Huge problem. I'm a plat who lives 10mi from SJC and about 25mi from SFO. From SJC NW has two daily flights (both to MSP, one leaving at ~6a the other noonish), there's a few CO flights to IAH and a redeye to EWR, a few DL flights to LAX, SLC, redeye to ATL, a few AS flights to BOI/PDX/SEA, and that's about it. SFO is only marginally better for Skyteam (roughly the same destinations, plus a few international).

How do I survive? Lots of traveling on partners and taking grief from co-workers. Almost all of my co-workers fly UA, and wonder why I would fly north to MSP to wind up south in AUS.

Luckily, flying out of SJC/SFO, Skyteam tends to be competitive and/or cheaper than *A direct flights, which helps when it comes to booking trips for work. It helps a lot if my destination is far enough east that connections in NW/CO cities seem reasonable. If I have to go to Denver, that's when I have problems (where problem translates to transiting SLC on DL).

Upsides: Usually get wacky routings yielding lots of miles (Can anyone say YYC via IAH?), and AS is a godsend living on the west coast.

Downsides: Longer routes, or putting up with DL via LAX/SLC. (that and the scarcity of upgrades on SFO-DTW.)