I don't think it's lack of competence, just that they are trained to deal with a whole bunch of things and do the first line of defense with non-intrusive and less expensive trials of things.

I have recently diagnosed arthritis in my shoulders and was shocked when my doctor (an internist) had me get a simple x-ray. But then I read up on the problems I was having and arthritis of the shoulder, etc. and found that's the first thing they do! I had to smile because after he confirmed it, he rattled off the "standard" 3-4 choices of treatment and asked me what I wanted to do. At the time I didn't have the time for physical therapy but I'll probably ask for that when I get back home in March and see him in April, just so I get the "right" exercises and get in the habit of them, etc.

But insurance companies and individuals are in direct opposition to the cost of testing with a zillion expensive tests (an MRI is very expensive) which doctors would like to do sometimes to make sure they can say they "tried" everything. It just all depends. In the end, the individual is responsible for their own health care, the doctor is just there to help. You study up on whatever symptoms you're having, keep good personal notes on time/degree of pain/handicap, etc. and narrow down the possible causes to two or three likely ones and then you explain all you have done and why and what you would like to test for and you have a dialogue with the doctor about why that may/may not be a good idea, how much it will cost, what the findings could mean, etc.

Psychosomatic is not a dirty word! It is very valid; people who are depressed have physical symptoms, we know that and the symptoms are part of the depression. That's just an obvious correlation with depression, I'm sure most other mental illnesses have their physical components; someone diagnosed with anxiety/panic attacks does not die of heart attacks very often even if they go to ER's feeling like they have one! If you are diagnosed with any illness, physical or mental, a doctor is going to look and see if the symptoms you are now having could be related to what is known you already have. It's not personal, mean, or because they feel you are a mental case wasting their time.

I look at some people here with multiple diagnoses and sometimes feel sorry for them because having a zillion diagnoses isn't very useful in many ways for treatment. I think it's almost better to have a single wrong diagnosis and treat and find the diagnosis is wrong because the treatment doesn't work and then try something else than to assume you have the "correct" 4-5 that conflict and leave one feeling confused and helpless.

The doctor did refer you to specialists and that's what a family care or primary care doctor is supposed to do after making sure all the lesser treatments don't work and "easier"/time-limited diagnoses aren't correct.