SAN FRANCISCO (KPIX 5) — Tourists are turning away from the City by the Bay, while a huge medical convention has cancelled plans to meet in San Francisco, saying its members don’t feel safe on the streets.

Locals may feel comfortable, but visitors are often shocked when the reality of San Francisco’s streets is a far cry from its postcard image.

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Tourists once took home memories of famed cable cars. These days, too often it is of the image of someone begging, or dancing in circles, or just wandering around the streets intoxicated or mentally ill.

“You can smell it,” says one tourist.

“I come from a third world county and it is not as bad as this,” says another.

Now it’s seriously affecting the city’s biggest business: tourism.

“They feel their safety is as risk because they are seeing so many people with issues,” says Kevin Carroll of the San Francisco Hotel Council.

“They see people laying on the streets — petty crimes going on in the streets,” says Joe D’Alessandro with Travel SF.

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Tourism rakes in $9 billion per year in San Francisco, so officials have been reluctant to go public with the problem. In part, it is because it makes the city look bad and that’s bad for business.

“Restaurants, taxis, people spend more money outside hotels than inside and for that reason it is something we should all be concerned about,” says Carroll.

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A major medical association has pulled its $40 million convention out of San Francisco over the state of the streets.

“The convention felt that the streets of San Francisco are not a place that a lot of their delegates wanted to come to,” says Alessandro.

The medical group is not alone.

“A number of groups are concerned about the streets of San Francisco,” says Alessandro. “They say ‘we don’t know if the streets are safe, we don’t know if we want to meet here.’”

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San Francisco spends over $300 million each year on housing and homeless programs, but you wouldn’t know it walking down Market Street.

“It’s obviously not making the difference that it needs to,” says Carroll.

“We are not going to able to accept bad behavior going forward,” says Alessandro. “We have to be compassionate about people in need – but if people are breaking the law.”

Alessandro has been saying this for years but the problem persists.

“There have been some steps in the right direction -we just need a lot more,” he says.

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The hotel industry is pressing for a heightened police presence in tourist spots to give people the feeling of safety and comfort. They also want the existing laws on drugs and loitering better-enforced.