First of all thank you for trying out the game! Since General Practitioner landed on Steam and other retail sites the player's community has nearly doubled its original size and that's helping me A LOT to find out what's working with the game and what isn't.
I'm receving a lot of feedback about the game and rest assured that I'm reading all of it, even improving the game as you are reading this announcement. However in a game as big as GP major updates are scheduled each month, even though as you might have noticed I'm also delivering smaller albeit very useful updates to fix the most important anomalies in the game, so you're getting a very dedicated support right now.
Let's talk about the game's difficulty: well, let's clear something first: some scenarios are in fact "Kobayashi Maru" like ones. The tutorial says at some point that sometimes you cannot do a perfect exam AND have a patient completely satisfied for many reasons. You could also have an angry patient (i.e. someone who fears needles and you HAD to take a blood sample) while achieving a perfect score.
That's perfectly working as intended and, as frustrating as it might be, it's a doctor's life.
However some medical exams ARE having some issues and as you saw in the news I'm actually in the process of checking them ALL (50), even to balance things up. Older exams (the one released more than a year ago on crowdfunding sites) were the most inaccurate of course, but I hope this overhaul will adjust them.
Also, the game is engineered to work as a trial and error one. You shouldn't worry too much about getting low averages and points. You (the player), like the MC (the Doctor) are learning together what it means and needs to be done as a GP and errors are normal, especially since most players don't have a MD. The game could tell you you performed bad but it will still continue and you will have learned something nonetheless.
There are no achievements for having a "Perfect Score" on each exam and I'm not planning to introduce them for this very reason. You can perform the exam, save and load and try to make it 100%, but it's for your own pleasure as it was never meant to be the purpose of the game.
Still, update 0.0.19 will have new Codex entries as to perform exams as well as new ways to get reviews from the Medical Board for each of them as you perform each exam. I hope this will clear things up.
Please also remember that the game's Early Access also means that game mechanics NEED to be tested and the more players are out there trying the game the easier is for me to understand what is working and what isn't. And for that I'm very grateful to you. :)
I hope you'll keep enjoying the game and telling me what needs to be improved. You can clearly see the potential of the game, so help me reach that potential!