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

A recent viral article argues that primary care physicians (PCPs) are fundamentally incompetent across multiple dimensions, citing surveys and clinical studies. The piece claims that PCPs fail to diagnose rare diseases: half of rare disease patients receive at least one incorrect diagnosis, and 30% wait over five years for correct diagnosis. For children, 38% require six or more doctors before receiving a correct diagnosis. The article also attacks physical examination skills, noting that PCPs detect heart murmurs with only 30-40% sensitivity, and detect lung crackles at rates from 19-67%, with inter-observer agreement barely above chance (kappa 0.18-0.45).

Additionally, the article highlights poor patient interaction: a replication of a 1984 study found that PCPs interrupt patients after just 11 seconds on average, and most patients stop elaborating after interruption. The author suggests that the current credentialing system is empty and proposes making it approximately 10x easier to become a PCP as a solution, arguing that more, less-trained providers would improve access and outcomes. While controversial, the piece raises systemic concerns about diagnostic accuracy and patient experience in primary care.