It sounds like you are weighing the pros and cons in a way that makes sense and I hope you get a really good offer to consider so you have a choice that makes you happy. I know what you mean about being undervalued in the your workplace. Unfortunately often the only thing to do that will change the situation is to switch jobs. Moving across the country away from family can be daunting. But I dont' understand that you are really losing your family. It can be difficult to find a good pdoc and therapist but given that you already have then chances are you can do that again.