My wife is also a physician so we are more than fine financially. This is the algorithm for family income:
For reference things stay the same and we will call my salary and her salary together 1X.
1. I commute part time and she stays working then our combo is 1.3X.
2. I move full time and she gets a new job then our combo is 2X.
3. I move full time and she quits her job then our combo is 1.5X.
Wife- The issue is she doesn't want to move and she wants to continue to work so quitting for her is unlikely. She doesn't want to be in Texas due to politics climate surrounding her job.
Money is not the main motivator. I am starting to hate my job. We have a new boss. To quote the WHO, "meet the new boss, same as the old boss". Our group has transformed and gotten really big. We still run the same way we did when we had 7 people and we are now up to 21. A mid tier guy got promoted (he's the guy who made the most sense of all internal candidates) but he's not listening to any senior people. We did outside candidate interviews and he was clearly the least qualified but the cheapest. Senior folks have been asking for leadership restructuring, resources, etc. Trying to give him grace and time but he's been interim and now permanent for almost 2 years. That and coupled with how the hospital works, they treat us like employees that are told what to do. Part of my ethos is to have an impact on the place I work and make it better for those around me. There is no ability to enact change here.
The best upside for me is I'm joining a med school classmate and a mentor who trained me. So the guys I'm working with I've known for 20 years.