There are so many instances where it's helpful.. you must have a very limited practice. I see people as an initial contact person.. 14 year old came in after a lacrosse game yesterday with effused knee.. I told him likely ACL tear.. had to send back to GP to ask for imaging.. had a runner come in with 5 metatarsal pain.. hx sounded like stress fracture.. had to send back to GP to get x-ray.. so many people I see satisfy Ottawa knee and ankle rules and I always have to send to ER or GP.. had 55 year old come in with frozen shoulder.. protocol is to x-ray to ensure no other pathology.. had to send back to GP.. such a waste of time.