How Early Is Too Early?

As much as I truly do like what hospital medicine represents, I have come to the very strong conclusion that there are greener pastures.

As the days of my contract tick ever-so-slowly away, I wonder how soon is too soon to seriously start the job hunt. Given that I'm looking to geographically relocate a not-insignificant distance, and that I really don't even have a solid idea about what state I'm shooting for, I figure it's not too early to put the feelers out and ask for some courtesy tours.

But I did get a lil bummed out by some of the Sermo posts talking about how it took one guy 3 hospitalist jobs before he found one he was happy in. For reasons mostly out of my control, I think I've had more jobs post-residency than I had before it. It would be nice to settle down in a position that I can think of as a career rather than a means-to-an-end.

As a lifelong Midwesterner who has lived in some pretty great Midwestern cities, I'm bracing myself to find that as the Quality-of-Life index goes up, the quality of the hospitalist job plummets. Maybe that's not universally true. But as someone who lives in a great city and commutes to work in a town precious few would voluntarily choose to live in, I can tell you that small town hospitalist jobs can be as malignant as any in a cosmopolitan city. (Even if you've read your contract with a fine-toothed comb.)

I suppose I need to decide if I would ever work directly for a hospital again. As many cons as that comes with, one of the most regal screw-jobs I've ever heard of came at the hands of a private physician group (granted, that friend is in Emergency Medicine, so maybe that's more par for the course).

I'm glad I've found a profession I like. Now I need to find the good peeps I want to work in a town I want to hang my hat for years.