I actually travel often for work so I've experienced this on both coasts and at most points in between, but the doctor was in Eastern Washington. Which is quite similar to Northern California about 20 years ago: a little bit country and a little bit Rock n Roll, if ya dig.
It surprised me as the area is generally well educated and has strong agriculture and services sectors in it's economy.
Until being a tradesman is a respectful living it will be passed over for "better" work.
As a degree holding manager in construction I don't like to mention the field of work I'm in to other (sometimes less) educated people as I then have to deal with the superiority complexes of the uninformed.
I mentioned it to my doctor at our first meeting and she asked me point blank if I used condoms since I obviously had multiple partners and likely used intravenious drugs.
I was shocked since as a heavy civil contractor with federal contracts I can't even smoke pot, in my state it is legal, and being that I am married I obviously have very little sex and even then only with the one person.
It surprised me as the area is generally well educated and has strong agriculture and services sectors in it's economy.