live on the coast for a while, build/augment your career and social circle, and then move somewhere else and keep your job(s).
note this plan actually involves dedicating years of your life to something without a guaranteed payoff or clearly defined steps, which is why it seems like such a mystery to most people.
200k in those areas is obviously quite good but not life-altering money. You'll need to work 5-10 years before you become a millionaire.
Anesthesiologists in that area can make up to 600k.