The American Board of Family Medicine (ABFM) uses virtual patients (VP) in Maintenance of Certification. User queries might be evaluated by calculating diagnostic value of information (VOI). Typical primary care queries address concerns far beyond efficient diagnosis. We identify practical constraints on VOI scoring in simulations of primary care practice. We imagine a Bayesian physician as the ideal candidate for VOI scoring. Bayesian physicians require an explicit decision making perspective and many local data.