflected in a check you get a week or two later.

      Cheers!
      -PoF

  • I live 4 km from the main hospital at which I work, and it takes me about 20-25 minutes to get there during peak traffic times, from the time I leave my apartment until I am taking my jacket off in my office. About half of that is getting into the parkade and walking to my office. Many of my colleagues live up to an hour away from the hospital, and I think they’re insane. We’re looking to buy our first home, and I’m adamant that we be in a similar neighbourhood so that I don’t spend any more of my life in a car.

  • Part of the reason I overreached on housing expenses was so that we could be close to the hospital. I am now either an 8min drive, 18min bike or 30min jog from work. Living close to work allows a right mix of exercise to and from work.

  • In a car it takes me 3-minutes (2-mins if I roll through the stop signs :O) ) to get to work. I can do it in 5 on a bike. It was a great blessing when the opportunity came along to work very close to my home. It is one of driving forces to staying (no pun intended, but a pretty darn good one).

  • My commute now is a 30 foot walk to my computer but when I had to show up at the office I always made sure my apartment was close to work. In Manhattan I was a 15 minute walk to the office. When I was in New England I made sure I was always within a 20 minute drive of the office. Saving time was the big reason, but also saving on commuting costs didn’t hurt.

  • Neither of us are physicians but I used to have a 80-minute commute, when there were no accidents, one way, with generally reliable public transit. If I had to drive, that commute could become 2-3 hours, one way. PiC’s worst was probably around an hour one way. I now have a 2 minute “commute” to my desk, and he has a 15 minute commute, and that’s going to be the absolute top consideration when and if we choose to relocate.

    I work nearly as much some days, 15 hour days the past few months, that I used to when I had that hideous commute but the difference now is that I can still walk the dog twice a day, usually have dinner ready for the family when they get home, and even get a few chores done by the end of my night. Back then, all I did was go to work, come home from work, pass out, rinse and repeat.

    If we want to relocate but can’t get any place that can match our current commutes, then assuming we’re not being forced to move, we will make the most of our current location and not move, it’s THAT important to our quality of life.

    • You’ve made a terrific change. How much more time do you have together now? Hours more each day.

      It’s one of those things that is hard to appreciate until you’ve lived both the long and short commute.

      Best,
      -PoF

  • I live 14 miles away from work. Depending on time of day, day of week, whether the stars are aligned and whether my weekly animal sacrifice pleased the gods or not, that can take me anywhere between 20 mins and 45 mins one way. This is the valley though, so in order to move closer I might have to consider selling Toddler BITA into bonded labour. If she keeps upping that tantrum rate I might just consider it.

    It is also a little tougher when you and your spouse both work. Finding a place that is a good commute for both is a bit like finding a unicorn. And if you are in a career where changing jobs every couple of years is the norm….the idea of an ideal commute is just laughable.

  • I currently work at two different hospitals. One is about 10 minutes away and the other 15-20 without traffic. With traffic they both can take up to 45-50 minutes. Fortunately I don’t take call (ER physician) so once I leave the hospital I’m gone until my next shift. My first job out of residency was a different story. That one was about 70 miles one way, which would equate to about 2.5 hours round trip. Not only was that job a time consumer in terms of commute, it was also costly in terms of fuel costs.

    • I’m surprised more people haven’t mentioned the multiple worksite issue. It’s very common. I actually work at a surgery center across town, too. It’s about an 18-minute bike ride or seven minute commute, depending on lights.

      The time and fuel costs are just part of the cost of driving. More frequent maintenance, oil changes, new tires, brake work. It’s easy to ignore, but the cost is real. Luckily, we’re doctors, and can afford it 🙂

  • When I knew I was moving back home and bought our house, I didn’t know where I’d be working. We bought with easy freeway access in 3 directions (and lived as far as we’d need to be in the 4th).

    It turned out to be a great decision, as I’ve worked for several hospital systems across the city over the years. If we lived close to the first place I worked, we’d have a long drive everywhere else and I would have felt more pressure to stay in a bad situation.

    After 4 more shifts, I’ll be cutting down to just one system with the two closest hospitals to my house (ignoring a super-close hospital where I wouldn’t be treated if I were injured in its own parking lot).

    Hopefully in the next few years we’ll be working less and less until the commute becomes 0.

  • Personally I loved telecommuting when it was an option. Those were the good old days. I understand that meeting customers and co-workers is good for building relationships, but I strongly feel like more telecommuting is the future.

    Life was just sooo much better when I didn’t have to commute every day!

  • Great post. I didn’t have this dialed in when I chose my current residence, but still not terrible. Driving (or biking) by really nice houses which are a five minute walk from work is a bit of salt in the wounds for sure. The real key is to think about this stuff from the beginning. Every new doc should read this and understand the value of time.

    • I might suggest you upgrade to one of those really nice homes, but at this point in your career, it probably wouldn’t make sense.

      Cheers!
      -PoF

      • I thought about it but it would involve changing school districts and there are pretty big monetary costs to moving. Also there is a huge time commitment to moving. All the moving, changing addresses, setting things up, fixing up the place how we want it, etc. Since I only work part time the impact of moving would be much less. I’m keeping my eye out for the perfect house which would be closer to everything, perhaps I will get lucky 🙂

  • Jacq

    I am not a physician but I have found out I don’t do well with long commutes. I am in an industry where turn over can be high, so the idea of buying close to current job, when it can end and then starts the search for next job (probably not within a 5 min radius of current job) and having to relocate on the whim of a board of directors is not my cup of tea. It kept me to apartments until now. Part of buying was a desire to put down some sort of root, and partly to have some control over my living expenses. Rent kept going up and I had gone through a job change over.
    There are apartments close to work for $300-500 more than my previous rent, because it is closer to a metro area, and there are a lot of commuters. Houses near work were way above my price range. Then there are swaths of farm field and preserved land between work and here, further changing housing availability. I love driving through and past the farms and woods, would not change that!
    Then by me the county you live in affects taxes, and other services. I also wanted to stay not too far from my yoga studio and lastly, my sister is 3.5-4 hours north of me by car, and I didn’t want to add a lot of extra time to a trip I take about 1x a month.
    Using back roads the trip home is about 40 min, the trip in depends more on sun glare, rain, scary grey clouds, possibly what house Saturn is in, and what day of the week, due to a large amount of workers able to work from home Fridays or alternate work schedules.
    A big part of my desire for FI is having money to live off that I could work for less in a place or job with a better commute, or be able to negotiate to work remotely and move somewhere lower cost of living. I enjoy my job currently and if the company grows, I am happy to stick around as I grow towards FI but I’ve learned to have a back up plan. 🙂

  • If you’re stuck with a long commute, it helps to have a scenic one.

    The tax issue is another good one to bring up. One of my long-term locum jobs was in a city with a 1% income tax. Quite a few docs lived in the surrounding counties that had no such thing, saving a few thousand dollars in taxes.

    Best,
    -PoF

  • S.G.

    I have about a 15 minutes commute, almost all freeway with rare accidents. I work near the edge of town and live outside it, so that’s great.

    However we had problems at our local public school, so the school we transferred to is 10 miles in the opposite direction, so it’s almost an hour once I have to drop off kiddos. We’ve minimized it by limiting extracurricular to things they can commute themselves to after school which includes sports and music lessons, so I don’t spend a lot of time waiting for those.

    We’ve thought about moving, but we really like living outside town and there are so many other considerations that we have stayed where we are. If we stay here the last one will be out of that school in 8 years, so we may get sick of it before then.

  • Hatton1

    One of the best decisions that I have made is my house. It is 1 mile from my hospital and 1.5 miles from my office. It allowed me to take OB call from my own bed rather than a hospital call room.

  • Awesome post!!!

    I am incredibly fortunate as I live approximately 11 minutes from work. Living in the DC area most people are not nearly as fortunate as I am.

    The really nice thing is I’m able to come home during lunch to play with my one year son and spend time with my wife. If we lived out further from work we may have a bigger house but I definitely wouldn’t have the quality time that I do with my family.