When we lived a small town in AZ it seemed to be a requirement to be rude to work any place, including doctor's offices and pharmacies. We even had a very rude pulmonology physician's assistant. My late husband was referred because he had just learned he had a heart murmur when he had a pre-op done. The NP that referred him must have suspected something else was going on so she wanted him checked.
Anyway, the PA at the pulmonologists office came in and asked us what we were doing there. He said he was referred but didn't really know why. She never examined him or did anything. She looked at his chart and said there was no reason for him to be there and dismissed him. That was in 2021. Fast forward to today. I'm finding out through his medical records from that time, he should have been checked for mesothelioma and other heart/lung diseases. Would it have saved his life? Probably not, but that PA did not do her job and being rude was inexcusable.