Why I Designed My Life Working Part-Time 931 Miles from Home

By Dr. Elisa Chiang, Guest Writer

Many people, physicians and patients alike, are dumbfounded when they hear how far I travel to work. While I live in the eastern suburbs of Cleveland, I currently work part-time as an oculoplastic surgeon in Sioux Falls, South Dakota. That's about 1,000 miles away from my home. Prior to working in Sioux Falls, I spent two years working in Peoria, Illinois. If I’m talking to a physician, the next question is usually some flavor of, “Do you work locums tenens?” While I do some locums work close to home, my primary job is actually a W-2 position where I hope to be for the remainder of my physician career.

Locums roles typically fill temporary gaps due to leave or staffing shortages. Typically, locums physicians travel to their work locations, and they are 1099 contractors. They usually receive malpractice coverage and have their flight, hotel, and rental car expenses covered. However, locums positions generally do not provide health insurance; retirement benefits; or other perks like covering the cost of licensing, professional societies, or CME. The duration of a locums position varies; assignments can last as short as a week or as long as a year.

In some ways, my job could be considered “locums-like,” but it is not locums. During the interview process, I discussed the long-term outlook of the position with my employer, and they intend to keep me, barring any extenuating circumstances, for as long as I wish to stay. That makes my job very different from a locums position; I am not simply working until they find a full-time replacement. While I won’t buy in to become a partner, I will be an associate for the foreseeable future. Since I’m part-time, I don’t receive healthcare benefits, but my practice covered the cost of licensing and I negotiated for CME funds. In a prior job in Peoria, which was a similar situation, I also had access to an employer-sponsored retirement account.

I typically work two weeks a month, with a schedule that I coordinate with the practice manager. It’s not a strict every-other-week schedule; there are some months where I work two weeks in a row, depending on staffing, clinic room and OR availability, and my own personal commitments. I am paid per session worked. I don’t take any call for the practice. My flights, rental car, housing, and food expenses are covered by the practice (the aspect of my job that resembles locums).

How I Commute to Work

I typically fly to work on Sunday evening and fly back home on Friday. I’ll drive myself to the Cleveland airport late Sunday afternoon and park my car. For dinner, I often pick up a bowl from Currito at the Cleveland airport and eat it on the flight from Cleveland to O’Hare in Chicago. I typically have an hour layover before my next flight to Sioux Falls (or previously to Peoria). Sadly, there are no direct flights available. On the flights, I write in my journal, read books, listen to podcasts or audiobooks, or get some sleep.

When I flew to Peoria, I would pick up a rental car and head to my hotel—a Hampton Inn near the office—and settle in for the night. If I arrived early enough, I would stop at the grocery store to pick up some food. At times, when the Peoria flight was canceled or on the rare occasion when my Cleveland flight was delayed so I missed the Peoria flight, I would get a rental car from O’Hare and drive three hours south to Peoria. I always made a car reservation for pick up in Peoria and a reservation to pick up in O’Hare and drop off in Peoria. The flights to Peoria were on small jets, which were more likely to get canceled due to weather.

On one occasion, the flight was delayed while we waited for the weather to clear. We finally boarded the flight, flew to Peoria, circled the airport a few times before the pilot determined it was unsafe to land, and we flew back to O’Hare. I got a rental car and drove to Peoria that night, getting in super late but still allowing me to get to the clinic on Monday morning. I would work Monday through Thursday and sometimes on Friday morning. On Friday, I drove the rental car back to the airport and flew back home, again with a layover in Chicago.

Now that I fly into Sioux Falls, the planes are a bit larger, and while there have still been delays, I so far haven’t had issues with flight cancellations. I get a Lyft from the airport to my apartment. My practice has rented and furnished a one-bedroom apartment in a building with a pool, hot tub, community room, and fitness room. A company car is parked in the parking lot, and the keys are left in my mailbox so I have a vehicle to use for the week. On Friday, I work in the morning and I leave the car at the office while someone drives me to the airport.

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My Logistical Life Working 1,000 Miles from Home

Each week, I pack a backpack as my personal item and a carry-on roller bag. I take my laptop, my journal, a book, and put my purse in my backpack. My luggage has clothes for the week and my toiletries. In Peoria, I had a desk where I left my surgical loupes, a pair of Danskos that I wear for surgery, and a few other items. In Sioux Falls, I have clothes and a pair of Danskos in my apartment, but I still end up bringing a suitcase and taking clothes back and forth. Even though my apartment has a washer and dryer, it’s easier to do laundry at home. Having my own apartment means I wash my sheets and have to clean more than when I was in a hotel. It’s the trade-off to having not only more space but my own personal space and a full kitchen.

When I first started traveling for work, I either ate at restaurants or got take-out. Later, I got into the routine of buying food from the grocery store to make salad for lunch every day. I still either eat out or get take-out for dinner, but I also sometimes order enough food at one dinner to have leftovers for another dinner. In Peoria, I made use of the doctor’s shared office space where we had our own full-size refrigerator separate from the staff lounge. My hotel room also had a mini-fridge and microwave. In Sioux Falls, I continue to have salad every day for lunch, which I make in my apartment’s kitchen and bring to the office. I occasionally cook dinner in Sioux Falls, but I still eat out a lot or eat leftovers. With these changes, I’ve maintained my weight despite eating out so often. I now rarely eat out when I am in Cleveland, since I eat out so often when away from home.

My work week is a mix of clinic and surgery that is scheduled starting at either 7:30 or 8 AM and ending by 5 PM, though the clinic sometimes runs later. After work, I may go for a walk or hike in a park or work out at the gym before dinner. As I settled into my job at Peoria, I started to find people to eat dinner with once or twice a week, and I have started to do this in Sioux Falls as well. I’ve gone out to eat with other physicians from my practice and staff members with whom I work. In Peoria, I became friends with two CRNAs who are sisters, and we ate dinner together regularly. I recently found people to meet up for dinner in Sioux Falls by posting on a South Dakota women physicians' Facebook Group. I spend other evenings on the phone with my husband or in virtual meetings on Zoom. I also do coaching calls and work on my coaching business. Even as an extrovert, I don’t find myself lonely since there is always something to do!

Travel and Credit Card Perks

While some people assume frequent travel between home and work would be difficult, there are many perks. I have Premier 1K status with United and often get upgraded to first class. I also accumulate frequent flyer miles and, with Premier status, earn more miles per flight than I would otherwise. Additional benefits include complimentary Economy Plus seating, early boarding, and free checked bags (even if overweight). When I travel internationally, I have access to United and Star Alliance lounges. Recently, I even had a plane held for me due to a tight connection after a delayed flight. I don’t know that they held the plane due to my status, but it’s a possibility. I made it to the gate after the usual boarding cutoff but with enough time for an on-time departure.

I also have Diamond status with Hilton and have accumulated hundreds of thousands of Hilton points, which I use for free hotel stays when traveling for pleasure. I haven’t tracked my exact savings, but it easily exceeds $1,000 per year. With Diamond status, I’ve received room upgrades (sometimes to an enormous room) and enjoy free breakfast or food credits. (My Diamond status will expire at the end of 2025 since I’m now in an apartment.)

Getting reimbursed for my travel expenses means I have a lot of credit card spend for which I get reimbursed. This is great for what people call “travel hacking,” or the credit card points game. Before traveling for work, I had to carefully plan credit card applications around upcoming expenses to ensure I got the signup bonus. While I do spend a lot on personal travel, I don’t tend to spend that much on credit cards when I’m not paying for personal trips. Now, I can use accumulated points to upgrade my personal travel, such as flying business class without paying cash. Full disclosure: I haven’t yet used my points for business class, but I have enough saved to do so. I’m still working on planning trips far enough in advance to find available business class award seats. However, I have used United miles to save about $3,000 on economy flights to New Zealand during peak holiday travel.

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Why Don't I Just Work in the Same City Where I Live?

I didn’t start traveling for work just to earn airline and hotel status. I traded hotel stays for my own apartment, with the housing expenses still covered by my job. My main priority was finding a job where I feel valued, provide high-quality patient care, have a reasonable level of autonomy, and receive fair compensation—goals I believe most physicians share. Ideally, I wanted to work in a physician-owned practice, as I believe physicians prioritize patient care when making business decisions. Flexibility was also important to me, allowing time for travel, as well as working on my coaching business and my podcast. Four weeks of PTO wasn’t enough for me, which was the policy for all new physicians at my last full-time job. With these priorities in mind, I set out to find my next career opportunity.

While there are oculoplastic jobs in Cleveland, being open to travel allowed me to find a better fit. Cleveland is dominated by large healthcare systems, and many private practices have been acquired by private equity. I previously worked for one of the large healthcare systems and turned down an opportunity at one of the other healthcare systems. I also received an offer from a private equity-owned practice close to home but ultimately chose to travel to work at a physician-owned practice instead.

Some may wonder why I chose not to relocate instead of commuting for work. I’ve committed to staying in the Cleveland area for my husband’s job and for stability. Having already moved once for a job that didn’t work out, I didn’t want to keep relocating only to find that the next position wasn’t the right fit either. I grew up in the Cleveland area, returned for the MSTP program at Case Western Reserve, and did my intern year in nearby Akron. Cleveland feels like home to me, and at least for the time being, I want to stay.

Many physicians have asked why I didn’t start my own practice. Before the pandemic, that was my plan. But when COVID-19 hit, I was grateful I hadn’t signed a lease for office space or hired staff. The pandemic led me to shift my entrepreneurial focus to coaching physicians on money and career shifts—which has low regulation, low overhead, and location flexibility. It's unlike running a medical practice—which involves high regulation, high overhead, and being tied to a geographic location. Coaching allows me to make a meaningful impact on individuals, something I love about being a physician, and I see myself coaching long after I stop practicing medicine. I’m not ready to step away from practicing medicine and surgery, but I’m also building the next chapter of my life through my coaching business.

My coaching business also keeps me busy on evenings when I’m alone and on my off weeks when I’m home. I spend time preparing and recording podcast episodes for The Grow Your Wealthy Mindset Podcast, marketing my business, and coaching clients. Coaching and building a digital business have led to so many online connections that I can be alone in my apartment but not be lonely. Many of these connections started with the pandemic when I also lost a lot of in-person social connections and went from meeting up with friends multiple times a week to being at home with my husband whenever I wasn’t at work.

The pandemic was also a reminder that tomorrow isn’t guaranteed. I wanted to see more of the world and spend more time with family and friends scattered across the country. My sister is in Chicago, my brother is in Seattle, and my parents are in Northern California. By working two weeks a month, I can schedule my off weeks for travel. Had I started my own practice, the responsibility to my patients and the financial demands of running a business wouldn’t have allowed for the same flexibility I currently enjoy—at least not for many years.

I’m often asked if I have children. I do not have children by choice; I have never wanted to have children. That said, I don’t believe having children would make travel-for-work impossible. While it would require a supportive spouse, many professionals with children travel extensively for work. Though travel means spending time away, it could also allow for more quality time with family during off weeks when at home.

I also do some locums work, taking ophthalmology call at a hospital 35 minutes from home. I do this because it allows me to work while I’m in Cleveland and earn 1099 income, which enables me to write off expenses and contribute to a solo 401(k). I work 4-6 weeks per year at this locums position based on my availability.

I believe I’ve designed the best work situation for myself. As a part-time associate of the practice in Sioux Falls, I can build long-term relationships with my colleagues and staff and have some benefits not typical of locums work. With traveling, I get some perks that are beneficial when I travel for leisure. Few locums positions exist in oculoplastics, and most would require me to practice as a general ophthalmologist. By being open to travel, I’ve found a position with a great culture that suits me while serving a community in need.

Medicine is evolving, and the traditional career path for physicians is no longer the only option. With rising burnout, corporate takeovers, and shifting job security, it’s more important than ever to take control of your career and design a life that aligns with your values. By thinking outside the box, I’ve created a work-life balance that allows me to practice medicine on my terms, maintain financial stability, and pursue my passions beyond medicine.

Design your life with intention, not by default. Explore your options and build a career that truly fits your life.

What do you think about this kind of work setup? Do you know anybody who regularly commutes across the country? What would be the positives and negatives of such a work life? 

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