San Diego Physicians Answer Your Most-Asked Questions
The county's medical experts break down some of the field’s most complex and pressing inquiries surrounding heart disease, Medicaid, cancer treatments & more
Heart disease is the leading cause of death in the US. Scripps Clinic electrophysiologist Dr. Doug Gibson; Kaiser Permanente cardiologist Dr. Bahram Khadivi; and Dr. Jia Shen, cardiologist and director of the Bankers Hill cardiovascular clinic at UC San Diego Health, weigh in on why—and what advancements might help change that stat.
Why is heart disease so prevalent in America today?
Dr. Doug Gibson: The simplest way to think about it is that, for most of modern human history, we haven’t had easy access to unlimited resources such as food, [and] we had to expend more physical energy to acquire these resources. We got more exercise, and we didn’t have processed foods at the convenience store down on the corner. Modern human genetics are largely the result of that scarcity that we all lived through as human beings over the last 500 years. These genetics don’t do well with easy access to unlimited resources and lack of exercise. The end result is that, because of the agricultural and industrial revolutions, humans have had to expend less effort to acquire resources such as food. This has resulted in more risk factors associated with cardiovascular disease, such as high blood pressure, diabetes, and obesity.
Generally, cardiologists will advise patients at risk for heart disease to achieve or maintain a healthy weight. GLP-1 or semaglutide medications have made the news in recentyears as a revolutionary weight loss solution—but I can’t help think of the fen-phen craze of the 1990s, which supported weight loss but turned out to damage the heart valves. Has research been done on GLP-1s’ impact on heart health?
Dr. Bahram Khadivi: Weight loss by lifestyle modification tends to be more permanent because new habits have been formed. This avoids medications and their side effects. However, there are some patients that truly struggle, and we will take any avenue for weight loss, because we know it will help them. These medications are indicated for patients who have risk factors for heart disease, and [we] also take into account body mass index. Widespread use of these medications is concerning as we don’t know [enough about potential] long-term side effects, such as loss of muscle mass and effects on vision.
Dr. Jia Shen: GLP-1s are very popular for weight loss, but they also have cardiovascular benefits. [Previously,] some diabetes medications were shown to improve [blood] sugar but also lead to worse cardiac outcomes, so a lot of the newer diabetes medicines have to prove that they’re not harmful to your heart. Because of that, [researchers] measure cardiovascular outcomes when they’re testing these medicines in the population. [A landmark trial] looking at semaglutide in diabetics found about a 26 percent risk reduction in cardiovascular endpoints. Then they took that one step further and asked, “Well, do we find [a similar] benefit in people that have obesity, but not diabetes?” It was true—there was about a 20 percent relative risk reduction in cardiovascular outcomes.
We find that not only do people lose significant amounts of weight with [semaglutide]—I believe it is around 15 percent of their total body weight—they also have vast improvements in their blood pressure, cholesterol, triglycerides, and inflammation. Their whole cardiometabolic panel gets better. These medications, we feel, are very safe and very good for the heart, and I will prescribe them as a heart medication for people that need them.
Courtesy of Scripps Health Dr. Doug Gibson
What are some of the latest breakthroughs in the field of heart disease treatment, and what innovations will we see in the future?
Dr. Bahram Khadivi: Our ability to treat structural heart disease—we often think of blocked arteries as heart disease, but heart disease can also involve the structures of the heart, such as heart valves and muscle. Historically, diseased valves were treated with open heart surgery, [but] we now have the capability to treat multiple heart valve disorders minimally invasively. This field has really come a long way, and we can avoid open heart surgery for many patients. Structural heart procedures are done [by accessing] a blood vessel in the groin, neck, or upper arm.
Half of the procedures that I perform today were not available 10 to 15 years ago. This is also true for robotic surgery, where [what was once] a large, open surgery can now be accomplished through small incisions. Everything is headed towards the minimally invasive route.
Dr. Jia Shen: There’s always something new in cardiology. For people that have really advanced disease, we have a mechanical device that can take the place of their heart. If the heart cannot pump anymore, we can put in something called a BiVAD—a biventricular assist device, or a mechanical pump—that can actually bypass the heart completely.
With transplantation, we take out the old heart and give you a new heart. One new innovation is that we now have a special machine that pumps the heart [outside of the body]. We can take the organ and put it onto this machine, and it keeps it good and alive longer so that we can actually travel greater distances to give that heart to a potential recipient. It’s very high-tech and very sci-fi.
I think one of the things that will transform the field more is the use of artificial intelligence. UCSD is looking at different algorithms that can identify heart disease in ancillary scanning—so let’s say you get a CT for something else. We can use AI to comb through these images to see if you could have an increased risk of heart disease, so maybe we can identify that disease earlier in young patients.
Dr. Doug Gibson: In general, I would say genetic-based therapies are most exciting. Any illness that is the result of a single gene mutation is on the target list for a real cure in the near-to-intermediate-term time frame.
In my specific discipline, the most exciting advance is pulsed field ablation, a new way to treat abnormal heart rhythms, specifically atrial fibrillation. I’m a cardiac electrician, if you will—the formal job title is cardiac electrophysiologist. I specialize in abnormal heart rhythms. We treat arrhythmias by threading catheters through the veins in your leg up to your heart. We then use these catheters to destroy the abnormal heart muscle that causes the abnormal heart rhythm. We used to [utilize] heat or cryotherapy to destroy the abnormal heart muscle. We did it this way for many years, and it worked, but it could be dangerous, and it suffered from a lack of adequate success.
As of February 2024, instead of burning abnormal heart tissue to get rid of it, we use something called pulsed field ablation. [It’s] a once-in-a-career revolutionary shift in the way we treat atrial fibrillation. Instead of heating or freezing abnormal heart muscle, we’re delivering microsecond— soon to be nanosecond—pulses of energy to the cardiac tissue. [Those pulses eliminate] only the abnormal heart cells that we are targeting. This results in less collateral damage and the ability to deliver what we know to be the effective dose safely, [meaning] shorter, safer, and more effective procedures. Adoption of this new technology has been widespread and robust. At Scripps, we participated in preclinical research and the pivotal clinical trials that led to FDA approval. This allowed us to get early access to the technology for clinical use.
Courtesy of Sharp HealthCare Sharp HealthCare President and CEO Chris Howard
Incoming Cuts to Medicaid Questions
The July 4th passage of the Trump administration’s “One Big Beautiful Bill Act” will have significant impacts on Medicaid in the US. Sharp HealthCare President and CEO Chris Howard explains how it may affect patients in San Diego.
Chris Howard: One-third of San Diegans are covered by Medicaid, which is known as Medi-Cal here in California. Medicaid provides health insurance coverage for low-income adults, children, pregnant women, elderly adults, and people with disabilities. It’s a federal-and state-funded health insurance program, so the states provide funding for a portion of it and the federal government provides a different portion for it.
What are the planned cuts, and how will they impact San Diegans?
Chris Howard: The passage of the 2025 federal reconciliation bill, known as HR1, puts many individuals at risk of losing their healthcare coverage. New eligibility and work requirements and coverage restrictions will result in more people being without insurance. In many cases, these are people who qualify for Medicaid, but they’ll lose their coverage because they aren’t able to complete the cumbersome paperwork process.
It’s also important to note that HR1 made significant changes to the Affordable Care Act’s health insurance exchanges, like Covered California, where small business owners, part-time and gig workers, young adults, and others who don’t have health benefits through their employers can shop for and purchase private insurance plans, often at reduced cost, some of which has been subsidized through tax credits. In San Diego County, there are more than 164,000 people who have purchased their health insurance through Covered California, and 88 percent of those people received tax credit help to reduce the costs. So, as this bill takes that away, some of those individuals will decide that healthcare is too expensive, and then they won’t buy it.
HR1’s restrictions on tax credits and its new renewal and validation processes [are] going to make it more difficult for people to receive healthcare insurance coverage. For Sharp, being the largest provider of medical services in San Diego County, we are keenly aware of how significant the loss of this coverage would be for the most vulnerable patients. This includes patients from fragile newborns in our neonatal intensive care units to people receiving end-of-life care in our hospice homes.
All of our local healthcare systems are dedicated to providing exceptional health care regardless of an individual’s ability to pay. But this will place extreme pressure on hospitals, in particular, and unfortunately, that could lead to decreased services or other challenges as hospitals simply try to bear the cost of this care without compensation. The entire healthcare system in San Diego County will be extremely burdened.
Is there anything providers and institutions can do to help mitigate these effects?
Chris Howard: Advocacy is our first and foremost priority. There is much that remains unknown about how the bill is ultimately going to impact Sharp and other providers in California, in part because some of the provisions of the bill don’t take place until later years. But what we do know is, of the San Diegans that are covered by Medi-Cal, a portion of them in the future will not have health insurance coverage. And so our focus right now is on county and state budget decisions being made in response to the decreased funding from the federal government for Medicaid services, and we’re closely monitoring these developments, advocating to minimize negative impacts to our patients, the community, and Sharp.
At the end of the day, the state will have to find funding sources for the healthcare that it desires to provide. We know the current status of the state budget, and we know it’s extremely challenged. The daunting part, though, is that the net impact of HR1 will be to reduce federal funding, in this case to the state of California. And so, moving forward, the state, perhaps the county, will have to understand what, if any, additional funding sources there are for healthcare coverage, because it’s going to fall on the state, in particular, to address that. That will be a headline in the coming years: How much can California fund relative to its Medicaid program, and who will pay for that?
Courtesy of Palomar Health Dr. Jonathan Bear
Groundbreaking Cancer Treatments Questions
Radiation oncologist Dr. Jonathan Bear explains the ins and outs of brachytherapy, an innovative approach to treating prostate cancer at Palomar Health.
What is brachytherapy, and what cancers does it best treat?
Dr. Jonathan Bear: The way that we treat most cancers is with external radiation, so we have a machine that delivers radiation, or high-power x-rays, through the body to get to the tumor. While we have great technology and modern treatments and we can really deliver accurate radiation, we still have to go from the outside to the inside. You can’t give an infinite amount of radiation, because, though we would get rid of the tumor, we’d harm the patient’s [healthy tissue].
Brachytherapy is internal radiation. “Brachy” is Greek. It means “close”—so the radiation is right up next to the tumor, exactly where we need it, and that allows us to deliver less radiation to the other organs and go to higher doses. High-dose-rate brachytherapy starts with a patient under anesthesia. I put catheters through the skin and do a CT scan so we can plan the radiation in three dimensions, and then we hook each of those catheters up to a radiation machine. The beauty is, because you have [multiple] channels and a computer that’s helping you, and each channel can be dosed differently, you can really steer the dose and get a lot of accuracy. The whole procedure, from start to finish, takes about three to four hours.
What the evidence shows us from numerous trials is that it translates to better outcomes as far as what we’re trying to accomplish, which is curing the cancer and minimizing side effects.
We can treat most cancers with brachytherapy. It’s most commonly used in prostate cancer and gynecological malignancies. It’s also used in lung cancer and gastrointestinal malignancies, where brachytherapy can be applied directly inside the airway or digestive tract. [At Palomar,] we’re going to start with prostate brachytherapy, and then we’re going to move on—probably toward the end of year—to gynecological cancers.
Palomar is the only hospital in San Diego County offering high-dose-rate brachytherapy for prostate cancer. What are the limits to accessibility?
Dr. Jonathan Bear: You need to be specially trained to do this procedure—it takes a lot of time and effort compared to external radiation therapy. So really what it comes down to is the training time, the effort, and the expertise. Brachytherapy is a team-based approach. It’s not just me, [the radiation oncologist]—you have to have a urologist. I have a bunch of nurses and OR staff; we have a physicist who helps with dosing the radiation. Not too many centers have the highly skilled team that’s required in order to successfully do this procedure.
What research is Palomar currently doing to push this and other cancer treatments forward?
Dr. Jonathan Bear: We’re growing our cancer clinic. We have a research team that is contracted through Palomar. We don’t have a clinical trial [for brachytherapy] right now, but that’s definitely on the horizon—I anticipate we will have trials opening up relatively soon.
Courtesy of University of Michigan Dr. Karandeep Singh
Advancements in Healthcare-Related AI Questions
Kaiser Permanente San Diego Assistant Area Medical Director Dr. William Tseng; Dr. Karandeep Singh, chief artificial intelligence officer at UC San Diego Health; and Shane Thielman, corporate senior vice president and chief information and digital officer at Scripps Health, share the latest advancements in AI and explore what the future might hold.
What new AI tools have you implemented at your hospital group?
Dr. William Tseng: One system that we implemented within the last year is the KP Intelligent Navigator. When you share your symptoms through our app, the system uses AI to assess how urgent your situation is. If it detects something critical, it won’t let you wait for a message or an appointment; it will direct you right away to the hospital or appropriate care.
The system has a built-in clinical alert feature. For example, if a patient says, “I’m having chest pain and it’s getting worse. Can I make an appointment tomorrow?” the system recognizes that as urgent. Instead of letting it sit in the queue for a routine reply, it directs the patient to seek immediate care and escalates the message for a physician follow-up.
From October of last year through March of this year, the system processed nearly three million encounters, averaging about 19,000 each day. The system is about 96 percent accurate, meaning it is very good at correctly identifying what is an emergency, with very few false alarms.
Dr. Karandeep Singh: If we want to measure the quality of care that we deliver as a health system, we have to actually look at patient charts and see, for example, “Hey, for this patient who had a bacterial infection that resulted in sepsis, did we give them all the right things that they needed?”
Amazingly, health systems are only required to read 20 charts a month to see if they did a good job—I say “amazingly” because that’s not nearly enough charts to actually get a sense of where your opportunities are to improve. And so one of the exciting areas that we’re right now getting into which is a space that I think we are leading in—is using AI to help us do that first pass and read those charts. Basically, we don’t have to only measure our quality on 20 patients; we can measure it on hundreds of patients. We don’t have to be constrained by the fact that we don’t have enough person power to do that. We can take a first pass with AI and get over 90 percent accuracy compared to having experts reviewing the same charts.
We are now piloting AI that reads through [a patient’s complete medical history] and gives doctors a kind of executive summary, so that once you have a holistic understanding of what is going on with this person, you can strategically figure out what order you’re going to read their chart in, rather than just reading things front to back. It’s much more efficient to read a chart when you actually know what you’re looking for.
Shane Thielman: We’re working with our radiologists to use a technology that takes their dictated findings and automates the clinical impression in their documentation. The idea there is to help reduce their time in documentation but also lighten some of the cognitive burden by automating and streamlining repetitive tasks. The radiologist is still signing off on that clinical impression, but the intention is to take that dictation and pull out the clinical impression in the radiologist’s notes. That’s been a more recent development.
Courtesy of Scripps Health Shane Thielman
What does the future hold for AI in healthcare? What developments might we see in the next 10, 20, even 100 years?
Shane Thielman: I’ll start off by saying I’m not much of a futurist—with the pace of advancement of technology in general and specifically AI, it’s difficult to think beyond probably the next two to three years. The rate of change will probably not ever be as slow as it is today. We’ve taken a very deliberate and serious approach to how we evaluate any proposed AI solution, with a level of caution and a degree of risk aversion so that we’re not unnecessarily impacting patient safety, the experience of our patients, and the reputation of the organization, while also building experience with using AI.
One area that I might highlight is that, historically, it has taken many years—oftentimes between 15 and 20 years on average—to translate evidence-based research into standard clinical practice. My hope is that AI will help us [identify the] connections and relationships between intervention, treatment, and outcomes in medical data and translate those into care processes more rapidly.
We have a responsibility in healthcare to continue to evaluate technology and tools that help improve care and outcomes, increasingly with a focus on delivering care in a cost-effective manner. I think that AI can really help contribute to those aims. It has the potential to help us identify disease sooner, which can lead to improved access to care and personalized treatment in order to more effectively manage and address the disease earlier. I think it has the potential, as well, to enable proactive and preventative care and help to identify patients that are at risk to offer them access to care interventions that, ultimately, will probably help them manage their condition more effectively over time.
Dr. Karandeep Singh: One place where I feel like it could really help is, when you receive a new diagnosis or you’re a caregiver of someone, there’s often this real feeling of loneliness. When someone has an advocate—a family member with them who’s asking all the right questions—they often have better outcomes. Having an AI [system] as a patient advocate, a kind of a sidekick that can help you navigate the broader system, could be a critical thing. [It would] not just tell you what you want to hear but actually tell you, “Here’s what’s next on the agenda for this year. Here’s why.”
My wildest dreams are that you get a new diagnosis and you’ve got your own AI that’s searching up all the clinical trials, helping you figure out how to get enrolled. At that moment when you’re in grief and you have all this stress on you, you really need something or someone that can take action and keep track of everything.
One other thing I’ll add is that, in the last five years, there have been tremendous advances with personalized treatments. Some of these things seem like science fiction, but because of advances in gene editing and advances in AI, there is a lot of potential that things we view today as incurable may be curable. Modern medicine in 100 years or 200 years may be unrecognizable because of the level of personalization we can do against things like cancer, and that’s an incredibly important use of AI that has sped things up.
Courtesy of Kaiser Permanente Dr. William Tseng
Conversely, what are the limits of AI?
Dr. William Tseng: AI won’t replace physicians, but, in time, physicians who understand AI will replace those who don’t. AI is most powerful, really, when it makes healthcare interactions feel more and not less human.
AI is an assistant. It is not a doctor. Physicians need to supply the wisdom behind its output and refine what it produces, because AI won’t always get it right.
Currently, AI is still largely language-based. It’s two-dimensional, not three-dimensional or tactile. It can ask questions, but it cannot yet fully recognize the unspoken: the silence, the tears, the nonverbal responses that carry so much meaning. Medicine is more than just words. It’s the touch of a hand in times of need. It’s delivering both good and bad news with humanity. No patient should ever hear a cancer diagnosis from a bot. That moment belongs to a physician, someone who understands, who is empathetic, who can share in the patient’s tears. These are the human connections that define healing, and they are far beyond the reach of AI.
Amelia Rodriguez is a writer and journalist and winner of the San Diego Press Club's 2023 Rising Star Award and 2024 Best of Show Award, she’s also covered music, food, arts and culture, fashion, and design for Rolling Stone, Palm Springs Life, and other national and regional publications. After work, you can find her hunting down San Diego’s best pastries and maintaining her five-year Duolingo streak.
As summertime inches closer to the shores of San Diego, there are plenty of reasons to be ecstatic. For one thing, there’s the impending arrival of the summer solstice (Sunday), and three days before that, Del Mar’s own Summer Solstice will return for its yearly golden hour. There are also plenty of local Juneteenth events, such as Kinfolk Fest, the Cooper Family Foundation’s Juneteenth Celebration, and The Freedom Table, a new, food-centered event from the originators of Juneteenth San Marcos. We’re also less than three weeks away from America’s 250th anniversary, and the celebrations range from the San Diego History Center’s America 250: San Diego 1776-2026 to NASCAR’s weekend of racing at Naval Base Coronado.
Cbar has planned a week’s worth of festivities to mark its first birthday, and everyone can get in on the fun. The 1-Year Anniversary Week celebrations continue with a special edition of the Sips & Shells craft series ($50) on Tuesday from 6-8:30 p.m., half-off pastries with any purchase of a barista drink (plus an anniversary summer wine flight) on Wednesday and a five-course winemaker dinner on Thursday from 6-9 p.m. ($130). Finally, the birthday bash will conclude with live music on Friday (Will Fedak) and Saturday (Cappo Kelley) from 6-9 p.m.
2917 State Street, Carlsbad
Taste of Little Italy
June 16 & 17
Little Italy’s annual food crawl has so many options that it warrants splitting into two evenings, each boasting a diverse lineup of 20 neighborhood vendors. During the Taste of Little Italy, taking place Tuesday and Wednesday from 4-8 p.m., attendees can make their way from the Piazza della Famiglia to nearby dining destinations for bites like esquites, sausage rolls, hot chicken tenders, and forkfuls of handmade pasta. Each night will also include live music and stops for drinks, desserts, and vegetarian items. Tickets are $71 per day.
As spring makes its golden transition into summer, welcome the new season with open arms and a big appetite during Del Mar Village’s marquee tasting event this Thursday from 5-8 p.m. With the Summer Solstice celebrating its 20th anniversary, this year’s iteration will include dozens of food and drink offerings from Del Mar Village vendors, soulful tunes from Christian Jules Taylor, live art by Sarah O’Connor, and wave-crashing views at Powerhouse Park. General admission (21+) is $157 and comes with unlimited tastings as well as a commemorative tasting glass, while VIP tickets are sold out; proceeds support the Del Mar Village Association.
1658 Coast Boulevard, Del Mar
The Freedom Table at TERI Campus of Life
June 19
After hosting the first-ever Juneteenth San Marcos festival in 2025, Lionel and Natalie Saulsberry have upped the ante with The Freedom Table, an elevated observance of community, culture, and the culinary arts. This Friday from 4-9 p.m. at TERI Campus of Life, guests can enjoy storytelling, art installations, live music, curated cocktails, and a chef-led dining experience, all in recognition of Juneteenth’s lasting importance. Ticket options include general admission ($261), plus two charitable ticket options: supporter ($313) and impact ($417), with a portion of sales going towards the youth nonprofit Achievement in Motion.
555 Deer Springs Road, San Marcos
Talladega Nights Father’s Day Brunch at ARLO
June 21
In honor of NASCAR’s Coronado debut and Talladega Nights: The Ballad of Ricky Bobby, ARLO is throwing a Father’s Day brunch for the dads who want to go fast. This Sunday from 8 a.m. to 2 p.m., patrons can order from ARLO’s regular brunch menu, as well as a trio of holiday specials: the Dad’s Day Steak and Fries ($64), the Fit For a King Muffuletta Sandwich ($29), and the Big Daddy Brookie ($14). This shake and bake-approved meal will also include a DJ, cigar rollings, whiskey tastings and a Ricky Bobby costume contest. Reservations can be made online.
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.
My 15-year-old daughter tried to steal our car this week, so I’m ready to become a NASCAR dad. It would be appropriate discipline. We just relocated to a very nice suburb within walking distance of her high school. The suburbs are like living in a Tesla commercial. I am pretty far from the wealthiest dad in this neighborhood (I am, in fact, the least wealthy dad in this ’hood), more than a few engineering degrees short of being in the running.
I’m fairly certain watching NASCAR is a violation of our HOA and a violation of my daughter’s emotional HOA. But NASCAR hits San Diego this weekend and I have a fever I’ve never felt before. I want to watch 111 drivers do dangerous things in cars and trucks on an active military base in the ocean. Since my lifelong exposure to NASCAR is limited to Talladega Nights and every single iteration of the movie Cars, I can only base my plan of attack on oafish stereotypes.
So while other neighbor dads are sizing bubble jackets for their golf simulators, I’m gonna grow a Ricky Bobby, run the extension cord for the TV out into the carport we share with six other condos, fill a cooler with a proper 80-20 split of Hamm’s and Mountain Dew, treat a lawn chair like an ADU, and spend a few hours yelling ohsheeeit as if it’s a single, nine-syllable word.
The quality parents in our neighborhood seem to be able to sense anytime a vehicle breaches the 6 MPH threshold, so I should gather a crowd pretty fast. They may come over with strongly worded emails in their hearts, but one glimpse of Shane van Gisbergen and hometown hero Jimmy Johnson guzzling the last remaining drops of gasoline on the planet in a dazzling display of carmanship—they’ll join my NASCAR pop-up party.
By the time my daughter brings her friends over, we’ll have a real welcoming committee. I’ll set a special lawn chair out for the nice young boy who bought her flowers on her birthday. Have a Dew and talk to me about yourself and please list out your morals alphabetically, kid, I’ll say.
Because, like I said, my daughter tried to steal my car.
She wasn’t going to Mexico. But while Claire and I were off doing businessy stuff to afford the teen’s skincare rituals, she and a friend decided to teach themselves stick shift. She’s never driven a stick before. I’m not saying she has, but if she has driven a vehicle at all—it would have been done in a remote, abandoned parking lot where the only possible thing she could destroy was the concept of driving itself.
But a couple TikTok videos later, she and her friends felt a certain level of mastery had been achieved, and they gave it a go. They backed our VW Bug out of the garage with a series of stalls and transmission seizures, and managed to get it into the carport, attempting to do “donuts.” That’s when I got a call from a resident, who had taken an active interest in this experiment.
Which got me wondering about the power and might of vehicles. Turns out, even at carport speeds there exists a bit of potential fireworks. A garage door could become not a garage door anymore. At 145 MPH on Naval Base Coronado this weekend (don’t worry, they slow down to 100 MPH for turns), NASCAR drivers are essentially doorbell ditching gods. I didn’t register the temperature after my daughter’s trial run, but the track at NASCAR races usually hits a cool 130-150 degrees, enough to lightly sear some Nikes (the tires themselves hover in the 200 degree range).
And that is at least part of our fascination with NASCAR (the other fascination is the legendary pit parties, which either set humanity back a few evolutionary links, or advance it by the same amount of links). These drivers take something us adults do every day in a very efficient, boring way and take it to its extreme impulse. Grace and precision at the thunderous edge of shit going terribly wrong. Most of us have, upon seeing the price of California gas, wanted to pile our worldly possessions into a Honda Pilot and see how fast we could make it to our new home in Vegas. So NASCAR drivers are acting on our own wildest impulse.
Troy Johnson is the magazine’s award-winning food writer and humorist, and a long-standing expert on Food Network. His work has been featured on NatGeo, Travel Channel, NPR, and in Food Matters, a textbook of the best American food writing.
Music drifts across the fairway. Someone’s in flip flops. The Pacific flashes in the distance. Sun peeks onto shoulders through the palm trees. It’s spring, technically, but the air reads suspiciously like summer. At the par-3 course at Liberty Station, the longest hole barely stretches past 120 yards, and no one looks particularly interested in becoming the next PGA legend.
“I got dragged to a par-3 course in 2019 —The Loma Club—and it was way more my jam,” says Ronan Galvin, CEO and co-founder of Sunday Golf, a company that makes lightweight golf bags for players who’d rather carry less and laugh more. “It was a lot different than the stereotypical ideas you have about golf where it’s kind of long, uptight, and exclusive.”
Galvin spent over a decade in the golf industry working in product development, sourcing and manufacturing. But he didn’t grow up swinging clubs. Basketball and football were more his speed. What clicked for him was a simpler, more relaxed kind of play: shorter rounds and weekend games built for fun rather than formality. The kind of golf that resonated for him felt accessible, effortless, and surprisingly his lifestyle.
Courtesy of Sunday Golf
He noticed something else, too.
On a course where five clubs do the job, players were still lugging 14. So Galvin built something smaller. Lighter. A bag designed specifically for par-3 rounds, the Loma Bag is sleek, functional, and refreshingly unfussy. It’s practical minimalism in a sport known for excess.
Sunday Golf was slated to launch in January 2020. Then, COVID hit. Shipments stalled; lost at sea. The future felt shaky. But the series of catastrophes for the young company turned out to be anything but: By the time inventory arrived that August, golf had become one of the few activities people could safely do.
“It introduced and brought so many people back to the game,” Galvin says. “It created a habit for a lot of people, which is a big reason golf is on its growth trajectory.”
It turns out Americans can’t get enough of golf. Forty-eight million of them swung clubs last year, a 41 percent jump since 2019, and the National Golf Foundation says the total could top 50 million by the end of 2026.
The brand rode this unlikely momentum. Since 2021, Sunday Golf has expanded into larger lightweight bags and continues evolving from there. A major reason for the company’s success is its approachability, a value so central that it’s literally written on the office walls in the form of the company’s guiding mission: “Get 500,000 golfers having more fun by 2027.” This goal is measured, fittingly, by golf bags sold.
Sunday Golf has already passed 300,000 bags sold.
But the numbers aren’t the point.
Courtesy of Sunday Golf
“To remind the world that life is meant to be enjoyed,” Galvin says of the brand’s why. In an era dominated by screens, golf offers something analog. “People are outside, touching grass with their friends. A golf bag is a golf bag, but our products are vehicles to help support that.”
Unlike legacy golf giants promising proximity to Rory McIlroy-level greatness, Sunday Golf leans into what Galvin jokingly calls “diet golf” or “golf light”—weekend rounds, driving range sessions, company scrambles. The bags are built for the casual golfer, and the fit feels obvious.
That philosophy resonates across Southern California, where year-round sunshine means golf courses never really hibernate for winter. As Galvin puts it, “the laid-back lifestyle of San Diego kind of seeps into everyone’s veins.”
Sometimes the validation arrives via email: a 76-year-old customer is able to walk the course again because their golf bag is lighter. Parents are able to take their children out with Sunday Golf’s kids line.
For Galvin, that’s the real win. Not perfection. Not prestige. Just more people outside, enjoying themselves. In San Diego, that might be the most natural mission of all.
Isabella Dallas is a freelance writer for San Diego Magazine and the Arts and Culture Editor at The Daily Aztec in her final year at San Diego State University. She previously worked as an editorial intern for SDM, but when she’s not writing, you can find her trying the best coffee spots in SD, devouring the latest rom-coms, and indulging in anything and everything pop culture.
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.
The initial project will be a landmark September edition of San Diego Magazine—fully dedicated to the people, ideas, and identities of the city’s creative community. After its release, those stories and more will extend across six months of integrated digital, social, and multi-platform coverage. Art & Design District and SDFC Playmakers will serve as co-publishers of the expanded editorial vision.
The Art & Design District is evolving into San Diego’s first home for the performing arts at iconic downtown venues like the Civic Theatre and Jacobs Music Center alongside research and development programs focused on artist live/work spaces, galleries, studios, and New School of Architecture & Design.
“[The Art & Design District initiative] is a long-term investment in San Diego’s creative life and the creative workforce that powers our cultural experiences and creative industries here at home and across the world,” says Jonathan Glus, Prebys Senior Fellow for Art & Design in Residence at Downtown San Diego Partnership. “But infrastructure alone is not enough. The public needs to see, understand, and participate in what’s being built and why. Joining as co-publisher of this issue means helping ensure that the story of San Diego’s creative community—its artists, its institutions, its future—gets told at the level of ambition the moment requires.”
San Diego has entered a defining chapter in how the region invests in its creative community, with civic and philanthropic leaders working alongside artists, brands, institutions, and people to chart a new model of public-private support for arts and culture.
As digital co-publishers of San Diego Magazine‘s arts and culture coverage, SDFC’s Playmakers partnership will include a six-month integrated collaboration designed to sustain the visibility of San Diego’s creative community well beyond a single issue.
“The Playmakers program was built on the belief that the creative community is essential to what makes San Diego, San Diego,” says Sebastian, San Diego FC’s SVP of Brand and Innovation. “Investing in local media that tells those stories—and reaches the audiences who need to hear them—is one of the most direct ways we can support the artists, organizations, and cultural leaders shaping this city’s future. We’re proud to step in as digital co-publishers of San Diego Magazine‘s arts and culture coverage and the founding partner of this new editorial program.”
Under the partnerships:
The Art & Design District joins as Co-Publisher of the September 2026 Arts & Culture Issue, undwriting San Diego Magazine‘s most ambitious editorial event of the year.
SDFC Playmakers joins as Digital Co-Publisher of San Diego Magazine‘s arts and culture coverage, founding a six-month integrated partnership that includes co-publisher presence in the September issue.
The partnership represents a new model for regional media: civic and cultural institutions providing the resources required for sustained, ambitious, local editorial media focused on the neighborhoods it serves.
“For 78 years, the magazine has told the story of arts and culture here,” says Claire Johnson, CEO of San Diego Magazine. “But the fragmentation of traditional media has made it harder than ever to cover this community at the depth and scale it deserves. SDFC Playmakers and the Art & Design District have recognized something critical: Media is not separate from the civic conversation, it’s the stage for the conversation.”
San Diego Magazine retains full editorial control over all reporting, features, and original content produced under both partnerships.
“Our role in this ecosystem is to tell the story of San Diego’s culture and provide context for our readers.” says Johnson. “These partnerships give us the resources to do justice to that responsibility—and to extend that commitment well beyond a single issue. Our readers also deserve to know exactly how this work was funded. I’m grateful to our partners, and to the arts and culture community in San Diego for letting us tell this story.”
The September Arts & Culture Issue will be released early September 2026, with digital, social, video, and podcast coverage rolling out through early 2027.
ABOUT SAN DIEGO MAGAZINE For 78 years, San Diego Magazine has been the region’s leading lifestyle and culture publication, reaching approximately 6 million readers monthly across print, digital, newsletter, and social platforms. Owned and operated locally, the magazine has been the connective tissue of San Diego’s cultural conversation since 1948.
ABOUT SDFC PLAYMAKERS The Playmakers program is an ongoing initiative that seeks to identify and showcase the talent of San Diego creatives who are contributing to the culture, substance, and flow of our community. We want to bring the San Diego community together by marrying football and creativity to provide a platform for these Playmakers who are positively impacting our culture by pushing the boundaries through innovative ideas. The goal is to create a program that consistently provides growth and exposure opportunities for San Diego creatives, while shaping an authentic direction for San Diego FC’s brand and community-building process. Through this program we hope to contribute to the creative fabric of our city by providing paid jobs, projects, collaborations, as well as networking opportunities for Playmakers.
ABOUT THE ART & DESIGN DISTRICT The Art & Design District is a Downtown San Diego Partnership initiative, supported by the Prebys Foundation, working to shape a connected, vibrant arts and design district in downtown San Diego. Led by Art and Culture Expert Fellow Jonathan Glus, the initiative convenes artists, cultural leaders, civic stakeholders, and residents in service of a downtown that reflects the creativity, identity, and diversity of the region. Learn more at downtownsandiego.org.
Golf doesn’t have to mean stiff collars, pleated khakis, whisper-talking on the green, or pretending your sand trap fails aren’t actually hilarious. Around San Diego, a handful of rebel courses are quietly rewriting the rules of an afternoon round, making them more relaxed, more social, and yes, more dog-friendly. These are the fairways where leashed pups pad alongside their people; where a suspenseful search for a golf ball in the bushes or—no!no!no!no!no!—in the water hazards are part of the fun; where every polite golf clap comes with a smiling, panting audience. If your ideal golf day includes a walk, a drink, and your dog riding shotgun, this is your teeing ground.
For proof that a golf course can be approachable without being boring, look no further than Emerald Isle Golf Course in Oceanside. The executive course delivers consistently beautiful greens, rolling elevations, and just enough challenge to keep you engaged, not stressed—unless your pup breaks free and runs for the rolling elevations, in which case you’ll be very engaged and maybe a little stressed. Locals love holes like the canal carry on No. 3 and the wildlife-dotted pond on No. 16, while golden-hour sunsets steal the show most evenings. Dogs are genuinely welcome here, not an afterthought. Grab them a slice of watermelon from the clubhouse, pose in the cart for Instagram cameos with an Emerald Isle scarf (it doubles as an adorable bandana for your four-legged friend), or introduce them to the course’s resident pups like Bogey, the assistant director of instruction, and shop dogs Karl and Frank. Affordable, friendly, and no-frills, Emerald Isle feels like golf you and doggo can’t wait to play.
660 S El Camino Real, Oceanside
Courtesy of The Loma Club
The Loma Club, Point Loma
The Loma Club is where golf goes social. Set in Liberty Station, this historic 9-hole par-3 course trades country club stiffness for an easy, neighborhood energy that feels distinctly San Diego. The course is walkable and unintimidating, with skyline and harbor views doing most of the heavy lifting. The Loma Club is just dipping its paws into the dog-friendly trend, and welcomes them on the mini course and off the fairways. Though your pup is the epicenter of your world, the patio at Loma Club is the real star, hosting live music, trivia (even the smartest dogs are stumped), and cocktails that rival golf itself. You don’t even need clubs to enjoy it. Show up with your dog, wander the course, grab something from the clubhouse, and stay for hours. You’ll feel like you’re exactly where you’re supposed to be.
Calling Goat Hill Park a golf course almost undersells it. Known as the “People’s Park,” this historic Oceanside staple operates more like a community space where golf happens. Expect dogs strolling alongside the players, music streaming from magnetic speakers attached to golf carts, beginners smacking balls alongside serious talent, and locals and tourists sharing the same teeing grounds with a few four-legged besties trotting alongside. Saved from redevelopment in 2014, Goat Hill embraces a raw, unpolished look that’s both intentional and refreshing. With ocean views, a “19th-hole” fire-pit, and zero pretense, it’s golf at its most human…because: dogs.
2323 Goat Hill Dr, Oceanside
Courtesy of Omni La Costa Resort
The Club at Omni La Costa
Ready to add your pup’s name to the illustrious list of golf greats? Same. At the iconic The Club at Omni La Costa, the vibe is equal parts championship-caliber and casually fabulous. Emerald fairways so perfect you’ll hesitate to step on them, palm-lined paths practically begging for a golden-hour strut, and rolling greens that ripple in the sun. And just when you thought it couldn’t get any better, your four-legged plus-one enters the chat: For members and overnight guests, the La Costa lifestyle rolls out the (very chic) welcome mat for your (leashed) pup, turning tee times into a social affair of breezy, citrus-kissed luxury and leisurely strolls. Really—what are you waiting for? Even your dog’s got a standing invite.
Isabella Dallas is a freelance writer for San Diego Magazine and the Arts and Culture Editor at The Daily Aztec in her final year at San Diego State University. She previously worked as an editorial intern for SDM, but when she’s not writing, you can find her trying the best coffee spots in SD, devouring the latest rom-coms, and indulging in anything and everything pop culture.
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.
703 16th Street, Suite 200, San Diego, California 92101 | 619-704-2700 | avrpstudios.com
