A friend who is a primary care doctor once told me that 85% of the symptoms that he sees in patients don't matter. They will simply go away over time. Jerry Groopman notes the same in his book How Doctors Think (on page 100): "Nearly all of the complaints patients describe to their primary care physician, such as headache, indigestion, and muscle pain, are of no serious consequence."
This makes it all the more impressive when a PCP has the diagnostic skill to notice the symptoms that do matter. This is especially the case for pediatricians, who often have to rely on noncommunicative patients and parents' descriptions of their child's symptoms. Two stories of this ilk follow.
A baby and mom go to visit the pediatrician for a "well child visit" several weeks after the child's birth. Everything seems normal, and the visit is about to end. The doctor closes with one last question: "Is there anything you have noticed about Sally that has you curious or concerned?" Mom replies, "Well, I notice that she sweats a lot while nursing." Alarms go off for the doctor, who suspects a problem and orders tests. It is found that the child has a rare heart defect that prevents proper blood flow, particularly during the somewhat strenuous nursing activity. Cardiac surgery is undertaken, and the baby is fine, avoiding major complications that might not have showed up till years later.
Another child, a two year old girl, returns to the PCP with the second urinary tract infection ("UTI") in as many months. Alarms go off for the doctor. After assuring herself that the parents are using proper sanitary practices during diaper changes, she orders a test of urinary function that indicates reflux of urine from the bladder back to the kidneys. The little girl's ureters are not properly implanted in the bladder, permitting backflow. The pediatrician notes, "I've seen too many teenage girls with kidneys damaged from years of undetected reflux and persistent UTIs." After several months of prophylactic antibiotics to see if the girl will outgrow the problem, she undergoes surgery in which the ureters are re-implanted, and the UTIs stop.