And it's not just scams for $, it's missing standard care.

My father (80) and I have the same (genetic) heart condition. My current and previous cardiologist (due to a move) ordered a week long heart rhythm recorder, noting that doing this every 2-3 years was the standard of care for the condition, to catch irregularities before they become serious.

My father's current and 2 previous cardiologists did not. They ended up having to do an urgent pacemaker implant since he was frequently on the verge of passing out in his apartment due to an irregular rhythm.

One of these two groups of Drs is very wrong.

Dermatologists (at least, the mundane sort you come across in a suburban office park) are another matter entirely. I assume it comes from doing a lot of elective work for wealthy people who are concerned with their appearance rather than their health. The PCP is more surprising to me.

One of the reasons I am an anesthesiologist is that while you might have issues with the surgeon or the surgery, I find that very few people decline my services. If anything, they generally want more.