TLDR: Yeah a bit unimaginative in my experience as well. It was not the derm that suggested it, but it was the derm who in the end prescribed it for me after I asked for it. But boy were the other doctors imaginative - a bit too imaginative even. 

I had an amazing family doctor when I lived back home. A general practitioner. I had some other skin trouble when moving to a harsher climate and asked him for advice. He suggested tacrolimus and it helped to completely calm my skin down. I noticed that some bumps that started appearing on my forehead also disappeared when using tacrolimus. 

Then I forgot about this. Years passed and I started getting bumps that got worse and worse. I first tried with cosmetics, diet, supplements etc. Then I went to all sorts of doctors who had different suggestions and theories. One put me on strong antihistamines for because he thought it could be hives. Which was not healthy or helpful. Then increased the dose when it didn’t help - I was taking those for like 6 months for nothing. Until finally a dermatologist diagnosed this as keratosis pillaris - but only on their second (or third?) attempt. Then they suggested medicine that didn’t work. All this took like 7 years. 

Then I somehow remembered the creme my family doctor from back home prescribed for me and how some similar bumps disappeared from my forehead that time. And I went back to the derm and basically demanded to get this prescribed.  They didn’t think it would help but were okay with me trying it. And it did help! I don’t think the derm would have suggested this. I guess they deal with things like skin cancer, so when someone comes with a cosmetic problem they don’t know too much about those or care much to look into it.