In my experience, for most general practitioners, it's not!

There are specialists for a reason though. But I've found that YOU need to be able to do the work to get the referral and make the diagnoses.

Interestingly though, I had a family practice MD early on in my medical process that had a hunch, long before I suspected I had what he thought I did. (i.e. before I was able to steer the conversation to heavily emphasize certain symptoms after I'd pretty much figured out what I had and needed some diagnostics to confirm.) He just knew... Alas, the test came back negative, and he got roped into other endeavors before retiring. He was brilliant though, he had a PhD in epidemiology as well as an MD. (He even saw one of the very last smallpox cases in the wild.) Much later on, and several doctors later, we finally got that diagnosis right. For one doctor, I had to walk him through the results of the test before he finally put it together.... pretty unbelieveable, and there's no hope for the average patient in that scenario.

One thing that a lot of people without familiarity in medicine as an industry, the residency match process, etc. don't realize, is that family medicine/GP is the least competitive field. If you don't match into any residency process, you go into a scramble mode to try to get picked up unless you want to wait a year and try again. Those scrambled slots are almost all in family medicine, and largely in toxic training programs or very undesirable areas. There's a decent chance your GP finished toward the bottom of their med school class and/or did poorly on their step exams and/or didn't even want to be a GP anyway.

None of this is to say that they're not smart, or good people, or hard working, any of that. But it's important to know the person sitting across from you very likely didn't dream of sitting in that seat the way a surgeon or ICU doc or neurologist very likely did. It changes the dynamic quite a bit. For general medical issues they likely know more than you. If you have a disease or condition requiring specialty treatment, you likely know more about it than they do within the first year or two of specialist visits.

> you go into a scramble mode to try to get picked up unless you want to wait a year and try again. Those scrambled slots are almost all in family medicine,

There's some errors/gross oversimplification in this post. Most scrambled spots are one year prelims, not family medicine. Of the minority categorical scrambled slots more are actually internal medicine, next is FM (but again this is the minority), then neuro, psych, etc.

Also minor point, if you fail to SOAP ("scramble" is kind of outdated), you can find job openings outside of the match system entirely, so waiting a year is not inevitable.

> and largely in toxic training programs or very undesirable areas.

Actually, most of these programs know this and they target FMGs - they tend to fill most of their spots through the regular match. Meanwhile numerous top academic programs SOAP/scramble their prelim spots.

> very likely didn't dream of sitting in that seat the way a surgeon or ICU doc or neurologist very likely did.

IM, Peds, EM, rads, anesthesia, neurology (not competitive at all), PM&R, psych, even gen surg are all relatively non-competitive. You may be surprised about surgery, but all those surgical subspecialty hopefuls that fail to match - many of them end up in gen surg via a "scramble" to a prelim, some may make it on round 2, but many will not and they will go on to an open categorical gen surg program - ie amongst the relatively "competitive" there is the not competitive that doesn't end up where they want to be.

Meanwhile whether your doctor was bottom of the class/poor academic pedigree has more to do with region. The IM and FMs at the top academic major regional centers will often be AOA/top of class/top programs.

IM/FM is just a hell of a lot more variable - it's also very large.

> If you have a disease or condition requiring specialty treatment.....

I dunno if this really has to do with academic pedigree/the process you're calling out as much as scope of practice. Even amazing GPs, unless they have a particular personal interest in something cannot faux subspecialize in everything.