I know one guy from a small town in South Carolina who had his chemo treatment plan set up by Mayo/Jacksonville, but received all his infusions back home. Similar case with a guy in Florida, several hours from Mayo, who got chemo and primary oncology care in his small town. Mayo had no problem with it in either case. If you were in a bigger city and getting chemo at a bigger "more established" clinic, they might be the ones who want to "drive" instead of letting someone else like Mayo be in charge. Ego if nothing else at some of these places.

Aside from Duke and UNC, the only big names I can think of in the general region are Mayo, Emory, Vandy, UVA, and Johns Hopkins.

Houston has two major airports and is a hub for Southwest Airlines, so MD Anderson might be within your reach. They have a lot of clinical trials going on, some of which don't require much travel. Lots of affordable flights into the two major NYC airports with good pancreas programs nearby. Dr. Christopher Wolfgang at Langone ( https://nyulangone.org/doctors/1770519761/christopher-wolfgang ) is said to perform surgery that other docs won't attempt.

If you don't have a primary onco you like and trust, you're right to keep looking as long as you have the fight in you. Hang in there!