Comment by steveBK123

One challenge that may sound obvious.. is that super rare stuff gets seen super rarely, even by specalists.

In practice it means you often have to escalate from GP to local specialist to even more narrow specialist all the way to one of the regional big city specialist that almost exclusively get the weird cases.

This is because every hop is an increasingly narrow area of speciality.

Instead of just “cancer doctor” its the “GI cancer doctor” then its “GI cancer doctor of this particular organ” then its “an entire department of cancer doctors who work exclusively on this organ who will review the case together”, etc.