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Rural Employment; Options for the Physician's Spouse

Published on: Oct 18, 2021

Rural Employment;
Options for the Physician's Spouse

If you’re a job-hunting neurologist, you may have noticed the preponderance of positions available in rural and under-served areas of the country. Tempted? You should be—these openings can present terrific opportunities to build your career while setting down roots for your family. Ah, the family…concern for your spouse might be one of the issues giving you pause. How will he or she find work? As it turns out, perhaps more easily now than ever before.

There are many factors that might make a neurologist wary of rural work assignments, including worries about low pay, opportunities to work within a subspecialty, and lifestyle in general. As it turns out, these worries can be put to rest. The salary is generally greater than that offered in larger urban areas. Combined with a lower cost of living, lucrative hiring bonuses, and other incentives, many physicians find rural employment to be a financial windfall. Likewise, the chances of practicing a subspecialty can be better than in areas with more neurologists vying for the same opportunities. As for lifestyle, that’s a subjective measure but many physicians report being pleasantly surprised to find more cultural and recreational opportunities than expected, along with a more relaxed pace of life.

Having crossed each of these issues off the checklist, the job-seeking neurologist might still be left with the question of opportunities for his or her spouse. Or, perhaps more troubling, opportunities for a spouse who is working now and would be uprooted by a move to the country.

This phenomenon, often described as the “trailing spouse” issue by relocation specialists, has plagued two-career couples for decades. It’s been especially common for military spouses and those married to corporate executives, which are two employee groups that are frequently required to relocate for their work. In those cases, the uprooted spouse has most frequently been the wife, and she’s often been responsible for managing the move itself along with issues related to the kids, with her own career indeed trailing in last place for attention.

That’s the history of the situation. But the current reality? Worker shortages plus remote work options equal unprecedented opportunity for the so-called trailing spouses of rural physicians. While both of these phenomena have been brewing for a while, the pandemic may have knocked down the final barrier in terms of employer resistance. Having now seen how many jobs can be performed in new ways, and having experienced nerve-wracking employee shortages, the nation’s employers are experiencing a twin burst of creativity and tolerance when it comes to how they get their work done. This is all good news for the neurologist considering the impact on a spouse’s career when considering relocation to a rural area.

If you are that neurologist, then read on. There are at least five ways your spouse can pursue a career if you decide to practice in rural America.

1. Work remotely for a current employer. If your spouse is currently employed, he or she might be able to continue in the same role from a rural location. This is a strong option for any job that is conducted primarily from an office, but it can also work for professional service roles, including counseling, social work, law, training, and others where the interactions primarily consist of conveying ideas and information. 

To explore these options, a little homework is needed. Before talking with his or her employer, the relocating spouse should do some brainstorming about how the current work or a variation of it (or a brand-new role) could be conducted remotely. Then, a brief cost/benefit analysis is needed. Nothing fancy, but it’s easy to anticipate the boss asking, “How much would this cost? How would our business benefit?” Being able to answer those questions will make for a better conversation when the time comes.

2. Obtain a new job that is remote. Again, if your spouse has skills that can be parlayed for remote work, he or she could be an excellent candidate for an entirely new job with a different employer, located anywhere in the country. Since many of the roles we never imagined being possible away from the workplace are now conducted partly or wholly online, the range of opportunities for remote work has expanded exponentially. If your spouse can't or doesn’t want to take his or her job along to the new location, this is an excellent option.

Online job boards are a good place to start when exploring this possibility. Many have filters that can be set for preferences such as “remote work” or “telework,” making the search easier to manage. Checking with specific employers within one’s industry to inquire about remote work opportunities is another pathway, and one which can sometimes reveal positions that aren’t yet (or won’t be) advertised.

 3. Find a local, hands-on job. No matter how rural the position you're planning to take, there's at least a medical center or clinic in the location, right? Right. Which means there are any number of local jobs that could appeal to your spouse.

Identifying local organizations and potential employers may be something your recruiter can assist with. If not, there’s always the old-fashioned process of checking with the chamber of commerce or town council for a list of businesses to contact. If there’s a newspaper serving the area or even a phone book, your spouse can get a head start by getting copies to review prior to your move.

 4. Work as an independent contractor. The concept of having a gig or side hustle is quite familiar by now and it may be that your spouse has already been operating as an independent contractor. Skills that work well for portable side hustles include writing, editing, software coding, managing projects, and more. Whatever skills are used, the work in this model is conducted on a contract or gig basis, rather than as an employee. Like any work structure, there are pluses and minuses to this option, but one of the major advantages for relocating spouses can be the flexibility of working only when it fits the schedule.

Independent contractors often locate assignments on web sites specific to their profession, or on more general sites that broker introductions with companies or individuals needing certain tasks performed. These sites can be convenient, but they can also drive down take-home pay through competitive bid processes. To maintain more control, your spouse may want to contact former employers to ask if they’d like any work conducted on a project basis.

 5. Start a business. The side hustle from above could certainly be treated as a business, but there are other, more traditional models to consider as well. For example, rental space would be available in your new town to operate anything from a coffee shop to a boutique. One advantage of rural living can be the availability of affordable or unoccupied buildings that can be renovated for new purposes. Other options for business startup can be conducted without any external space, provided your new home can accommodate it. Or, your spouse might review ideas for buying into a franchise operation, where much of the setup is already in place.

Like any business startup process, legwork is needed before diving in. Regulations governing home-based businesses, for example, or state and county business licensing would be good information to have. Luckily, there are quite a few web sites and government-sponsored resources for business owners, so the research doesn’t need to be difficult.

6. Educational goals. Depending on where your spouse is in his or her career path, one of the best options might not involve work at all. If career improvement is important at this stage, now might be the time to start or complete a degree or certificate that will enhance future work opportunities. No matter how rural your new location, as long as there’s broadband, there will be training options available. This may even be a benefit for you to negotiate on your spouse’s behalf, particularly if your new employer is a university that could sponsor tuition.

7. Getting creative. Your spouse may have creative talents, previously restricted by available time and space to explore. If their current career path is less than satisfying, is it time to explore a detour? Homes with studio or art space could well be an affordable option in your new community. Things like supplies, workshops, and distribution channels can be easily accessed online. Your spouse’s potential new career could emerge as that of a creative artisan or teacher given the slower pace of life, newly available time, and generous in-home workshop.   

What not to do…

Procrastinate! The sooner you and your partner get started on this transition, the more smoothly it will go for both of you. Even if you don’t yet know which town or state you’ll be working in, there are still steps that can be taken now. Internet research is key. Resumes and CVs should be up to date, LinkedIn profiles can be written, and voicemail can be programmed on your cell phones so recruiters know they’ve reached the right person with the next great job offer. Remember: While relocation will always bring challenges as well as adventure, with a little planning and creativity, it can also be a benefit for your spouse’s career.