If you usually draw simultaneously in Upkeep you may need to slow down a bit to play with this card correctly. Actual steps is drawing in player order (lead first, then clockwise).
For example if someone drawing this card goes the last, the other players all had already seen their Upkeep draw when deciding which pile to pick. If goes first, then other players do not yet perform their Upkeep draw until you finished picking the pile.
Playing correctly may matter with other Dilemma, cards with effects on draw, when you pick a pile with weakness like Amnesia, or you may draw the shuffled back weakness from unpicked piles.