I tried to schedule a doctor's appointment in San Diego last month, just something routine -- a check-in for the kind of persistent, shapeless ache you're told not to ignore. It wasn't urgent, not yet, but it wasn't nothing either. I called my provider's office, gave my ID number, waited on hold and was told with a practiced politeness that the next available date was in mid-November.
By then, the pain might shift into something else entirely. By then, I might no longer need the appointment -- or my issue could be in a worse state. Either way, the calendar didn't bend, and I had no choice but to accept it until something closer freed up.
I've lived in San Diego long enough to recognize the city's mood swings: the early dusk of fire season, the sudden brightness of bougainvillea in alleyways, the quiet collapse of another small business no one could afford to keep open. But what I didn't expect was how difficult it would become just to access basic care -- to be helped without a countdown or the weary suggestion to "just go to urgent care if it gets worse."
Primary care, once the most fundamental tier of health support, has become something almost mythic in California. In San Diego County, which now has over 3.3 million residents, the shortage is more than anecdotal -- it's documented. Many regions in the state fall below the federally recommended threshold of 60 primary care doctors per 100,000 residents. In some neighborhoods, the ratio is half that.
My experience reflects a documented crisis that has reached San Diego. According to NBC San Diego's 2023 investigation, the California Health Care Foundation found that a decade ago, more than half of San Diegans could see a doctor within two days. Today, that number has plummeted to just 20% -- only 1 in 5 residents can secure timely care. Dr. Paul Schalch Lepe, an ear, nose, and throat specialist, told NBC that even with his large practice spread throughout the county, "oftentimes, the wait times can be upwards of four to six weeks."
This local deterioration mirrors a nationwide crisis. A comprehensive 2025 survey by AMN Healthcare that included San Diego among 15 major metropolitan areas found that the average wait time for a physician appointment across six medical specialties has reached 31 days -- a 19% increase from 2022 and a 48% increase from 2004. Even more concerning, this survey focused on areas with "some of the highest physician-to-population ratios in the country," meaning the situation is likely far worse in underserved regions.
You'd think that in a city marketed as a hub of wellness, access to a general practitioner wouldn't feel like winning a lottery. And yet, more of us are calling around, refreshing appointment portals, asking friends for recommendations that lead nowhere. Clinics are no longer taking new patients. Those that do may offer a slot -- months away -- if your insurance qualifies, if your schedule allows, if the stars align.
You'll hear this described in distant language: staffing shortages, pandemic aftershocks, insurance bottlenecks. But when you're the one in the waiting room -- or worse, the one not even able to reach the waiting room -- those phrases feel like excuses stacked atop delay.
We self-diagnose, delay care and ration our worry. We tell ourselves that it's probably nothing and that we'll go in if it gets worse. We search symptoms and compare timelines, and hope the body forgives our patience. Meanwhile, urgent care clinics become catch-alls, emergency rooms absorb preventable visits and the word "routine" starts to feel like a joke. In fact, California emergency rooms have seen a 17% increase in non-emergency visits in the last three years, many of them driven by gaps in access to primary care.
When care is out of reach, we learn to mistrust the system meant to sustain us. And when the appointment finally arrives, you carry with you weeks of anxiety, along with the quiet question: What if it had been worse?
This issue touches neighborhoods and households across San Diego. It isolates immigrants who fear navigating an overwhelmed system in a second language. It traps the elderly in long loops of delay. And it gaslights middle-class families who assumed that decent insurance meant access to care, only to find themselves locked out of the most basic appointments.
Why are we building more wellness spas than clinics? Why is mental health treated like a luxury, and primary care like a privilege? Why are there neighborhoods where it's easier to find a boutique IV drip bar than a physician currently taking on new patients?
We have accepted a kind of civic gaslighting -- that because San Diego looks clean and functions on the surface, the deeper systems must be working too. This is not just my story, it's becoming everyone's. And we deserve to stop treating health care like a scavenger hunt.