Why Job Stacking in San Diego Makes Sense for This New Physician and Young Family

The Entrepreneur’s Life

Why Job Stacking in San Diego Makes Sense for This New Physician and Young Family

This week, we’re sharing the story of Dr. JS, a newly graduated family medicine resident who made a strategic—and unconventional decision for his first two years as an attending: job stack in San Diego with his wife and baby son, and then relocate to the South to build his long-term life and career.

What’s driving that decision? It’s more than just money.

As Marit Health has noted in articles like "Does Higher Physician Compensation Really Lead to Greater Satisfaction?", physician pay satisfaction is shaped by lifestyle, cost of living, practice type, autonomy, and how rooted you feel in the community—not just your paycheck.

In fact, Marit Health’s most recent report, "Where Are Physicians Happiest With Their Pay?", uncovered exactly what Dr. JS sensed in his gut: location is critical to your quality of life—especially in those first formative years of your career.

A Young Family at a Career Crossroads

Dr. JS’s story begins like so many others. He finished his residency at a top program in Texas, got married during medical school to an accountant, and now has a 6-month-old son. His wife’s family lives in Alabama, and the long-term goal is clear: move closer to “home” to raise their children in a rooted, supportive, small-town community.

But after interviewing for jobs in the South, Jay noticed a theme:

• The base salaries looked appealing,

• But the positions came with intense call schedules, RVU-heavy contracts, and long-term lock-ins.

• And none of them seemed to allow for testing new roles or exploring entrepreneurial freedom.

So he paused and asked:

“What if we give ourselves 2 years of margin? What if we pick a place where I can job stack, build savings, test my interests—and then move back home with more clarity and more control?”

That “what if” led them west—to San Diego.

Why San Diego?

Dr. Jay didn’t pick San Diego because it was the “forever place.” He picked it because it was the right place for right now. His goals for the next 24 months?

• Gain exposure to different care models

• Maximize income by job stacking across several 1099 roles

• Explore micro-business potential (he’s already considering expert witness work and a cash-based lifestyle medicine clinic)

• Spend time with his wife and baby in a beautiful, wellness-oriented city

Yes, the cost of living in San Diego is high. But as Marit Health noted, cities like San Diego offer diverse professional ecosystems that allow physicians to build freedom and satisfaction—despite below-average pay satisfaction scores.

Let’s take a look at the numbers.

What the Data Says: Marit Health on Pay Satisfaction

In their latest analysis of thousands of physician salary submissions, Marit Health revealed something surprising:

Satisfaction with pay doesn’t always track with the size of the paycheck.

Instead, it’s shaped by where you live, what kind of lifestyle you can afford there, and whether your professional life feels aligned with your values.

Consider this:

• San Diego has an average physician salary of $423K, yet pay satisfaction is only 3.37★, below the national average of 3.59★.

• By comparison, Los Angeles physicians average $427K, with slightly better satisfaction at 3.55★.

• Meanwhile, states like Nebraska, Indiana, and Arkansas, with more modest average salaries, score some of the highest satisfaction rates (3.9★–4.13★), largely due to lower costs of living and greater work-life balance.

• Their findings mirror my own experience

  • Rural beats big cities. Rural physicians report the highest satisfaction with their pay. Mega-city doctors? The lowest.

  • Self-Employment is A Winner. Practice setting is key. Self-employed physicians are the most satisfied. Academic and hospital-employed doctors lag behind.

JS knows that long-term, his family will thrive better in a more affordable state with deeper roots and community support.

But right now? San Diego offers a career greenhouse—a chance to try new things and earn well while keeping options open.

Lifestyle as a Strategic Variable

JSs not chasing glamour. He’s renting a modest 2-bedroom apartment with close proximity to the beach. He is stacking ER shifts, endoscopy clinics, and some outpatient primary care. But he is making sure to leave ample margin to enjoy the time and location of SoCal.

But here’s what he’s gaining:

• Three diverse income streams with more 1099 options available if desired.

• Time with his young son and wife during daylight hours—something few full-time W-2 roles in his training offered

• Low overhead and high upside—he’s learning the business of medicine before being buried in its bureaucracy

As the Marit Health report emphasizes:

“Physicians in Iowa, Utah, and Georgia consistently rate their compensation more favorably, suggesting that quality of life and perceived fairness may be driving satisfaction.”

JS believes the same logic applies in reverse: Use high-income metros early, when mobility is high—and then transition to a high-satisfaction setting when your family roots are ready.

What Young Physicians Can Learn From JS

If you're in that post-residency, pre-roots stage of life, consider these takeaways:

1. Job Stacking is a Launchpad: Use this phase to build wealth, gain experience, and experiment with non-clinical income streams.

2. Location is a Lever: Where you start can shape how fast you grow—not just financially, but professionally.

3. Satisfaction Isn’t Linear: As Marit Health shows, the happiest doctors aren’t always in the highest-paying jobs.

4. Micro-business Thinking = Freedom: JS isn’t boxed in by a 3-year W-2 contract. He’s building his own self-employment playbook.

Want to Follow JS’s Playbook?

We’ve created tools to help you do just that:

• Course: “Doctor, You Are A Business”: This comprehensive course will walk you through all the critical steps to thrive as a self-employed doctor who job stacks to fulfill your lifestyle goals. Sign up here for our flash sale of 30% off.

• E-Book: The Micro-Business Vault: 10 Hidden Revenue Streams for Physician Entrepreneurs

• E-Book: Job Options for Independent Physicians

• Coaching: 4-Pack Business Coaching (Now 30% Off) – build your own job stacking strategy with expert guidance

• Consultation: Our PEA Business Strategy Session – perfect for mapping your micro-business goals no matter which stage of your career you are in.

🧾 Is This Deductible?

Scenario: As part of their family’s move to San Diego, the physician and his wife replaced their aging vehicle with a 2023 baby blue Ford Bronco (perfect for San Diego). He wondered:

“Can my new professional micro-corporation buy the vehicle for business use?”

Answer: ❌ Not directly.

Since the Bronco is titled to his wife and used primarily for personal and family purposes, the corporation cannot deduct the full purchase as a business vehicle.

However… If the physician uses the Bronco for legitimate business travel—such as driving to locums shifts, medical conferences, or client meetings—then he can track and deduct mileage through his micro-corp using the IRS standard mileage rate.

Pro Tip: Start a simple mileage log (apps like MileIQ), and have your business reimburse you personally. It’s a clean, IRS-compliant strategy for mixed-use vehicles.

Learn more in our free e-book: Mileage Reimbursement: Maximizing Tax Benefits for Medical Professionals →

Join the Movement

“Don’t design your career around someone else’s life. Design it around your own.”

Ready to build a life-first medical career that supports your family, your health, and your ambitions?

Join the PEA Explorer Membership →

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