hard it is to accurately diagnose things that don't fit easily in a differential diagnosis. Plus, the replication crisis that is bubbling through the medical field doesn't help

This is so true and glad that he acknowledges it. I am one who does not fit in the box. The doctors that discuss these things make up the best doctors. I have meet a few and know some of them.
All I ask of a doctor is honesty. I don't care if they make a mistake. Stand up to it and correct it. It's not hard.
What gets me is when they have superior attitude syndrome.