Newcomer negotiating Salary, wish to live in Brookline. (Boston, Newton: house, taxes)

[MrLinderman]

Originally Posted by emm74

I work at an academic medical center, am directly involved in clinical research including oncology research (although am not personally one of the investigators), and I have both a JD and an MPH so I'm pretty sure I have the inside info and education to discuss this.

And OP's phrasing was very odd. If he had said "Hey, there's lots of great research going on here in Houston, I don't need to move to Boston to be a part of that!" I would have wholeheartedly agreed. There's lots of great research happening where I am too, which is not in Boston.

But the comment that there's "actual hands-on success" in Houston as a justification for not wanting to move to Boston definitely implies that is something lacking in Boston. And that is simply an objectively untrue statement. It's not a zero sum game, success in one location doesn't mean there can't be success in other places. As a matter of fact, we do multi-site studies all the time, with locations across the country and across the world, spreading the success.

And yes, I'm speculating because I asked OP to clarify what he meant but he has, at least so far, declined to do so. To clarify, none of this means OP should move to Boston. There are lots of good reasons why it's not the right fit for any number of people. But to imply that it's because of a lack of successful medical research remains a bizarre excuse.

If you were just a JD and not an MPH I would have thought you were me.

The overwhelming majority of onc trials that I have encountered are multi-site trials. That being said, Not every trial is everywhere. Even the big centers, like DF/HCC, MD Anderson, Sloan Kettering, Cleveland and the like while having a lot of overlap, don't have the same portfolio.

The hands-on success comment really irked me too. I mean a 5 minute google search can tell you that the chair of one of the big midostaurin trials (Just got approved as rydapt) was a DFCI doctor.

Originally Posted by Whatsnext75

It still won't cure cancer though just by living near a good cancer center. Chemo is chemo...and the research ideas are obviously passed along and not just kept secret in boston.

I get the convenience of living near a good cancer center if you get cancer. But boston is not the only place to have a good cancer center.

Just wanted to clarify a bit on this as this is information that people often don't realize; this isn't really how oncology works at the clinical trial level. Clinical trials, while often-multisite, aren't everywhere. Many trials only have 2 or 3 sites, and if you don't get treated at one of those sites, you can't be on the trial. Sure you can get treatment 5 years later if it's FDA approved by then (big if), but you'll probably be long gone by then. Also, a lot of stuff that doesn't get approved still shows efficacy for a small percentage of people,so the big centers often have treatments available that are not only available years earlier than other places, but treatments that may never be available in other places.

Another thing to note is that oftentimes trials don't extend to affiliate sites. For instance, you may not be able to go on to a DFCI trial in DFCI New Hampshire.

Call Houston vs. Boston a wash for clinical trials. Even if it is, you have access to way way way more treatment options in Boston than you do in 95% of the country. Chemo isn't just chemo when you get to the clinical trial stage.

[BaustinTejas]

Originally Posted by emm74

agreed.

I love Boston but I don't live there anymore and I have a much better standard of living where I am now (Denver) than I could ever afford in Boston. It's legitimate comment, even criticism, to discuss the fact that Boston is not an affordable place to live.

But I also work in the medical research field, and his statement about Boston not having success in that area was just bizarre.

Now that is not true. I never typed they don't have success in the medical field. If that was the case I would have never visited. I did imply at the very least that they were upseling themselves and diminishing the significance of my local and others. I found that ridiculous, as a public example high earning celebrities often come to my current local when other institutions fail them.

Let me spell it more clearly. I was not sold on the superiority of the MIT/Harvard research industry there relative to Houston or other places in the country. I was told I should consider that when factoring COL. I did, and found it a ridiculous premise.

[timberline742]

Originally Posted by Whatsnext75

Where is cheaper than stop and shop?

market basket is far cheaper

Originally Posted by BaustinTejas

Now that is not true. I never typed they don't have success in the medical field. If that was the case I would have never visited. I did imply at the very least that they were upseling themselves and diminishing the significance of my local and others. I found that ridiculous, as a public example high earning celebrities often come to my current local when other institutions fail them.

Let me spell it more clearly. I was not sold on the superiority of the MIT/Harvard research industry there relative to Houston or other places in the country. I was told I should consider that when factoring COL. I did, and found it a ridiculous premise.

I think they would be idiots if they didn't try to use it in their recruiting. It's, undoubtedly, more effective when speaking to a candidate from say, Lincoln NE than from Houston, and it didn't work on you, but its not ridiculous.

When I was interviewing for a job in SF they tried to use the superiority of their field in the region to Boston as a recruiting tool too. I took the job because it was a step in the direction I wanted to go, but that claim was lost on me, it might have worked for others, but not me coming from Boston. I wasn't going to get offended over it. They were using their pitch.

[Whatsnext75]

I didnt think of clinical trials but not everyone is eligible or able to participate.

[charolastra00]

I'd rather have cancer in Boston than Houston, myself. Then again, the leading minds for my type of cancer both left MD Anderson for either Dana Farber or MSK (NYC is still a viable trip for specialized treatment from Boston), so...

While front-line treatment cured me, my waiting room at Dana-Farber was filled with people from other parts of the country who couldn't get the treatment they needed there. I'm sure that's also true of MD Anderson, but the combination of both Dana-Farber AND MGH, as well as Harvard, MIT, BU, and more labs and tons of biotech/pharma startups is great here. There are lots of opportunities as a patient to get involved in corporate patient advocacy here, which makes me feel like a more empowered survivor.

YMMV, obviously, but having access to clinical trials and the best doctors in the world matter. Even at the local hospital where I actually got day to day treatment, my whole medical team was Ivy+ trained doctors who did residencies at Dana Farber or MGH. I don't mind being elitist about my medical team.

[BaustinTejas]

Originally Posted by charolastra00

I'd rather have cancer in Boston than Houston, myself. Then again, the leading minds for my type of cancer both left MD Anderson for either Dana Farber or MSK (NYC is still a viable trip for specialized treatment from Boston), so...

While front-line treatment cured me, my waiting room at Dana-Farber was filled with people from other parts of the country who couldn't get the treatment they needed there. I'm sure that's also true of MD Anderson, but the combination of both Dana-Farber AND MGH, as well as Harvard, MIT, BU, and more labs and tons of biotech/pharma startups is great here. There are lots of opportunities as a patient to get involved in corporate patient advocacy here, which makes me feel like a more empowered survivor.

YMMV, obviously, but having access to clinical trials and the best doctors in the world matter. Even at the local hospital where I actually got day to day treatment, my whole medical team was Ivy+ trained doctors who did residencies at Dana Farber or MGH. I don't mind being elitist about my medical team.

That is great to hear and stories like that are some of the reasons why I even bothered to interview. However, as I already said. I would be hard pressed to manage my grocery list and have a roof over my head let alone survive cancer there. For some it works fine, but I struggle to rationalize how anyone would want to move their family in unless they had a 7 figure estate coming with them.

Then there is this completely subjective rating.
Best Hospitals for Cancer | US News Best Hospitals

[bjimmy24]

All this pissing contest about hospitals in Boston is part of the reason people don't like it.

[BOORGONG]

Originally Posted by bjimmy24

All this pissing contest about hospitals in Boston is part of the reason people don't like it.

Bostonians say prostate.

Houstonians say prostrate.

Which pisses further?

[bugelrex]

Originally Posted by Dm84

People who live in Newton are usually happy, because after all they have enough money to live there.

I wonder how happy most people would be to live in a 3br 1600 sqft shack with 2 kids and a 700k mortgage and both parents working making 100k each just to make ends meet.

Well, I guess at least the kids will be happy in a great school and the parents get to say they live in Newton.

[timberline742]

1600 sq ft is a shack????!!!!????!!!