I read that about the doc saying school didn't matter at this age?? what the heck ??
Any stressor at any age, doesn't matter where.. could cause problems. (oh and Alex, I get eye twitches too. I read that it is likely due to stress.)
Since you did say there was nothing new and home life was okay, he should have done a full assesment and history.

I really detest docs that don't bother to do their job. They make an assumption and throw down the attitude to boss patients around. It's suppose to be a partnership.
I get irritated at clinic visits, the doc and nurse chat about E like he isn't even there.
I make a point of moving the chair off to the side so it is obvious that I am a bystander, not a person in charge of his health decisions.
I made the mistake last visit of sitting close by and the doc would talk to me and barely a word to hubby.. I was like uhhhh , you have to ask him since he is the one dialyzing..
But we don't this doc that well yet, hubby is still building that partnership.
I miss the nephrologist he had years ago-- she was awesome! He would ask for med changes, she would counter with reasons why those choices could be good or bad. And together they would hash out a deal .
Nice give and take. She would draw diagrams and explain everything.
Sadly she moved on to a new clinic and less patient load -- understandable as she had young children at home-- that was funny too.. hubby thought she was getting fat-- nope she was preg.