Recent regulatory changes create a national staffing level for nursing facilities. Despite the much-needed rule change and the well-known stench of understaffed nursing homes that many Americans dread going to, most of the news cycle has portrayed this as a negative development. This is but one example where our patients are being manipulated into beliefs and actions that are contrary to their best health care interests. Recently, the same lies were told about the No Surprises Act. We cannot let these myths and stories continue to sabotage our patients into creating a system that serves those who care the least for their well-being.

As I see my patients, diagnose, and treat them, I feel that despite their trust in me and the treatment plan, the system that I stand upon is bound to fail them. Medical providers must pivot and begin diagnosing and treating the system as it has become the largest threat to the public and their patients. Americans spend $4.5 trillion on health care according to CMS, yet the health care system could be considered to be in the critical care unit: the largest physician-run hospital has declared bankruptcy; Walmart called it quits for providing care to the underserved population just a few years after a joint effort by Berkshire Hathaway, Chase, and Amazon ceased attempting to disrupt the industry. My own mother left the country for a medically necessary procedure because it’s cheaper than her deductible; private equity provider networks are filing bankruptcy now that surprise billing is illegal, and I still cannot tell my insured or uninsured patients how much their necessary blood work will cost them.

At various times, the sickness that has overtaken the health care system has been blamed on each player: doctors being paid too much, hospitals gouging their patients, insurance companies being for-profit, PBMs and drug companies setting unrealistic prices, and private equity showing its ugly hand. But upon examination of each culprit, the symptoms do not match: doctors are working more for less pay; hospitals are going bankrupt despite the large bills they serve; PBMs and drug companies are corrupt but aren’t large enough to ruin an entire system. Private equity is playing a game of cat and mouse with regulators, and although they leave destruction in their wake, the damage is typically limited to what they touch. Insurance companies are playing dirty in a world where they are mandated to exist, but only the most ruthless survive. One piece of regulation will not fix this mess, but one piece of legislation can hardly pass Congress and become law. We can no longer let ourselves and our patients be victims of this sickness and suffer burnout and death as a result. We must begin educating our patients on what they must do to fix it.

To reign in the system, we must educate our patients that the system needs to be reformed. We pay dues to national organizations to lobby our stubborn lawmakers, but what these organizations cannot do is bring the conversation to the everyday man and woman. We have to do that in the exam room. When our patient asks about their outrageous bill, tell them the treatment for that is we must remove corporate greed from the health care system, even if it means making it illegal for private equity to buy more practices; when they complain about the price of prescribed medication or a procedure, tell them to speak with their legislator and advocate for standardized pricing or doing away with prior authorizations or unreasonable formularies. The list goes on, but it can no longer be appropriate for us to shrug and say a manufactured lie that perpetuates our burnout.

As we treat our patients, we should use our broad reach and the trust the patients have in us to help them see that each of their decisions drives the broken system toward its demise or a solution. We must rectify the myths, such as medication prices have to be outrageously priced to encourage innovation, proclaim the successes such as the No Surprise Act, and give them the state insurance department or health advocate contact information when the appeal has been lost. We must let the patients know that we have successfully diagnosed the system and that the treatment plan is for our patients as an aggregate to stand up and fix it.

Joseph Lanctot is a nurse practitioner.