Even without poverty in the picture you still have the problem of the medical system failing pretty badly with the complex cases. Everything is geared towards short appointments, that simply doesn't give the doc enough time to see a complex picture. Unless you can afford to go outside the system to docs who actually have the time you're not likely to get good answers.
Short appointments on the front end, specialisation on the back end.
Both of them doing a remarkably good job in the circumstances, but the front end doctor's job is to figure out which specialist you need or send you home with basic painkillers or antibiotics.
And the specialists deal with their area, as such perhaps more concerned with the body part or system rather than the patient and their circumstances.
Not a good fit for complex cases or those whose root cause falls outside the scope of strictly medical.
