Colorful collages line the hallways of Best Start Birth Center in San Diego, the squishy faces of hundreds of newborns carefully cut out and framed. A picture of Executive Director Karen Roslie’s son, born in 2003, hangs among the smiling, crying, and squinting babies.
Thirty years ago, Roslie’s mother, Roberta Frank, opened Best Start after training to become a certified nurse midwife. Since that time, state agencies and national organizations have recognized the birth center as a model for alternative birth practices. The Canadian health ministry even visited in the 1990s as it developed plans to fund midwifery services, Roslie says.
But in March, Best Start closed its doors, unable to keep up with escalating costs. TRICARE, a major military insurer and Best Start’s biggest contractor, wouldn’t pay for licensed midwives—only nurses, who can make much more money in a hospital. In a community where the Navy is a prominent employer, it was a debilitating blow to the birth center. The photos Roslie meticulously framed over the years will most likely have to be destroyed to avoid any medical privacy violations—evidence of more than 5,600 births shredded.
(Left to right) Executive Director Karen Rosalie and Founder Roberta Frank at the Best Start Birthing Center in San Diego. | Photo Credit: Ariana Drehsler for CalMatters
“It feels like I’m mourning a death,” Roslie says, gazing at the pictures. Best Start was the first licensed and accredited birth center in California, and even those credentials couldn’t save it. In fact, they may have hindered the birth center’s survival, requiring expensive renovations that many midwives say aren’t relevant to the care they provide or the safety of their practice. Its closure was one of at least 19 recent birth center shutdowns and reductions in service in the past four years, according to the California chapter of the American Association of Birth Centers (AABC).
Those closures deepen a crisis of declining women’s health services across California. More than 50 labor and delivery wards have closed in California hospitals in the past decade, creating maternity care deserts in rural communities and overburdening the remaining labor wards in cities and suburbs.
Sally K. (left) thirty-eight weeks pregnant, talks to midwife Andrea Bergleen (right), during a check-up. | Photo Credit: Ariana Drehsler for CalMatters
Consumer health and policy experts have pointed to birth centers as a way to expand capacity in communities where hospitals are no longer delivering babies. The midwife-run clinics deliver low-risk births and direct higher-risk pregnancies to hospitals.
But California has some of the toughest licensing requirements in the country, AABC says, and facilities like Best Start have long argued that California’s onerous regulations and an uncooperative Public Health Department prevent them from succeeding.
Only six operating birth centers are licensed in California. Another 26 are unlicensed. Licensure isn’t required, but it enables practices to work with insurance plans and helps them serve lower-income families who can’t cover birthing costs out of pocket.
Increasingly, only wealthy families who pay cash can afford to have a midwife or give birth outside of a hospital.
“The system is just a mess. It’s flawed. It’s set up to prevent providers that can provide really good care from even getting started,” says Best Start founder Frank.
Photo Credit: Ariana Drehsler for CalMatters
While most births in California take place in hospitals, birth centers serve a small but growing number of families. The number of planned out-of-hospital births attended by midwives has doubled over the past decade, even as birth rates overall declined, according to data from the Medical Board of California. And a statewide survey conducted in 2018 by the California Health Care Foundation indicated that more than one-third of pregnant people would be interested in having a midwife for a future birth.
Frequently, those who seek the services of midwives and birth centers cite the desire for more personalized care or poor experiences with previous hospital births. Studies show that for low-risk pregnancies, midwife-led deliveries at birth centers are safe and lead to fewer interventions such as cesarean sections.
“Women deserve this,” Frank says. “Every human deserves to find their own strength, find their place, [and] exercise their initiative.”
But even as demand for out-of-hospital births increases, birth centers across the state are shutting their doors, unable to withstand the joint battering ram of financial and regulatory challenges.
California’s health system was too unfriendly to make ends meet. Another Sacramento birth center is also on the verge of closure because it cannot get a state license. In September, Monterey Birth and Wellness Center will close, citing high costs and poor insurance reimbursement.
The California Department of Public Health refused multiple requests for an interview about the licensure process, responding only to emailed questions. The licensing process sets “minimum standards” for patient care, which include regulations around proper equipment and staff competency, the department said in an unsigned statement.
“We cannot speculate or comment on any reason why providers chose to close these facilities [or] aren’t seeking licensure for new [birth centers], or what could be done to improve the process,” the department statement added.
Executive Director Karen Rosalie | Photo by Ariana Drehsler for CalMatters
Licensing Can Take Years
Nancy Myrick, a co-founder of the San Francisco Birth Center, says it took four-and-a-half years of back-and-forth with the state health department to obtain a license. At one point, Myrick asked for a list of items that an inspector would check and was referred to regulations that had not yet been written.
“In the process of opening, the state bureaucracy was like the Great Wall of China. It was such a horrible barrier,” Myrick says.
It wasn’t until Myrick called her local assemblymember’s office to complain about the inability to get licensed and see Medi-Cal patients that the application was approved, she adds. The birth center was licensed in 2020.
“It literally took calling in the political dogs to get it done,” Myrick says.
Many providers noticed that getting a license became much more difficult after the state centralized the process with the public health department in 2018. Since then, nearly all birth center applications have been rejected, according to data provided by the department.
The department said in a statement the change was necessary to improve “standardization and consistency” in the licensure process for multiple kinds of facilities. Previously, the department’s 14 regional offices processed applications and approved most of them.
Yet midwives and advocates say multiple issues continue to plague the process. It’s slow, often taking years; it’s expensive, costing tens of thousands to retrofit buildings and maintain a license; and the standards are frequently at odds with midwives’ scope of practice. What results is a “de facto ban” on birth center licensure in California, says Sandra Poole, a lobbyist with the Western Center on Law and Poverty.
Without licensing reform, more birth centers will close, warns Bethany Sasaki, president of the state chapter of the American Association of Birth Centers.
A key problem, Sasaki continues, is that birth centers are expected to comply with building standards designed for hospitals. Requirements include negative pressure rooms for infection control and cast-iron plumbing for water supply and drainage.
Many midwives argue the standards don’t make sense because their patients are legally required to be healthy, with low-risk pregnancies. Any condition that would require the additional medical intervention the standards are meant to accommodate, such as surgery, would force the patient to be transferred to a doctor or hospital, Sasaki says.
“There’s no reason to hold a birth center to the same standards as a hospital, because it’s not a hospital, and that’s the whole point,” Sasaki adds.
Photo Credit: Ariana Drehsler for CalMatters
According to the Department of Health Care Access and Information, which sets building codes for health facilities, it would take legislative changes to make exceptions for birth centers. Poole and a number of groups representing midwives and Black maternal health advocates tried to introduce a bill earlier this year that would ease licensing requirements, but they were unable to find a legislator willing to carry it.
Sasaki’s licensure application for Midtown Nurse Midwives in Sacramento was denied in 2020. The holdup is the ventilation system in her building, which doesn’t meet hospital building code.
In March, Sasaki requested an appeal and emergency license after TRICARE, the same insurer that Best Start relied on, stopped contracting with unlicensed facilities. As of mid-July, she has not received a response from the state, though the department told CalMattersit was past the deadline for her to file an appeal.
Sasaki says that, without the TRICARE contract, which made up about 30 percent of her clients, the birth center will close by November.
“We’ve had to turn away so many people that we stopped answering our phone, because I don’t want to listen to another person cry,” Sasaki says.
Birth Centers Must Get Licensed to Accept Medi-Cal
Why is licensure such a stumbling block for birth centers? Medi-Cal, the state’s public insurance program for low- income families, pays for half of all births in the state, and it requires birth centers to be licensed.
“The single biggest thing that will help with sustainability is if birth centers can take Medi-Cal and if Medi-Cal can actually reimburse appropriately,” Sasaki says.
The majority of Medi-Cal births—more than 80 percent—are babies of color. A statewide survey also indicates that people of color, particularly Black women, want alternative birth support such as midwives and doulas the most. White women and those with private insurance were the highest users of midwives, the survey shows, while those who wanted a midwife but didn’t use one most commonly cited lack of insurance coverage as a barrier.
Caroline Cusenza, a midwife and the owner of the Monterey Birth and Wellness Center, says accepting insurance allowed her to serve a more diverse population in the working-class Latino enclave where the birth center is located. She wanted to take Medi-Cal patients but couldn’t. Though Cusenza applied for licensure twice, she was also rejected because the building didn’t meet ventilation standards.
The birth center will close in September after seven years.
“It was a hard decision to walk away, but we really just could see no path forward,” Cusenza says.
Executive Director Karen Rosalie hugs Kendra Wyatt, while Founder Roberta Frank hugs Jolene Wyatt. | Photo Credit: Ariana Drehsler for CalMatters
The Western Center for Law and Poverty has pointed to accreditation as a possible alternative to licensure. The Commission for the Accreditation of Birth Centers is the national organization that sets standards for birth center quality and safety. California regulators have used accreditation to help license other kinds of health facilities, but health department officials see no need to provide birth centers with alternate options. They argue that very few have tried to get a license in the first place. Only 23 birth centers have applied in the past decade.
Holly Smith, a certified nurse midwife and co-lead of Midwifery Access California, contends that the low number of applicants reflects the difficulty of the process. Midwives know licensure is nearly impossible, so they don’t bother applying, Smith argues.
“If [the Department of Public Health] can be much more involved in figuring out solutions to help birth centers exist and be licensed, should they want to be, then we would see a greater proliferation of applications,” Smith says.
Midwifery Access California is working with another state agency to improve access for low-income patients, Smith adds. They hope to convince the Department of Health Care Services to increase Medi-Cal payments to midwives. Right now, a licensed birth center gets about $1,300 per birth, while the midwife gets $400.
Some birth centers say that, at those rates, even Medi-Cal wouldn’t be enough to save them.
“If our birth center were to accept Medi-Cal, we would go bankrupt,” says Trisha Wimbs, owner of the California Birth Center in Rocklin.
Licensed in 2023, Wimbs’ facility was one of only three birth centers to achieve licensure since the public health department took over and tightened building codes. Wimbs says it cost $1 million to build the “hospital-grade facility” to code, including $80,000 to move a fire hydrant two feet closer to the building. The birth center does not take Medi-Cal because it pays too little to recoup expenses. Instead, the birth center caters to cash-pay and commercially insured clients in the affluent Sacramento suburb.
To sustain birth centers, Medi-Cal needs to pay around $8,000 per birth, Smith says. At that price point, delivering at a birth center would still cost less than half as much as a hospital delivery.
Saying Goodbye to Best Start
Eighteen years ago, Ellary Alonso was born at Best Start Birth Center when her mom, a former labor and delivery nurse, sought a more personalized birth experience. Alonso, who was 21 weeks along in March, wanted to deliver her son in the same place, surrounded by midwives she knew, maybe even in a bath. She wanted the emotional support of the team, she says, because her husband is a Marine, and there’s no guarantee he’ll be able to make it to the birth.
But a week before her first prenatal appointment at Best Start, Alonso got a call that the center was closing permanently. There are no other birth centers in Southern California that take her insurance, TRICARE.
“In this time when everything is about choice, you can choose not to have a baby, but you can’t choose how to have your baby,” Alonso says. “Hospitals are the only option.”
Compared to a hospital room, Best Start offered a homey atmosphere and the promise that the midwife attending each birth was familiar to the laboring client. The birthing rooms came with queen-sized beds, floral duvets, and white porcelain tubs for water births. A marble-topped “crash cart” sat in each room. With the doors closed, the cart looked like an end table, matching the décor. Inside, it was filled with medical supplies for conducting emergency resuscitations or stitching up lacerations.
Photo Credit: Ariana Drehsler for CalMatters
Though cozy, the rooms bore the hallmarks of a by-the-book clinic: boxes of nitrile gloves in each room, hazardous waste bins mounted discreetly to the wall. Best Start was the only birth center in the state to have a licensed clinical laboratory to confirm water breakage.
They never lost a mother or baby, Roslie says. Their transfer rate for cesarean sections was 20 percent less than the state average in 2022. In the past five years, they performed no episiotomies, perineum incisions intended to enlarge the vaginal opening during birth. And 96 percent of newborns were exclusively breastfed before leaving Best Start, compared to the statewide hospital rate of 69 percent.
Despite the center’s recognized success, keeping it running was always a labor of love, Roslie says.
“It’s never been a thriving business,” she adds. “Roberta’s gone without pay. I’ve gone with reduced pay. That’s what it takes to run a birth center.”
When Roberta Frank, Roslie’s mother, graduated from UC San Diego with her nursing midwifery degree in 1981, she was told, “San Diego will never accept midwives.”
Sometimes—in the face of Best Start’s closure—it still feels that way.
This story is produced by CalMatters, published jointly with San Diego Magazine.
Kristen Hwang is a reporter for CalMatters covering health care. Prior to joining CalMatters, Kristen earned a master’s degree in journalism from UC Berkeley’s Graduate School of Journalism and a master of public health degree from Berkeley’s School of Public Health.
What Will It Take to Make San Diego a Global Arts City?
Jonathon Glus on the Art + Design District, investing in the creative economy, keeping artists in the city, and what we can learn from places like London and Chicago
Jonathon Glus is the Prebys Foundation senior fellow leading the development of the Art + Design District at the Downtown San Diego Partnership. He has been asked what an arts and design district is many times. In our conversation, I asked him instead to describe what it isn’t. His answer opened up a broader discussion about what San Diego has and hasn’t invested in, what it has the capacity to become, and what other cities have done that we haven’t. Glus speaks about global art fairs and architecture biennials in Chicago and long tables at dinner parties all with the same fluency. He also discusses who gets to live in the neighborhoods where creative work happens, and what it means when they can’t afford to stay.
Claire Johnson: You have been asked what an arts and design district is many times. Can you tell me what it isn’t?
Jonathon Glus: It is not a place designed intentionally and specifically for tourists. Of course there will be opportunities for tourists to come, but the district is really focused on creatives, on creative education, and on the creative workforce—as well as our major performing arts organizations. That is the emphasis.
What does the district need to do in the next five years for you to consider it a success?
[It needs to] develop greater connectivity between the anchor institutions—the symphony, Broadway San Diego, the opera, all the wonderful things happening in Balboa [Park]—and the creative workforce that will be living and working in that neighborhood 24/7.
What does San Diego not have that you wish it did?
We have not been intentionally investing in the contemporary art product that other major cities have been building. A contemporary art fair. A biennial that reflects the ethos of this region. Chicago developed an architecture biennial about eight years ago. London has a design biennial. Desert X, right here in Southern California, invests in and elevates contemporary artists inside a city. We have not really been playing in the global art market in a way that we have the capacity to.
What capacity do we have?
We have a wonderful foundation. Two theater companies that produce work that goes to Broadway more than many regional theaters in the country, major museums, artists teaching at UC San Diego and University of San Diego. What a city does when it wants to take itself to the next level is intentionally create the product. Miami went after the Art Basel fair; they did not passively receive it. You have to have the intention and the will, and you have to go after it. We haven’t done that in the way that other cities have.
Look at what we did with the tech sector; we’re now a major tech center. That was intentional. Leadership organized around it. We have to do the same thing around the arts. We have a lot of contemporary art collectors here. We have a lot of galleries. But the ecosystem of the business of contemporary art is not as organized or as visible as it should be.
Which city is your North Star?
It’s bits and pieces of different cities. Dubai has invested very quickly and very intentionally in contemporary art—art fairs, design fairs, higher education, artist residencies from all over the world. London has centered artists and creatives in the contemporary zeitgeist in a way that was not true 40 years ago. They built biennials. They ensured British artists had affordable housing and workspace. They made sure the media paid attention to what they were doing.
If you don’t have an artist at your dinner table, it’s not a dinner party. That sounds elitist, but it’s true. It shows the value that artists have in a community. Our relationship culturally with Tijuana is really significant here because artists in Baja seem to be at the table.
We’ve talked before about how food, fashion, design, and art aren’t siloed anymore.
They aren’t. When super creative people are in a community doing extraordinary work, that draws other super creative people doing extraordinary work. That’s why other arts and design districts around the world end up populated with some of the most interesting restaurants and young fashion designers. Creatives want to be around other creatives.
Which leads to the economic argument…
Our creative economy already employs about 170,000 people and generates more than $11 billion in economic activity. It’s large and robust. But we must center all of this in accessibility and affordability. Williamsburg used to be affordable. Artists can’t afford to live there anymore. Wicker Park and Bucktown in Chicago—artist central, now unaffordable. If we’re going to invest in this district, we have to be really intentional about housing and workspace, so creatives have a place in the future of this district.
I see all these new supper clubs and creative collectives popping up. What is the lesson there for San Diego in terms of the commercialization of cultural and creative groups?
I think the lesson is that nothing changes. What do people love? Long tables. Why? Because you’re with a lot of people—some you may have known your entire life, but most you don’t. And if it’s driven by a creative process, all the better. We know one of the best ways to do that is around food, but also music.
For the Art + Design District, part of why we’re leaning into the process is because, culturally, we’re bringing down the barriers between film, fashion, multimedia, tech, and architecture. It’s an experiential mashup in the best possible way.
And it’s not just about art and design, but community writ large. Creative expression is something we all desire. Whether it’s at a long table, at the opera, or in your studio, we gravitate toward creative expression as a way of building community and communicating with the people around us.
Is there a question I should have asked you but haven’t?
I hope you are writing about this in seven years when the district is fully mature. But this is just the beginning for all of this. I think that’s what’s most exciting to me. We don’t know what this is going to be like, but we know it’s going to be creatively centered, and that’s super exciting to me.
On February 28, 1926, the Fine Arts Gallery of San Diego (now called the San Diego Museum of Art) opened its Plateresque doors to 3,000 guests for opening day. Over the next century, the museum changed with the times—even once functioning as a naval hospital after Pearl Harbor. This year, the museum is celebrating its 100th birthday with an exhibit (open through January 24, 2027) featuring photographs, ephemera, and film footage spanning the museum’s history.
Courtesy of Tim Novara
Free Concerts at Spreckels Organ Pavilion
Every Sunday from 2 to 3 p.m., stop by the historic Spreckels Organ Pavilion for a free concert presented by the City of San Diego on the largest outdoor organ in the world (more than 5,000 pipes). The pavilion seats 2,400 for performances by the civic organist or guest artists.
Some think natural history museums are just cemeteries for dioramas that haven’t received an update since the Reagan administration. When it comes to The Nat, which just finished a $7.5 million rejuvenation, they’re totally wrong. The museum debuted a new rooftop that replaces its 25-year-old atrium. The old roof created a greenhouse effect that steamed up some exhibits, so the new one—which includes 200 solar panels and better temperature control—will help preserve the artifacts inside. Each Friday in the summer, The Nat also becomes one of the season’s vibiest hotspots during Nat at Night, with food from places like Wolf in the Woods and The Craft Taco, bars and signature cocktails on several floors, and a rooftop DJ.
Fleet Science Theater Remodel
The Fleet Science Center just received its most significant update since the 1990s. It expanded its exhibit space by 20 percent and introduced a newly designed entrance gallery (formerly the IMAX theater lobby) that includes free exhibits for visitors who want a taste of the science without paying an admission fee. The former ticketing area now houses the Mindbender Mansion exhibit, and there’s a new café, Element 8, that will, of course, sell the center’s famous soft serve.
September is San Diego’s unofficial second summer—the crowds thin, the weather stays warm, and the city’s calendar somehow gets even busier. This month brings stadium-sized rock shows, Broadway’s buzziest comedy, a new anime convention, world-premiere theater, gallery openings, food festivals, and the first signs of spooky season. Whether you’re ready to lean into fall or determined to keep summer going, here are the best things to do in San Diego this September.
As Guns N’ Roses storm into decade five, their appetite for destruction persists. During their Snapdragon Stadium concert, hear the hard rock anthems, new material and a set from The Black Crowes.
9/23
Kehlani is proof that the romance and earnest sensuality of old-school R&B will never go out of style. Hear her take it back to the aughts at Viejas Arena.
From the silver screen to The Old Globe stage, John Carney will Begin Again (again) with a world premiere musical adaptation featuring new songs—courtesy of Train—and a story overflowing with hope.
9/12-10/17
The concept of work is a guiding principle for San Diego native and multidisciplinary creative noé olivas. Observe his community-informed approach via Tierra y Cielo (Earth and Sky) at Best Practice Gallery.
9/18-10/25
Two workers grapple with the weight of their roles at a temporary migrant shelter in Mario Vega’s world premiere play Our Lady of the San Diego Convention Center, set for citywide performances.
9/26-2/28/2027
Luminous visions of peace and the Punjabi-American roots of Rupinder Kaloti inform The Gathering, a wondrous unification of family foretold via paintings at Oceanside Museum of Art.
9/29-10/4
It’s Mary Todd Lincoln’s world and we’re just living in it. See the presidential paramour barrel to her way to stardom at the Civic Theatre during Oh, Mary!, Cole Escola’s political spoof.
Courtesy of SeaWorld
More Fun Things to Do in San Diego This Month
9/5 & 9/6
Pros and Con(vention)s: Anime San Diego will debut at the San Diego Convention Center with cosplayers, panels and more than 400 vendors well-versed in Japanese animation.
9/11-10/31
Scaredy cats beware: SeaWorld San Diego’s Howl-O-Scream embraces frights forged in darkness. Enjoy an ominous lineup of live shows, scare zones and bloody bars ahead of Halloween.
9/12
The best parts of Artivál and the Alley Cat Art Walk have united for the free Alley Cat Art Fest, an all-day outing for live music and immersive artwork in Downtown El Cajon.
9/12 & 9/13
Take a Grecian vacation for a fraction of the price during the annual Cardiff Greek Festival, two days of immersive cuisine and culture—with plenty of dancing—on the Encinitas coast.
9/13-9/20
Step away from the stove! The California Restaurant Association has eight days of eating experiences with your name on it. During San Diego Restaurant Week, explore by meal, neighborhood or cuisine for your personal dining plan.
9/16
Nourish yourself with an all-inclusive spread of Pacific Beach eats and locally-crafted artwork during the HeArt of PB Restaurant Walk on Garnet Avenue.
9/19
When it comes to stand-up comedy, Chelsea Handler is always ready to roast. See Handler tell anecdotes and skewer an assemblage of victims during her Balboa Theatre performance.
Ryan Hardison is a freelance arts and entertainment writer and recent graduate of San Diego State. When he's not staring at his laptop, he's likely eating an adobada burrito or getting sunburnt at the beach.
Kelly H. Harfouche, founder of KQ Aesthetic Society, knows firsthand that cosmetic treatments like fillers, neurotoxins, and microneedling, can not only enhance a person’s appearance and restore confidence, they have the power to truly change a person’s life. An expert injector has the ability to tailor treatments to each individual patient’s anatomy and goals for personalized results. Harfouche, a board-certified nurse practitioner, has spent nearly a decade perfecting her craft as an aesthetic injector and integrating her multifaceted artistic skills with precision patient care. Her commitment to continual education and training, plus a passion for helping people look—and feel—their best, set KQ Aesthetic Society apart in a sea of local medspas.
For many people considering nonsurgical treatments, the intent is to look refreshed and refined. KQ Aesthetic Society’s philosophy eschews a cookie cutter approach that bases treatments around units, instead working to understand each person’s unique goals, then curating a treatment plan to fit that vision. Harfouche focuses on “inclusive luxury,” the belief that everyone deserves access to aesthetic treatments, respective of budget restrictions. She develops long-standing trusted relationships with her patients, and works with each one to achieve their aesthetic objectives and address the underlying causes of their concerns.
“For me, forming an honest and open relationship with every patient who walks through the door is essential. This means understanding them on a deeper level and meeting them where they are to define and achieve their individual goals,” she says.
Drawing on her artistic background, which inspired her transition into medical aesthetics, Harfouche sees each client as a “unique canvas.” Rather than relying on standardized procedures, the practitioner’s distinctive approach combines her profound understanding of the physiological and anatomical changes associated with aging with an unwavering commitment to ongoing education about the newest products and their mechanisms of action. Her goal is to make each patient feel beautiful in their own skin and to embrace their individuality.
She has also pioneered a way to combine her talent for aesthetic artistry with her philanthropic nature. Harfouche is one of only a handful of providers using dermal fillers to treat patients with lip asymmetry and scarring resulting from cleft lip surgery. Patients travel from around the country for this transformative treatment, noting increased confidence and a restored identity. She hopes to eventually launch a training program to help fill the void in this space.
“My passion has always been connecting with people and giving back in any capacity that I can,” she says. In the rapidly advancing landscape of aesthetic medicine, you can place your confidence in Harfouche and KQ Aesthetic Society to deliver exceptional care. To learn more or book a consultation, please visit kqaestheticsociety.com.
A Rare Look Inside Callaway Golf’s San Diego Test Center
The Ely Callaway Performance Center is where tour-level fittings, cutting-edge technology, and golf equipment you can’t buy yet all come together
Courtesy of Ely Callaway Performance Center
By Tina Mickelson
“Come test something.”
Those are quite possibly my three favorite words in the English language—all due respect to “I love you” or the highly underrated “you were right.”
I’ve been a PGA Golf Professional since 1994, and yes, full bias disclosure, a Callaway Golf Ambassador for 18 years. One of the bonuses that comes with that combo is access to the Ely Callaway Performance Center—a place so exclusive it gives “velvet rope” vibes.
Originally opened in 2006 as a highly functional (yet not exactly breathtaking) test facility, the ECPC got a serious glow-up in 2018 when Gil Hanse (along with partner Geoff Shackelford) turned it into what can only be described as a fully engineered golf playground. Hanse is no stranger to golf course renovations. In 2024, he completed an extensive redesign of the Omni La Costa North Course in Carlsbad, so it could host the NCAA Division 1 Golf Championships. He also worked on acclaimed courses like Winged Foot, Merion Golf Club, and Oakmont Country Club.
In just two months, it went from a standard test center and R&D lab to a fully dialed-in golf playground.
Courtesy of Ely Callaway Performance Center
What was once purely practical is now intentionally designed to be both precise and inspiring. The targets are staggered with purpose—forcing creative shot-making while also calling you out on your actual distances (no more “that’s my 150-yard club … ish”).
Add a massive hitting area, bunkers and greens that mimic real on-course conditions, a “Himalayas” putting green (named for its roller-coaster undulations), an upgraded indoor putting lab, and a 120-decibel sound system blasting a very golf-appropriate playlist, and suddenly it’s a rare blend of high-performance testing facility and “don’t mind if I stay here all day” energy. Since this isn’t exactly open to the public, SDM asked me to take you behind the curtain.
As the iron gates part, it feels less like arriving at a practice facility and more like being granted backstage access at a rock concert—if the bandmembers were made entirely of launch monitors and perfectly manicured turf.
There are no mats. No guessing. No “I think that one felt good?” Just conditions that mirror exactly what tour players see in competition. Because when you’re testing equipment at this level, accuracy isn’t a bonus—it’s the whole point.
Even the sand matters. Different textures. Different densities. Because bunkers have personalities, too, and they are often unfriendly. And the golf balls? Brand. New. Not the usual “these have seen some things” range balls. New balls mean consistent spin, truer trajectory, and no surprises. The older a golf ball gets—and the more it’s been baked in the sun, scuffed, or generally lived a full and complicated life—the less reliable it becomes. Think of it like this: fresh ball, predictable performance; old range ball, slight chaos with a side of mystery.
I’m escorted to my personal hitting bay—basically a pop-up shaded oasis stocked with enough equipment to make a gear junkie weak in the knees. Shafts in every weight and profile imaginable. Heads lined up like they’re waiting to be drafted by their favorite team.
Courtesy of Ely Callaway Performance Center
Toptracer technology was patiently waiting to track every one of my swings, each shot instantly delivering ball speed, launch, spin, carry distance, and dispersion (a polite way of saying consistency, or lack thereof), so there’s no guessing—just data telling the truth, whether I like it or not.
We start with irons. Different heads, different feels, different results. When I miss a shot, the ball tends to leak right, so we check lie angle. A quick adjustment—2 degrees upright—and suddenly the clubface is consistently square at impact like it remembered its job. Effort level: down. Ball flight: improved. Confidence: creeping back.
Next we look at the different shaft options—because nothing says “fun afternoon” like realizing a higher kick point can change your entire golf identity. Shaft flex (how much the shaft bends during your swing) helps determine whether you get more height and distance or more control, while kick point (where the shaft bends the most) influences your ball flight—lower kick point for higher launch, higher kick point for a flatter, more penetrating shot. In other words, one small tweak and suddenly you’re hitting shots you’d normally only describe later, slightly exaggerated, over a glass of wine.
Then we move through the bag: hybrids, fairway woods, drivers, wedges. It’s a full rotation of “try this,” “now try this,” and “okay wait … THAT one.”
And yes—the new Quantum driver and fairway woods made an appearance. Without getting too deep in the weeds, they’re faster, more forgiving, and smarter (thanks to AI face mapping) than previous models. Translation: Even your mishits are now slightly less embarrassing. And they were not the only things getting tested. My patience was under attack because the driver and woods would not be available to the public for a good three months.
Courtesy of Ely Callaway Performance Center
Watching the fitting team work is like watching a Formula 1 pit crew. Clubs are swapped in seconds. Shafts tightened, adjusted, replaced. One minute you’re swinging something that seems “fine,” and the next, you’re holding a club that feels like it is a part of your DNA.
Then there’s the putter fitting. Drivers are physics. Putters are therapy. Inside the putting lab, sensors track everything—tempo, face angle, path—things you didn’t even know could be measured. Within minutes, my data politely informs me that my putter face is slightly closed at impact. Not shocking, but also not ideal.
A few quick adjustments—different head (with a bit more weight at the toe to discourage the face swinging closed at impact), shorter shaft (so I feel more over the ball, which helps my eyeline)—and suddenly the ball starts rolling exactly where I’m aimed.
Same stroke. Same golfer. Completely different outcome. If only the rest of life worked like that.
And then there’s the part that feels slightly classified. The ECPC isn’t “just” a performance center—it’s also where future equipment lives before the public even knows it exists. I’ve been there when certain clubs were basically under surveillance. Not “don’t touch,” but more “please keep phones in your pocket.”
It’s golf’s version of Area 51. Except instead of aliens, it’s drivers that won’t hit shelves for another year—and like I mentioned, waiting is not my strong suit.
Getting to test the newest equipment isn’t just a perk—it’s part of the job. It’s what allows me to stand in front of students and say, “I’ve tried it. I know what works and what doesn’t. And more importantly, I know why.” And if I happen to sprint to my car every time the phone rings and someone says, “Come test something” … well, that’s just professional courtesy.
Callaway isn’t the only place to get your swing analyzed and clubs fitted. You can stroll into big retail spots like The Golf Mart or Golf Galaxy, book a next-level session at a dedicated studio like Club Champion or True Spec Golf, test brand-specific gear at various manufacturing companies (many located in Carlsbad), or even combine a lesson and a fitting at GOLFTEC. And let’s not forget your local golf course, where fittings happen on actual turf, on a driving range you have some history with—many times with the golf professional who is familiar with your swing so they can give you valuable input. With this many options, there’s really no excuse, other than pride, to keep blaming your clubs.
San Diego has always worshipped at the altar of good skin. Equal parts surf town, biotech hub, and wellness capital, it’s a city where lunch breaks become beach walks and sunscreen sits beside car keys by the front door. The products that get used here earn their place. With 266 sunny days a year and one of the highest rates of skin cancer in the country, we take skincare seriously. Dr. Bronner’s has been making soap in North County since the 1960s. Sun Bum was born in Encinitas and is now on shelves in over 70 countries. The tradition runs deep.
“Living in San Diego means your skin is exposed to sun almost every day of the year,” says Sue Zhang, M.D., a San Diego physician specializing in aesthetic medicine. “The products that tend to succeed here are the ones that can keep up with daily life, UV exposure, sweat, and movement, while still supporting long-term skin health.”
From a mineral powder that solves the sunscreen-over-makeup problem to an acorn oil serum rooted in Indigenous plant medicine, the local San Diego shelf is more diverse, and comprehensive, than most of us realize.
Courtesy of Kopari
Kopari
Sun Shield Body Glow SPF
A hydrating gel-oil hybrid that applies like a body treatment and leaves skin with a sheen that reads as healthy rather than oily. La Jolla–founded Kopari built its reputation on cold-pressed coconut oil sourced from family farms in the Philippines, and the Sun Shield Body Glow SPF is exactly that in summer form: coverage that doubles as skincare.
4-Skin
Morning Rub
The name is intentional. The founder got a basal cell carcinoma diagnosis that his dermatologist caught—she’s now his business partner. The question he couldn’t shake was why the skincare industry hadn’t yet figured out how to talk to men, and 4-Skin is the answer: a premium sunscreen and skincare line built around the kind of blunt, self-aware humor that gets guys to pay attention. Men’s skincare has needed this for a long time, and the formulas are serious enough to deliver.
Courtesy of Coola
Coola
Classic Face Sunscreen SPF 50
Carlsbad-based Coola was formulating organic SPF before “clean sunscreen” was a marketing category, and the Classic Face Sunscreen is the brand’s thesis: protection that disappears into skin and layers cleanly under makeup. Sheer and lightly hydrating, it makes sunscreen easy to reapply before an afternoon walk at Torrey Pines.
Saffron and Sage
Glow Finishing Oil
Squalane, argan, jojoba, and CoQ10: a short ingredient list that does a lot. The Glow Finishing Oil from Mission Hills wellness sanctuary Saffron and Sage is plant-based, scientifically grounded, and formulated to absorb rather than sit on the skin. The brand started as an integrative health practice where acupuncture, naturopathic care, and functional medicine share a roof, and the skincare line runs on the same philosophy.
Courtesy of Alastin
Alastin
Restorative Skin Complex with TriHex+
The Restorative Skin Complex is powered by TriHex+, a patented peptide blend developed by Carlsbad-based Alastin’s team of SkinMedica veterans. It promises to clear out damaged collagen and elastin while supporting new production, the kind of gradual improvement that makes a product hard to quit.
Beldi is a multi-functional cleansing tradition rooted in Moroccan hammam culture, dating back over 12 centuries. Alia Jouj is the brand’s flagship product, and San Diego–based founder Dr. Mia Chae Reddy built a brand around it. Alia Jouj uses 100 percent organic, cold-pressed argan oil and the same ancient saponification method to produce a honey-thick liquid cleanser that softens skin without stripping it.
Courtesy of N8iV Beauty
N8iV Beauty
Móyla Moon Polish
Acorn oil has been used by California’s Indigenous communities as plant medicine for generations. Ruth-Ann Thorn, an enrolled member of the Rincon Band of Luiseño Indians, built N8iV around it as the first Native American–owned skincare brand to reach the national mainstream. The Móyla Moon Polish, named for the Luiseño word for moon, is an exfoliant centered on acorn oil Thorn gathers herself each year from the La Jolla reservation. Find it at the Gaslamp Quarter store Thorn owns at the historic Yuma Building.
Courtesy of Colorescience
Colorescience
Sunforgettable Total Protection Brush-On Shield SPF 50
This product solved the reapplication problem. As a brush applicator, this mineral SPF goes over makeup without disturbing it, which is why it has been on derm-office retail shelves in Carlsbad and beyond for over two decades. The tinted version doubles as foundation.
Courtesy of Tubby Todd
Tubby Todd
All Over Ointment
This steroid-free, petroleum-free eczema treatment was built specifically for babies and toddlers (although grown-ups can use it, too). It’s centered on FDA-approved 1 percent colloidal oatmeal with a base of sunflower seed oil, beeswax, and jojoba. The “linoleic-acid-rich sunflower oil is helpful for atopic, eczema-prone skin that is often deficient in that fatty acid,” says Dr. Zhang. Gentle enough for newborns, safe for daily use, and tested by both pediatricians and dermatologists.
Korej
The Mandelic Night Serum
The Mandelic Night Serum pairs mandelic acid, an AHA derived from almonds and gentler than glycolic acid on sensitive skin, with lactic acid, niacinamide, and urea to brighten, smooth texture, and reduce breakouts overnight. Fragrance-free, vegan, cruelty-free. The brand name is the initials of the founder’s five daughters, pronounced like courage. Dr. Zhang also says she “really value[s] [the founder’s] mission to create pregnancy-safe skincare products that are both effective and wallet-friendly.”
Ingrid Yang, M.D., J.D. is a hospital-based physician in San Diego, CA, certified yoga therapist, and longevity specialist. She loves *double hearts* San Diego and spends her days helping people fully engage in long, healthy lives through evidence-based lifestyle medicine. Her books include Adaptive Yoga, Zen Mindfulness, and Hatha Yoga Asanas. When she’s not leading international wellness retreats, she is chasing sunsets, handstanding in nature, or geeking out over mitochondria.
AVRP Studios’ tradition for Design Excellence and Innovation began in 1976 with Doug Austin, FAIA, in Solana Beach, California. The firm has since grown to complete major projects throughout the United States and Canada. We think of ourselves as a family and we care deeply about people. We want to inspire, help make their lives richer and more complete through our efforts. We believe that architecture is one of the most important art forms because of the impact it can have on the lives of those it touches. We’re delighted to have been recognized with over 150 awards for design excellence.
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