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Choosing Where to Live

I never realized how much where I live matters. Choosing where to live is a big decision and one many make based on proximity to where they grew up or where family is at.

Economically and socially, choosing where we live can make life easier and more enjoyable – or the exact opposite.

The first time I made a location choice independent of external factors was in 2014 when I moved to Portland, Oregon. It wasn’t for a job and it wasn’t for family.

Factors to Consider

Factors I prioritize might seem rather trivial to some. Still, let me share with you what matters to me in descending order when it comes to where to live.

  1. Freedom
  2. Social connection
  3. Economic opportunity
  4. Open-minded culture
  5. Community
  6. Weather
  7. Traffic
  8. Resources
  9. Proximity to family/friends

Some of these things are interdependent. For example, an enlightened city which encourages public transportation and independent business will likely have tolerable traffic and a lot of resources for its population.

But it’s still important to list these out separately, and rank them. Obviously for many of you proximity to family and friends is far more important.

9 Criteria For Choosing My Location

I want the place where I live to sing to my heart. I want to feel at home while feeling a sense of adventure. I don’t want it to feel too easy – I enjoy a good struggle. But I also don’t want my daily living to be a grind.

And I suspect that at different times in my life my taste and priorities will change.

#1. Freedom

One of the reasons I love living in the US is for the sense of freedom. Granted, I’m not a minority and I’m not a woman and I don’t have any disabilities, therefore there is a ton of bias here.

I enjoy the freedom to express myself. Freedom to pursue what I want despite what society thinks I should say or do. Freedom to wear what I want and freedom to own whatever I want.

It’s a rare place where there is a lot of freedom but you feel totally unsafe. If that’s the case, it might be a personal misperception. Countries with a lot of freedom tend to be quite safe.

#2. Social Connection

Though I’m an introvert in many regards, or maybe because I’m such a damn introvert, I appreciate making deep connection with a small group of people.

I cherish a solid social connection. Especially now that I’m pursuing a less conventional lifestyle, it’s important that I can feel a sense of belonging where I live.

A social connection means that I can approach random people and build a connection with some effort. It means that the locals want to form bonds with other human instead of bond to consumer brands.

#3. Economic Opportunity

If the local economy in your country and city is strong then there will be ample economic opportunity. Which could be in the form of being able to pursue a career of interest or start a business which you’re passionate about.

This is a good time to talk about cost of living. There is a lot of economic opportunity in Los Angeles, but the competition is fierce and you need a lot of cash flow in order to live a comfortable lifestyle.

In another city, say Santiago de Compostela, the economic opportunity might be less but the cost of living is much lower. I’m comfortable with such ratios.

#4. Open-Minded Culture

In San Diego, for example, people around me were very open-minded but many felt the pressure (oppressed?) to keep up appearances and live more luxuriously.

When I moved to Portland, Oregon people seemed as open-minded, if not more, and they, for the most part, lived more freely. From open relationships to drugs and hobo lifestyles.

#5. Community

Hodgepodge cities like Los Angeles are amazing because there are so many different cultures you can interact with. But because there are so many cultures it can be harder to feel a sense of community.

In cities like LA, one word or gesture is insulting in one zip code and a complement in another. In cities like Portland or Santiago de Compostela there is less diversity but the sense of community is stronger.

Portlanders are trying to live the most hipster life possible, while Santiagoans are trying to live the most relaxed life possible. Neither is better than the other. It’s whatever you prefer.

#6. Weather

When it comes to weather, most prefer a lot of sun but tint the shit out of their cars and hide inside most of the day with the A/C on.

I love mild seasonal weather. I like to go through a few months of wind and rain. And a few months of heat and sun. And I don’t mind a little snow and hot chocolate weather.

Weather and climate also determine air pollution, something else I’m rather sensitive to. In fresh clean air I thrive. In smoggy hot weather I don’t want to do anything.

#7. Traffic

It’s 2019, I can’t tolerate traffic, nor rationalize it. Where can I live and how can I live so that I don’t need to own a car? How can I decrease my environmental footprint by flying less?

Traffic happens because people can’t afford living where they want or need to be. Traffic also happens because people have excess wealth but very little time, forcing them to all hit the streets after work and be weekend warriors on weekends.

Cities with a lot of traffic won’t have inhabitants with a lot of free time – they are sitting in traffic, after all. These cities also won’t have clean air and stress levels will generally be higher.

#8. Resources

The reason we pay taxes to cities, states, and the federal government is so that we can enjoy resources. If I’m living in a place where my tax dollars are squandered, I would cast a vote by moving. It’s up to me where I choose to live.

My ideal city has libraries, safe streets, walkable streets, parks, funding for social programs, sustainable accountability for businesses, and support for community outreach.

To each their own, and I have no beef with Walmart, but I would rather live in a place where people prefer to shop locally which isn’t the business model of Walmart or Costco.

#9. Proximity to Family and Friends

I’m not a cold, heartless bastard, I enjoy being around my family and I love seeing my friends. But I have also learned that most friends and family have little time to meet up when both parties work full-time.

The world has become busier and busier and our free time has dropped down to nothing. At a time when technology is so advanced many of us could work less, earn less, and live on less, while enjoying a solid quality of life.

Now, I may not live in a place where I’m physically close to family or friends. But by choosing where I live carefully, where I have plenty of more free time and a low cost of living then I can make time to see my family more.

Amtrak may be more expensive than flying on an airline but it’s much better for my health and the environment. It also means that my city will have less pollution.

Location Independent Income

I realize that for many it’s important to be close to family and friends. And having familiarity with the culture and language is another important factor.

For those don’t have that pariority, you get to enjoy living anywhere you want and you can change your city as often as it’s practical as long as your income is location independent.

I have talked a lot about location independent income because of the opportunities it affords for medical professionals. From healthcare consulting to doing telemedicine to health coaching.

City/Country Rankings

When it comes to choosing where to live you can’t really leave that up to a rating website. There are many such headlines “Best Places to Retire 2019” or “Best Cities to Live In”.

The best way to find out which place is ideal is to go live there for a while. A visit may suffice if you trust your first impression – which I don’t.

City and country rankings are a bit biased because they will rarely mention cities with small tourism budgets. Some of the tiniest cities are the most beautiful. Göttingen was such a city in Germany, where I lived for 5 years.

4 replies on “Choosing Where to Live”

This is SUCH an important topic that I mill around in my disorganized brain probably 50% of my waking hours. As a resident doctor who has lived in 5 different cities for at least 1 year during the past decade, and who has been essentially displaced from my hometown in California due to outrageous housing prices, these thoughts are very helpful to help me systematically prioritize where I want to live/practice medicine.

Sorry for the long-winded response, but one point that I find interesting in your post if that you place proximity to family/friends at #9. Maybe because its that you did your undergraduate/medical school/residency at the same place and have seen enough of those folks that your were ready to embrace a new set of social connections in 2014. But for me, as someone who has been through of the medical school/match process that has required me to move across the country multiple times, and has made a “new set of social connections” at least 3x times, I am very “thirsty” for the chance to be a part of a community and to re-establish connections with siblings and friends who I “left behind” a decade ago to “become a doctor”. I wonder if you or some of your colleagues feel similarly that it is challenging to participate in a community of your own choosing when your career forces you to move frequently. Maybe it gets better after residency/fellowship? I feel like it is a lesser-known psychological burden that physicians go through (forced isolation brought upon by moving every 2-3 years) that contributes to some of the burnout/depression we see in epidemiological studies of physicians.

I never thought of it that way – as a forced isolation. You’re right and I think that’s why I hear it a lot from colleagues that they just want to be closer to friends and family. I think one worrying idea that looms in the background is that they may have to move again for their work, especially if they are in a higher specialized field. But that’s not too common, to have to move cities or states after you’re an attending.
I think prioritizing family and friends and placing that social connection at the very top of your list is totally normal and you’d fall in the majority of people who read this blog. I am a bit of a weirdo in that sense but I’m also single and kind of a nomad – doesn’t mean I don’t crave my friends and family but I try to stay in touch with them through other means.

Central America might be of interest para un hispanohablante como tú. Particularmente Guatemala o Nicaragua. “Vivía” en Nicaragua por 3 meses por <$1000 en total… y lo pasé bien cómodo. Yo comía bistec, tomaba unos cervezas a la semana… Fue relajante y bien accesible.

I think Central America can have a lot of advantages but the instability of the economy and the potential for heavy corruption or sudden political unrest makes it a place lower on my list. The US has those things licked but I think Spain and Mexico are strong competitors. For that reason obtaining permanent residency in either of these countries is a relatively cheap and easy investment for a physician who wants to preserve their right to practice medicine and profit from the endeavor.

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