Primary Care Physicians are Incompetent. We Need More of Them.

The typical primary care physician is incompetent in every measurable respect. This is a huge problem.Here, I make the case that Primary care physicians are broadly, grossly incompetent. This is due to empty credentialism Making it much (~10X) easier to become a PCP is a good solution Primary Care Physicians are Broadly, Grossly Incompetent. The standard of competence I am comparing primary care physicians against is:They should be able to reliably diagnose diseases they are trained to diagnose.They should be knowledgeable to a standard similar to what is required to qualify as a doctorThey should be attentive and empathetic towards patientsVisiting them is empirically superior to not visiting themWhen actually examined according to these standards, PCPs fail on all counts.Failure to diagnose uncommon diseases is rampantA survey of patients with rare diseases found that, in about half of cases, patients received at least one incorrect diagnosis, and two thirds required visits to at least three different doctors before being diagnosed. For 30% of them, a correct diagnosis took over five years.Another survey of children with rare diseases showed that 38% of them needed to see six or more doctors before being diagnosed correctly. 27% received an initially incorrect diagnosis.If you happen to suffer from a rare disease, the likelihood you will actually receive a correct diagnosis and treatment for it within a year of first setting foot in a doctor’s office is astonishingly low.PCPs Are not good at physical examinationsPhysical examinations are often hailed as a reason for the necessity of PCPs and their rigorous training. However, every time they are tested on their ability to perform these tests and derive accurate conclusions, they fail abysmally.PCPs detect heart murmurs at sensitivities of 30-40%, with high inter-rater disagreement. This is a worse level of accuracy than just taking self report at face value.“Crackles” in the lungs are detected at rates ranging from 19-67%