This rural physician feels that today’s generalists spend most of their time managing chronic disease, like hypertension, diabetes and heart disease, rather than diagnosing new disease. Which isn’t necessarily a bad thing, but not what it used to be:

Managing chronic illnesses can be very meaningful and satisfying, but it isn’t quite what I imagined I would be doing to this extent. But it is one of the reasons we need to hone our skills as physicians; it is no longer enough to be a good diagnostician when almost every patient we see in a given day already has a diagnosis established. Our challenge is to help them manage that diagnosis. That means we need to practice motivational interviewing for our patients with lifestyle-inflicted diseases, serve as our patients’ medical home in a fragmented health care system and be a voice of reason in an era of information overload.

Not sure that’s true, since I certainly find my share of new diagnoses over the course of a day. A lot can be uncovered by ordering the recommended USPSTF screening tests.

It’s true however that if you really want to see new, untreated diseases in a patient, you’d have to practice in a more remote area.