Apparently, two appointments in 2023 constituted a lifetime commitment.

Nobody told me. I would have dressed better.

I called a rheumatology practice to collect my medical records. I’d been there exactly twice, three years ago. I couldn’t remember the doctor’s name. First, we had to establish that I had ever been a patient.

Yes. Found me. Excellent.

For the record, I remembered the care positively. The nurse practitioner had been so helpful that I’ve quoted our conversation for years. She was no longer there. Her conversation stayed with me; the doctor’s name did not.

Then I learned the office has an internist—the type of physician I’m trying to get in to see, with a wait until December elsewhere.

Well, that’s promising. Could I see her?

No.

Because I had already seen the other doctor in the practice.

Three years ago.

Twice.

I repeated this back, just to make sure we were both participating in the same conversation.

Yes.

Then a giggle.

“I know it’s silly, but…”

Policy.

I had apparently experienced the administrative equivalent of a one-night stand and accidentally entered a covenant marriage.

Technically, there were two appointments. Apparently, the follow-up was the wedding.

I don’t remember the man’s name. I remember his nurse practitioner. And now I’m being told we’re exclusive.

My medical chart has a noncompete clause.

I can change healthcare systems. Transfer records. Learn another portal. Retell my medical history. Wait months.

But see somebody else in the same office?

We don’t support that lifestyle.

The part that makes this especially ridiculous is that I wanted to return because I’d had a good experience. I even called back to explain that. This was an office I remembered favorably while working to move my care elsewhere.

They had earned enough trust for me to come back.

The policy took it from there.

The woman on the phone recognized the absurdity. She may have had no authority to resolve it. So there we were, agreeing that something was silly while I remained responsible for its consequences.

The policy was fine. Please relocate the patient.

And that was one of the pleasant conversations.

At another office, I was expected to sign on a digital pad without being able to see the document attached to my signature.

I asked to see it.

This became an event.

There was a paper copy offered as essentially the same thing. There was a screen facing someone else. There was increasing frustration with me for wanting to see exactly what I was signing.

I offered options. An iPad. A computer. A paper document I could actually sign. Pick a format. I’m versatile.

“Essentially the same” is a fascinating phrase to introduce at the precise moment you’re asking for a signature.

Essentially visible. Essentially informed. Essentially absolutely fucking not.

My teenager was there. The conversation was loud enough to have an audience. I felt publicly cast as the difficult person for maintaining a boundary I would teach my children to maintain.

An educational outing, apparently.

Then the issue followed me into the exam room, where I explained it again.

The time spent getting me to agree to something I couldn’t see could have been spent showing it to me.

At another appointment, I asked for something to place under my bare feet on the scale. I was directed four rooms down the hall to get it myself, with the problem framed as my failure to wear socks.

I got the paper. I stepped on the scale. Then, while waiting in the exam room, I added “find a new primary” to my to-do list.

That decision had a history. By then, I was repeatedly chasing the basic work of appointments for myself and my family: prescriptions, orders, follow-ups. I could not identify one requested item that had gone through without my having to pursue it.

By appointment three, I had acquired an unpaid administrative position.

The scale incident was simply the employee orientation.

A different doctor once compared me to his “crazy sister.”

I can only imagine Christmas dinner. Fortunately, I was already pursuing relationships outside that family.

These experiences span different offices. Across four primary care providers in twelve months and multiple specialists, I’ve spent an extraordinary amount of time trying to get past the administrative interaction and into the medical conversation.

I have actual questions waiting.

How does this treatment fit with my existing treatment plans? Which symptoms belong to which condition? What overlaps? What might conflict? What else could be contributing?

I have multiple things happening in one body. They did not consult the departmental directory before interacting.

I need help understanding those interactions.

Instead, too many appointments have become negotiations about whether I’m allowed to ask the question.

From my professional perspective, I recognize the strain: overloaded people, fragmented work, mistakes passed along until they reach someone who has to stop and deal with them.

That someone keeps being the patient.

Mistakes happen. What matters next is whether the organization corrects the process or continues sending the consequences to the person paying for the service.

“Please follow up if you haven’t heard from us” gets rather impressive when I’m following up on the follow-up to the thing we discussed at the follow-up.

At some point, I’d like an appointment with the original task.

I also recognize what happens when authority expects compliance and receives a reasonable question instead. The conversation becomes about the person’s willingness to cooperate. The original need sits there, unattended.

I can have compassion for an exhausted workforce. I still need care.

And I know those two things can fit in the same room, because I’m experiencing it.

Through our family’s benefits, I now have a care team helping gather options, send information, coordinate next steps, and follow up.

If I haven’t reviewed something yet, the conversation goes roughly like this:

“Okay. Let’s go through some of it in the fifteen minutes we have now. Then we’ll schedule another call. A week or two? What time of day works best for you?”

Excuse me.

You found the bottleneck and offered to help?

Nobody asked me to become a more resilient bottleneck first?

They work with the capacity I actually have. We use the available time. We agree on a next step and when to return to it.

That is what great looks like.

I still make decisions. There are still questions, limits, and work to do. Someone else picks up a paddle.

Same patient. Different crew.

That comparison matters. I have professional experience in systems design and navigation. I have a background that makes me attentive to contracts. I have additional support through our benefits. Through my husband’s care, I also get to see examples of effective coordination at the VA.

Even with those resources, this has been exhausting.

How much work are we expecting from someone who has none of that support and is already sick?

When I’ve caught myself wondering whether I’m the problem, that question helps restore perspective. So does remembering what I did for a living.

My résumé did not evaporate when I put on a paper gown.

I can recognize when a process consumes more capacity than it returns. I can also recognize the difference when that changes.

Which is why I’m already moving.

I’m planning to shift my specialist care to Ann Arbor and coordinate trips with my husband’s VA appointments. I’m choosing where to put my time based on where I expect to find the conversations and coordination I need.

I’ve done enough canoeing, kayaking, and paddleboarding to know that paddling harder has limits. Your arms are tired. Your heart rate is up. You’re hot. The scenery is showing a concerning lack of ambition.

Eventually, you change something. Shift your weight. Change your angle. Move toward shelter. Turn and find out what the current can do for you.

The wind is unlikely to improve after hearing your explanation.

Neither is a policy that everyone agrees is silly but nobody can reconsider.

By the time that phone call ended, choosing a new doctor was already next on my list.

I was collecting my records. I was also collecting material.

Switching systems is a fuck of a lot easier than trying to integrate myself into one that hasn’t figured out how to work with me.

Which brings me to the question my husband texted earlier that day, before any of this happened.

“What’s your favorite ERP system?”

Enterprise resource planning. The software businesses use to coordinate operations and resources. The sort of professional question we occasionally float past each other.

My answer came immediately.

“The one the implementation team hasn’t fucked up yet.”