In the U.S. I actually have witnessed both, seemingly contradictory, aspects. That is cases as you mentioned in urgent care where there is an extensive work done to you for no reason, that ends up to be even unrelated in the end, just to cover all bases and follow protocol. Yet, cases where a personal doctor is reluctant to prescribe blood work or chase symptoms that are not life-threatening, even with prior family history due to costs.

For instance, there was a with E.U. doctor referral for ultrasound and blood work. The reply was if it bothers me to consider painkillers or wait for it to get worse and come back. (Why should I take painkillers if we are not certain of the cause to begin with?) On the other hand, walking a friend into urgent care for their leg leads to a full checkup.

With the above I want to complement your view, that there is some extreme behavioral gap in how doctors' react that is not related with the patient's ailment.

And there is a lack of a middle ground between urgent care and making a personal doctor appointment. I find it surprising that if I break my leg I need to go to urgent care. There is no contagious disease, and I am not going to die if left untreated, but it is an event that requires time sensitive treatment. Yet, there is no concept of walking into a doctor's office, or at least it is not that easy.

Example case 2. Eye pain etc. After failing to get an appointment with any doctor, K is instructed to go to urgent care. K called ahead and asked if they could handle their case, yet there was no actual ophthalmologist there. K got a full "checkup" and got a "it's probably an infection"; they were prescribed antibiotics. Next day K's eye pain worsens with new symptoms. K gets an appointment with an optometrist so as to be referred to an ophthalmologist. It is the protocol to have an optometrist check you first apparently. Another half a day later, an ophthalmologist actually checks K and comments "thank god you came in this fast." That was after my wife begging several times on the phone with several doctors, that we need an appointment today and not in 2 months. Yes, patient K is I. (I could not make any phone call or walk at this point, I was for all intents and purposes blind and in pain.)

Thus, the system in place from my experience assumes that the patient i) is stupid ii) if not dying does not need a checkup within the next 2 months, or else has to go to urgent care.

Thus is it really the patients' fault when they are used to walk into urgent care to get any sort of timely treatment? Why would a person with a broken leg take the invaluable resources from someone actually in need of urgent care? I argue the system somewhat enforces this over-treatment. You have to go through the urgent care for any timely treatment, it is rightfully instilled in you that perhaps there is something serious going on. You would not pay urgent care prices for a strain right? Thus, it must not be a strain.

My E.U. experience: As a patient,you walk in to a doctor you consider appropriate (You can also make an appointment ahead of time and ask if uncertain). One might wait for a few hours. If it is deemed urgent, the doctor will make sure to see you first, or send you to urgent care/emergency room or hospital. If the doctor is not of the appropriate specialty, they will refer one appropriately. Paying everything out of pocket, costs extremely less compared to my copay for urgent care -- this is a simple doctor appointment, no urgent care.