Ok.
For folks who truly have medfet, I have to think there's gotta be SOMETHING from the real exam that feeds that medfet, whatever that may be.
For folks who get nothing out of real exams, i would say those folks don't really have a medfet. At best, a "medfet fantassy' of what they fantasize about having happen that is too far fetched TO happen.
I can understand how one would arrive at that conclusion! It could seem a little funny to say "Well here I am on this medical fetish site, discussing every aspect of examination in lavish detail, fantasizing about it daily, longing to be awkwardly probed...oh, my annual appointment? Yeah I've been putting that off for weeks, freaks me the hell out!" It seems initially incongruous, no?
I would ask though, do we presume a BDSM enthusiast would welcome the opportunity to be restrained and beaten by every man or woman they pass on the street? If someone says, "Oh man I love pizza, it's my favorite food" do we tell them they're wrong if they don't want to eat it for every meal, or if they only enjoy certain toppings, or order exclusively from one pizzeria? We certainly wouldn't presume someone with a kink for noncon actually wants to be assaulted in real life! Even on this site, where everyone bonds together over their shared overarching fetish, there's a great deal of variance. Some enjoy being gently probed, some roughly handled. Some are all about the stethoscopes and basic physical exam, while others fantasize about being anesthetized and prepped for surgery. Clearly there are many different ways to express the fetish.
There are many different angles to approach the fetish, too. Some people may have come here due to pleasant early memories at the doctor's office, perhaps their first tinglings of burgeoning sexuality. It's easy to see why that would make an impression on someone's developing psyche. Others, though, may recall the fear and anxiety they felt, the pain of a particularly scary procedure, or something they were subjected to against their will. This sort of experience would leave an impression, too! Wanting to act out a similar scenario, even a fearful one, can be empowering in a big way, because it is ultimately in that person's control as they structure the scene. Contrast that with an actual visit to a medical professional, where the doctor could be unexpectedly crabby or brusque, where the diagnosis is uncertain, where there is most definitely no safe word to end the scene.
In conclusion, it's rad if you can and do get off on your real-world medical exams, and it's also okay if you don't. There's no one right way to interact with medfet.
As for myself? I've experienced it both ways. Sometimes my heart is racing and stomach is churning with anticipation or arousal, and sometimes it's doing those things in near-panic and absolute dread. And sometimes it is surprisingly difficult to distinguish between the two. ;3