In course of preparing this article, one particular patient came to mind who encapsulates the issues in the current system as they relate to post-transplant patients and skin cancer. During a routine posttransplant follow-up – this patient had a successful kidney transplant for more than 10 years. I requested that she see a dermatologist for preventative skin cancer surveillance. In the past when I had made this request, she told me it was on her to-do list and promised to make the appointment soon. This time, however, she gave me a different reply. Between seeing her primary care provider three to four times a year, nephrologist twice a year, transplant nephrologist once a year, endocrinologist three to four times a year and cardiologist once a year, she was overwhelmed by the number of separate providers she had to visit. She further explained that while she may have new skin lesions and would think about making a dermatology appointment soon, she did not understand why one of the providers could not take care of it. Her frustration at the system was greater than her desire to possible avoid skin…..