I tried to get a personal appointment at a large prestigious academic outpatient service. The website had a “contact us” link, which directed me to a very prolonged questionnaire wanting to know details (mainly financial) that practically included turning over my firstborn child. After spending extensive time clicking through the questionnaire, I finally came to a screen that “allowed” me to pick a time over two weeks in the future for a patient service representative to call me back and get more information to schedule an appointment. I was instructed many times that this would not be an appointment, nor would I be speaking to a professional. OK, I get it. This was just the next step. I received multiple annoying AI texts and emails reminding me of this “appointment” time over the ensuing weeks.

When I finally spoke to the young clerk, she made me repeat much of what I had already filled out and then had trouble with her computer screen because it wouldn’t accept the “reason” I wanted the appointment. Being the professional I am, I gave her multiple correct codes that she could use in Epic, but it seemed none of them worked. She had no solution. By now, I’m easily an hour into trying to make a simple appointment. She finally said a nurse from the outpatient department would call me back and see if I could be scheduled (no promises). As of three weeks later, I have not received a call, text, or email. I surrender!

Here’s another one: I received a bill for $130 for X-ray services from April 2023 from yet another large medical system. Yes, from over a year ago! The bill had absolutely no information that told me what was paid by insurance, just that it was “past due.” I was caught in voice mail bot hell for what seemed like hours as I was told multiple times, “If this is an emergency, call 911.” “Please enter the invoice number. Please enter the insurance number. Please click 2 if you want to know our hours of service. Please click 1 if you want to repeat this message.” Eventually, I found a live person who made me repeat all of the information I had painstakingly entered before.

I feel sorry for the help desk people, so I always try to be kind. They are likely poorly paid and under-resourced. But this was the finance department that was listed on the bill. Certainly, they are able to provide simple billing information. Wrong! All I wanted was an explanation of this bill, which she could not provide. I had already spoken to my insurer (another 30 minutes of voice bots to get to a live person), who informed me they had no record of the bill. The poor girl kept deferring to her script that said, “I’m sorry, you need to call your insurer to get information. No, I’m not allowed to send you the explanation of benefits. You need to get it from your insurer.” But I’ve already spoken to my insurer, who has no record of this.

Blah. Blah. Blah.

Unfortunately, these large health systems have centralized every aspect of phone contact, scheduling, billing, and service, and no one on the ground is allowed to have common sense or even make a decision that would be in the patients’ interest. These were simple tasks that could not be accomplished, yet both of these health giants advertise that they are innovative, cutting-edge, and care about patients. Corporations are not people. Institutions are not people. They don’t care.

Yes, I have both physical and mental fatigue from dealing with the U.S. health system. I couldn’t get my simple needs met, and I’m an insider who is not even sick! As a primary care doctor, I spend way too much time advocating for patients and trying to help them solve these bureaucratic issues. And I can’t even begin to describe the swim in the quagmire of pharmaceutical and insurance preauthorizations and denials. The caregivers and people who work in medical offices are doing their best, but the large conglomerates have made it impossible for the people who actually care for patients to use common sense and solve simple problems.

I was unsuccessful in solving my own issues and getting my personal health needs met. I don’t think it is an unusual tale.

Toni Brayer is an internal medicine physician.