How the system designed to keep us healthy started pushing us away

I meet people every single week—private clients and clinic patients alike—who have a version of the same story.

They went to their doctor with real concerns. They’d done research. They had questions. They wanted to understand their medications, their labs, their treatment plan—and instead of being met with openness, they were met with a wall. Their concerns were brushed aside. Their questions were treated as an inconvenience. Some were told outright that they had no business looking things up on their own.

That experience leaves a mark.

It changes how a person shows up in their next appointment, if they show up at all. It erodes something that should be the foundation of every healthcare interaction—trust.

This isn’t just anecdotal

The research on this is staggering. Surveys show that trust in physicians and hospitals has dropped from roughly 71% in 2020 to about 40% as of 2024—across every demographic, every age group, every part of the country. That’s not a dip; that’s a collapse.

A national poll found that over half of Americans feel their symptoms have been “ignored, dismissed, or not believed” when seeking medical care. A massive research review—covering more than 11,000 patients—found that this kind of dismissal causes real, lasting psychological harm and, in many cases, drives people away from seeking care entirely.

Let that sink in.

People are avoiding doctors—not because they don’t need help, but because the experience of asking for help has been so invalidating that they’d rather suffer in silence.

It’s both the system and the people in it

Here’s where I want to be careful, because I think the temptation is to pick a side—either blame the healthcare system entirely or blame individual providers. In my experience, it’s a combination of the two, and separating them is important if we actually want to understand the problem.

The system itself is fundamentally broken in ways that make good care almost impossible to deliver. The average primary care appointment lasts somewhere between 15 and 20 minutes. When you factor in travel, waiting, paperwork, and administrative overhead, the whole process eats up about two hours—and only around 20 minutes of that is actual face-to-face time with a provider. That’s the window in which you’re supposed to describe your symptoms, ask your questions, understand your treatment plan, and make informed decisions about your own body.

That’s not a setup for success. That’s a setup for people to feel rushed, dismissed, and unheard—because they are being rushed.

The system wasn’t built for the kind of care people actually need. It was built for volume. Insurance-driven payment models reward the number of patients seen, not the quality of time spent with any single person. Providers are under enormous pressure to move fast, document everything, and keep the schedule running. I don’t think most of them went into medicine to be assembly-line workers—they entered the field because they wanted to help people. The system they work inside often makes that nearly impossible.

That’s the system side.

The people side is harder to talk about, because it requires acknowledging something uncomfortable: some healthcare professionals have internalized a power dynamic that doesn’t serve their patients. They’ve been trained in a culture where the provider is the authority and the patient is the recipient—and questioning that authority is treated as defiance rather than engagement.

I’ve heard it from hundreds of clinic patients. “My doctor got defensive when I asked about my medication.” “She told me to stop reading things on the internet.” “He rolled his eyes when I brought up my own research.”

That’s not collaboration. That’s control.

I want to be clear—I don’t think most providers are doing this maliciously. I think many of them are overwhelmed, under-supported, and operating in a system that has never prioritized the kind of relational skills that build trust. Medical education, in my experience, teaches people how to diagnose and prescribe; it doesn’t spend nearly enough time teaching them how to listen, how to hold space for someone’s fear, or how to share power with the person sitting across from them.

The nutrition gap tells the whole story

If you want a single example that captures how the system sets providers up to fail their patients, look at nutrition education.

As of 2024, 75% of U.S. medical schools required zero clinical nutrition classes. Medical students reported receiving an average of about one hour of formal nutrition education per year. Only 14% of residency programs include a required nutrition curriculum, and only 14% of practicing providers feel comfortable discussing nutrition with patients.

Think about that for a second. The number one modifiable risk factor for chronic disease—what we eat—and the vast majority of doctors receive almost no training on it.

This isn’t a knock on individual doctors. This is a systemic failure. They can’t teach what they were never taught. They can’t confidently guide patients on nutrition when their education devoted less time to it than most people spend watching a movie. The system decided, somewhere along the way, that nutrition wasn’t important enough to prioritize—and patients have been paying the price for decades.

When a patient asks their doctor about dietary approaches to managing blood pressure, or blood sugar, or inflammation, and the doctor responds with a vague “eat less and move more” or dismisses the question entirely, that’s not the doctor being lazy. That’s the doctor hitting the edge of their training. The gap between what patients need and what providers were equipped to give them is enormous—and it’s only getting wider as people become more informed about their own health.

This one cuts deep for me, because informed consent is supposed to be the cornerstone of ethical medical practice. The idea is simple: before any treatment, medication, or intervention, the patient deserves to understand what it is, why it’s being recommended, what the risks are, what the alternatives are, and what happens if they do nothing.

In practice, from what I’ve seen—both in my own health journey and in working with hundreds of private clients and clinic patients—informed consent often looks like this: here’s your prescription, here’s the dose, see you in three months.

That’s not informed consent. That’s an instruction.

True informed consent requires time—time to explain, time to answer questions, time to sit with someone’s hesitation and meet them there. It requires humility—the willingness to say “here are the options, and here’s what I’d recommend, but ultimately this is your body and your decision.” It requires a relationship built on mutual respect, not a hierarchy where one person holds all the knowledge and the other is expected to comply.

When patients don’t understand their treatment plan well enough to meaningfully consent to it, we’ve failed them. Not because the treatment was wrong—maybe it was exactly the right call—but because the process stripped them of their agency. People don’t just want to get better; they want to understand how they’re getting better and why they’re making the choices they’re making.

The rise of self-directed health

Here’s the thing—people aren’t sitting idle while this trust erodes. They’re taking their health into their own hands. They’re researching. They’re reading studies. They’re asking questions in online communities. They’re seeking out practitioners who will actually partner with them rather than prescribe at them.

This is a double-edged sword, honestly. On one hand, it’s empowering. People becoming active participants in their own health is exactly what I’d love to see happening. On the other hand, without trusted guidance, some of that self-directed learning leads people down paths that aren’t helpful—or worse, that are actively harmful. Misinformation thrives in the vacuum that conventional medicine left behind.

The solution isn’t to tell people to stop doing their own research. The solution is to create healthcare environments where that research is welcomed, discussed, and integrated into a collaborative care plan. When a patient walks into an appointment with questions about a study they read, the appropriate response isn’t “stop Googling things.” It’s “let’s look at that together.”

What actually builds trust

I’ve been sitting with this question for a long time—in my own practice, in my work at the clinic, and in conversations with other coaches and clinicians. What I’ve noticed is that trust isn’t rebuilt through grand gestures or policy changes alone. It’s rebuilt one interaction at a time, in the smallest moments.

It’s rebuilt when a provider says, “Tell me more about that,” instead of redirecting to the next checkbox.

It’s rebuilt when someone’s concern is met with curiosity instead of dismissal.

It’s rebuilt when a practitioner admits they don’t have the answer and commits to finding it—or refers the patient to someone who does.

It’s rebuilt when the power dynamic shifts from “I’m the expert and you’re the patient” to “we’re a team, and your experience in your own body is just as valuable as my clinical training.”

This is what health coaching was designed to do. Not to replace medical care—that’s not what this is about—but to fill the massive relational gap that the current system has created. Coaching lives in the space between appointments, in the conversations that a 15-minute visit can’t hold, in the partnership that a volume-driven system can’t sustain.

All that to say —

The erosion of trust in conventional medicine didn’t happen overnight, and it won’t be repaired overnight. It’s the result of decades of systemic choices—how we train providers, how we structure appointments, how we incentivize care, and how we define the relationship between the person seeking help and the person providing it.

I don’t think the healthcare professionals working within this system are the enemy. Most of them are doing the best they can with the tools and time they were given. Some have had the self-awareness to recognize that what they were taught isn’t serving the people in front of them, and they’ve evolved. That shared intention—wanting to help people—is something I never lose sight of, even when I’m critical of the system they operate inside.

What I do believe is that patients deserve more. More time. More transparency. More partnership. More respect for the intelligence and agency they bring to their own care. The current model treats patients as passive recipients of expertise, and people are tired of it. They want to be met as whole human beings with valid questions, valid concerns, and the right to understand every decision being made about their body.

I hope this connects some dots. I hope it gives some language to the frustration that so many people carry but struggle to articulate. And if you’ve been one of those people—someone who left a doctor’s office feeling smaller than when you walked in—I want you to know that your experience is valid, it’s common, and it does not have to be the norm.

Sources

  • Perlis RH, Ognyanova K, Uslu A, et al. “Trust in Physicians and Hospitals During the COVID-19 Pandemic in a 50-State Survey of US Adults.” JAMA Network Open, 2024. 10.1001/jamanetworkopen.2024.24984
  • Bontempo AC, Bontempo JM, Duberstein PR. “Ignored, Dismissed, and Minimized: Understanding the Harmful Consequences of Invalidation in Health Care—A Systematic Meta-Synthesis of Qualitative Research.” Psychological Bulletin, 2025. 10.1037/bul0000473
  • U.S. Department of Health and Human Services. Medical Education Nutrition Competency Framework, 2026. hhs.gov

Rance Edwards is a National Board Certified Health and Wellness Coach (NBC-HWC) with over 2,000 clinical hours of experience, specializing in chronic disease management and lifestyle medicine.

If you’re looking for a healthcare partner who listens first and leads with your goals—not a protocol—I’d love to connect. Book a free discovery call—no pressure, just a conversation about where you are and what might help.

Photo by RDNE Stock project on Pexels