Yes I realize the error of comparison and have since added the correct information of 5 million people. Not sure why the post doesn't update, but it looks updated from my end.

Through this post I have realized that these specialist hospitals serve a large portion of the population, but the same can be said for CA. Both UCSF and Stanford are nationally recognized hospitals with high honors in many fields and I can assure you people travel from far away to go there as well.

I have not tried getting a new PCP since 2020 in CA, but I had a surgery in 2021 with 100% elective ACL revision surgery with an orthopedic surgeon. A different surgeon than had performed my previous ACL surgery. in 2019 No crazy wait time, readily available for appointments (2-3 weeks). Again as I commented on another, this may be due to the specialist as orthopedics is likely more fluid than others (Neurology, etc.).

Appreciate your response to specific points. Very concise. Thanks!