Looking forward – June 2019

David B. Hoyt, MD, FACSSome members of the American College of Surgeons (ACS) have indicated that they plan to skip Clinical Congress 2019 because San Francisco, CA, is the host city. These surgeons point to media reports and personal experiences with regard to aggressive panhandling, dirty needles on the street, and public defecation and urination, particularly in Union Square, which is near the headquarters hotel and the Moscone Center. They note that a few other organizations have pulled San Francisco from their roster of convention host cities and believe the College should follow suit.

I would urge people to reconsider attending Clinical Congress in San Francisco and to focus less on the negative and more on the positive aspects of the meeting and its host city. I also would encourage them to consider the facts about public safety and the many advantages of attending Clinical Congress in this world-class city.

Steps that San Francisco is taking

Like many big cities across the nation, San Francisco does have a large number of homeless people, but it might interest you to know that its homeless population is smaller than that of several other metropolises. San Francisco has 6,857 homeless people. Comparatively, San Diego, CA, has an estimated 8,576 homeless people; Seattle, WA, has 12,112; Los Angeles, CA, 49,955; and New York, NY, 78,676.1

The reality is that many homeless people have mental illnesses and substance abuse disorders that can lead to erratic behavior. San Francisco is taking proactive steps to address these issues firmly but compassionately under the leadership of Mayor London Breed. A native San Franciscan, Mayor Breed has made a significant investment in helping the city’s homeless population gain access to health care and shelter, including opening more than 330 new shelter beds and getting nearly 1,000 people off the streets and into affordable housing. She is focused on adding more housing for residents of all income levels by streamlining bureaucracy and cutting permit times and intends to move forward plans for a $300 million affordable housing bond. She has added mental health stabilization beds and authored conservatorship legislation to help people who are suffering from mental health and substance use disorders.2

In fact, the city is investing $60 million in temporary and permanent housing; $27 million in state funding for homeless programs; $6 million in developing a drug addiction street team; $16 million in street cleaning services and equipment; $44 million in emergency response services; and $300 million in long-term improvement projects, such as street resurfacing, sidewalk repair, and park improvements (personal communication with Rick Hud, senior manager, convention sales, San Francisco Travel Association, April 19, 2019).

To those individuals who say that crime is rampant in San Francisco, the Major Cities Chiefs Association reports that the city’s overall and violent crime rates are lower than that of New York; Los Angeles; Chicago, IL; and Denver, CO.3 In fact, according to The Economist Intelligence Unit’s Safe City Index, San Francisco is the safest city in the U.S. and 15th in the world.4 The city’s homicide rate is at its lowest point in 50 years.

The city also has added 250 new police officers, many of whom have been specifically assigned to policing in and around the Moscone Center. The police department has created a crime unit to deal directly with smash-and-grab crimes and has added more foot patrols. In addition, San Francisco Travel, the city’s tourism bureau, has hired a retired San Francisco Police Lieutenant to serve as a safety consultant.

Union Square now has Business Improvement Department red-jacketed ambassadors to assist visitors who are looking for directions to points of interest. These individuals serve as additional “eyes and ears” on the street and provide such services as sidewalk and gutter sweeping, graffiti removal, and sidewalk power washing. The city has installed 3,000 garbage cans citywide, increased cleaning services, established safe injection sites, and expanded the number of rest areas equipped with public toilets.

Hence, it seems reasonable to say that San Francisco is making a good faith effort to be a safe, clean, and enjoyable place to visit.

Take in the culture and scenery

And, of course, the city and its surrounding areas always have been home to many wonderful attractions that are fun and educational for the whole family. If historic sites and museums appeal to you and your traveling companions, visit Alcatraz, the California Academy of Sciences, the Walt Disney Family Museum, the Cable Car Museum, the San Francisco Museum of Modern Art, and the Palace of Fine Arts. If you prefer outdoor activities, you can bike across the Golden Gate Bridge, take a San Francisco Bay Twilight and Sunset Cruise, visit Fisherman’s Wharf, go golfing, visit the sea lions at Pier 39, drive or walk down Lombard Street, see the Victorian houses known as the Painted Ladies, stroll around Chinatown, or hop the ferry to Sausalito. And of course, for the gourmands, San Francisco has more Michelin star restaurants than any U.S. city.

If you decide to add a couple of days to your trip, you can tour Yosemite, check out the wineries of Napa Valley and Sonoma County, wend your way through Muir Woods and see the giant redwoods, visit the state capitol in Sacramento, and breathe in the fresh air of the Sierra Nevada range. Or cruise south down Highway 1 to Monterey or Carmel, stopping to explore the string of beach towns along the way.

Many of these locations will be on the list of Guest Programs offered through the ACS during the Clinical Congress. Participation in these tours ensures that your spouse, children, and other guests are visiting these attractions in a safe environment while you are busy attending Panel Sessions and Skills and Didactic Postgraduate Courses at the Moscone Center. For the youngest members of your family, ACCENT on Children’s Arrangements, Inc., partners with the College to provide an on-site Camp ACS for children ages six months to 17 years old.

San Francisco has been a host city for the Clinical Congress for decades and typically has drawn some of our highest attendance numbers, which should come as no surprise given all that the city and the conference have to offer. I look forward to seeing you in October.

If you have comments or suggestions about this or other issues, please send them to Dr. Hoyt at lookingforward@facs.org.


  1. McCarthy N. The U.S. cities with the most homeless people in 2018. Forbes. Available at: www.forbes.com/sites/niallmccarthy/2018/12/20/the-u-s-cities-with-the-most-homeless-people-in-2018-infographic/#4be77f411780. Accessed April 30, 2019.
  2. Office of the Mayor. About Mayor London Breed. Available at: https://sfmayor.org/about-mayor. Accessed April 30, 2019.
  3. Major Cities Chiefs Association. Violent Crime Survey, January 1 to March 31, 2018 and 2017. Available at: https://majorcitieschiefs.com/pdf/news/mcca_violent_crime_report_2018_and_2017_first_quarter_update.pdf. Accessed April 30, 2019.
  4. The Economist Intelligence Unit. Safe Cities Index: Security in a rapidly urbanising world. Available at: http://safecities.economist.com/safe-cities-index-2017. Accessed April 30, 2019.

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