Medicine is messy. And healthcare is getting harder to handle.

We need to raise collective awareness about the subtle ways that health systems disempower patients.

As both a patient and a provider, I’ve seen it from both sides. What surprises me most about the landscape of health care is the profound passivity that’s been baked into health care systems. It evokes a quiet resignation that many patients (including me) slip into. It’s not apathy. It’s more like exhaustion from navigating systems that don’t really listen.

Over time, I've watched the gap widen between patient and provider.

Most of us as patients (or advocates) don’t feel heard, so we stop speaking. Or we wait, hoping the system will save us. But at some point, each of us must decide: Am I just putting up with this? Or am I willing to step into the role only I can play—the one who must live this life, manage this body, and choose how I spend my minutes, my money, my energy?

In my years working as a primary care physician assistant across pediatric units, group homes, and hospital settings, the most powerful lessons didn’t come from textbooks or top specialists. They came from families—often the poorest ones—who showed up for each other with fierce compassion. These weren’t people with unlimited resources, but they came armed with attentiveness, empathy, and persistence. They knew nurses’ and providers’ names, advocated respectfully, and created a circle of care that uplifted everyone involved.

These patient advocates knew how to hold a mindset of gratitude, take notes, ask questions, and build bridges of mutual respect with everyone from janitors to specialists. They didn’t bulldoze the system—they worked around it, through it, and above it with compassion and clarity. Their quiet leadership brought out the best in anyone who stepped into the room.

Meanwhile, the system itself seems built to divide. Providers are overburdened by endless notifications, audits, and mandates. Patients are handed “satisfaction surveys” that invite blame rather than responsibility and measure satisfaction but not solutions. Insurance companies increasingly push one-size-fits-all treatments regardless of personal need. I’ve seen firsthand how this causes patients and providers to speak at, not with, each other.

The result? A widening gap between patients and providers, both distracted by demands and disconnected from each other. Everyone's burned out. And yet the stakes keep rising—especially for the “little guy”: small families, small businesses, the aging, the overwhelmed. They’re the ones getting squeezed the hardest right now. And worst of all, we’ve been conditioned to think this is normal.

But when patients—and their advocates—step into their role as active collaborators, everything changes. Healing can happen even inside a broken system. I’ve seen patients and families become savvy navigators, building respectful, informed partnerships with care teams. They research, ask questions, set boundaries, and bring their full presence. They don’t let ego or fear rule the room. And they remind us that at its core, health care is about human connection—not compliance. This kind of ownership fosters self-knowing and, over time, self-mastery.

What I’ve heard myself saying lately is this: in these times, the little guy is in big jeopardy. The only ones I’ve seen make it through are those who really pay attention—who recognize where the real power lies. I learned this from the poorest of the poor: those who survive and thrive are the ones who build a circle of trust, rely on instinct and discernment, and understand they can't do it all alone.

Whether it’s health or wealth, these folks learn to read the room, read the system, and make wise, informed choices. It’s why I believe in building perspective, vocabulary, skills, and tools for problem solving. I call this patient empowerment. It is not easy. It requires meeting resistance, both internal and external as a part of the process. It cannot be done alone, due to the multiple forces and blind spots involved. This is what I practice in my Health Coaching and teaching. I hope to bring this concept into the conversation so we can re-balance the collective awareness and co-create a more viable future.

So here are the important questions:

• What would change if more patients stepped into that role—with confidence, clarity, and a trusted circle to back them up?

• What if we started listening to ourselves again, and led with that kind of knowing?

• What might change if we stopped waiting and started facilitating compassionate collaboration?

Your comments, stories, and ideas are welcome.