Can details in an order really be enforced

My order states:

DECISION MAKING
Before making any final decisions or commitments, the parties shall consult with each other by giving reasonable advance notice and time as needed (but in no event less that 14 days notice except in the event of emergency or other exigent circumstance) for proper consideration of all matters reqarding the child’s education, summer camp selection, work-related day care, medical and dental issues, health welfare and other matters of similar importance.

should the parties fail to agree on matters regarding the minor child , the mother shall make the final decision provided she does not abuse this right. Should the Mother be adjudged to have abused this right, this right shall be changed to the Father under the same requirement.

Appointments
The parents shall keep each other informed of all appointments for the minor child by providing as much advance notice as possible to the other parent so that each parent has the opportunity to attend such appointments. Further, both parents shall keep each other informed of the results of said appointments, as well as after-test results or other improtant information, within 24 hours of the appointment or of obtaining the results of the tests.

The current problem
I am the Dad and my son has a learning disorder
I am being completely bypassed when it comes to medications/adjustments etc.
Here is the continued pattern:

I get an email late in the evening with a scheduled doctor appoinment for the next day. I can not make arrangements with my job to be there (she knows this) I have called and confirmed that she made the actual appointment days before she notified me.

After the appointment I get an email stating the decisions made with little or no real details. Often referring to information collected from my sons school that I have never seen nor had any knowledge of. (There is language in the order requiring we share all this information as soon as we get it)

By default (I was not there) I was not consulted with in any way and my input could not be considered and I have no knowledge of the information they did use to make the decision.

I was not informed prior to making the appointment that there are issues mom wants to address with a doctor. The email about the appoinment does not clarify what the issues or her intentions are, just a date and time.

I took her to court once on this matter with no lawyer (for contempt and abuse of final decision making authority). I did not present the case well. The judge stated that in these cases she is not making a decision but the doctor is. It did not appear that the Judge cared about the rest (lack of notice, not considering my opinion or even asking for it, not supplying me with complete and detailed information etc)

MY 3 questions:

Can a person really bypass consulting with the other party and ask a doctor to do something then claim they made no decision at all but rather the doctor did. In my opinion going to the doctor requesting services is a decision in itself.

Can a person really bypass every part of an order in the way of supplying information and notice to the other parent and get away with it.

It seems whenever I am in court all they care about is paying child support and visitation times. Is this really how it is, am I wasting my time trying to enforce ordered rights that really dont mean anything?

If the judge has stated that the doctor is the one making the decision your ex is not in contempt on that issue. Her continued lack of notice regarding appointments however does seem to me to be a clear violation of the order and you may file another motion for contempt and attempt to have the decision making power vested in you as the order states it will in the event your ex abuses her authority.