Sorry for the rude question. i mean it with the purest of intent and am genuinely curious. are doctors in the us trained to see patients as horses not zebras? meaning when symptoms present the more common answer is usually correct. thank you?

You are probably correct if I understand your question correctly. We are trained to make the diagnosis based not only by symptoms, physical findings and laboratory results but also on statistics (what is the most common disease in the US which has these findings?) then we may miss the rare disease (Zebra) because United States is a country of immigrants.

Bottom line answer to your question gets to the rationale of having subspecialties, and areas of expertise. If things do not go well, an appropriate referral can be made, and the unusual diagnosis can be confirmed.