I had to see the only available PCP to see anyone else. This automatically prompted medical releases that, even if unethical, would have still made everything technically legal. If it was an emergency room trip, there were always the same two or three physicians there, so they all became aware of me from the first couple of episodes and could warn any specialist they referred me to see.

Same deal with laboratories and radiological facilities. When you've got only one or two options in town, they have your consent to release PHI by default if you ever want the results interpreted, and their interpreting physician can just accompany the report with a courtesy call to the receiving provider about a suspected diagnosis.