The Portland offices for InterMed, which sent an email to patients asking them to be more considerate of staff. Gregory Rec/Portland Press Herald

I was still seething from two big bills from other doctors’ offices for unnecessary medical expenses when I got the email from my primary-care provider. The subject line: “Kindness and Respect Matter.”

In a note sent to patients last month, InterMed Chief Medical Officer Dan Loiselle acknowledged the difficulties around accessing health care, including long hold times and hurdles to getting prior authorizations, but was writing “to gently remind everyone of the importance of kindness and respect in all interactions, regardless of what we all might be dealing with.

“Our dedicated team is here to support you, and we ask that you extend the same courtesy to us. In times of stress, we recognize it can be difficult, but a positive and respectful environment helps us all provide the best care possible,” he said.

Sounds reasonable enough, if you’ve never dealt with our health care system. Knowing the tears I’ve shed and the screaming I’ve done in my head over my own health care aggravations, I wasn’t surprised to learn that some people couldn’t help but lash out — at least that’s what the message seemed to imply had happened.

InterMed wouldn’t say what sort of incidents or behavior prompted the email to patients, citing doctor-patient confidentiality, and didn’t answer questions about what protocols it has in place for dealing with aggravated patients or helping them work with health insurance companies. As my frustration with getting any information from the southern Maine medical practice grew, so did my sympathy for the people who failed to maintain “a positive and respectful environment.”

Of course, I don’t think employees who have nothing to do with patient care or our broken system should be taking the brunt of our anger, if that’s whom InterMed patients are treating unkindly. Nor do I think the solution is shooting and killing the CEO of an insurance company — even the one whose app gave me a cost estimate that was a fraction of my bill (no, that’s after you’ve met your deductible, I was told by UnitedHealthcare’s help center, whose employees surely also take undeserved heat).

But if doctors’ offices want us to be more considerate, they need to do more to help us navigate a complicated system that they’re more knowledgeable about than we are. Give us the billing codes to the procedures you’re ordering. Help us understand our options and allow us the time to weigh them. Inform us, when we ask a question, if the answer is going to cost us. If that’s beyond what bedside manner entails — though I’d argue, today, it should — then offices need to have someone on staff who handles that aspect of our health care. That way, we won’t take it out on whoever happens to be in front of our face.

With the amount of self-advocacy health care requires these days, the line between being assertive and being rude is a fine one and, when needs aren’t being met, it’s easy to cross. While my anger revolves around the lack of consideration for health care costs, InterMed Chief Human Resources Officer Lindsay Fitzgerald said the frustrations referenced in Loiselle’s email mostly have to do with patients getting care in a timely manner.

Both are among the upsides of the direct primary care model, according to Maine doctors who have adopted it. By breaking with hospital systems and insurance companies, they say, they have more control of their care and time for their patients.

No wonder the model has risen in popularity both in Maine and nationally. But, as I learned at a recent dentist appointment, that level of care is possible in a more traditional setting, too.

Although I usually sit back and take whatever fluoride treatments or X-rays are recommended without question, after those two big bills, I decided I couldn’t risk it. Before my cleaning, I asked my hygienist if I was scheduled to have any additional procedures. Why, she asked, do you have to be somewhere? No, I said, I just can’t afford it.

By the end of my appointment, she had consulted with my dentist and determined I could put off any X-rays for another year or two, and before I came in for them, she said she’d run it through my insurance so she could tell me how much it would cost ahead of time. If I hadn’t been lying prostrate with plaque-speckled glasses on, I would have given her a hug.

That kind of courtesy is easy to return.