During my first two years as a medical student, I have often been struck not only by how much medicine has advanced, but by how frequently the foundations of health are overlooked. This perspective was shaped early in my career through my first postgraduate role, where I spent three years collecting patient data for a multisite study evaluating a lifestyle-based intervention to reverse metabolic syndrome.

At a data analysis meeting with my team members, we were discussing the application of this study, and one of the principal investigators made a jarring comment: “The results from this study won’t be as influential now with these new medications on the market.” He was talking about GLP-1s. Unfortunately, he had a valid point. The health care system is built for acuteness. It’s very good at identifying problems and prescribing treatment. In terms of preventing or reversing chronic illness, work needs to be done.

A system built for reactivity

Chronic disease has become the defining challenge of modern medicine. According to the Centers for Disease Control and Prevention, “90 percent of the nation’s $4.9 trillion in annual health care expenditures are for people with chronic and mental health conditions.” Conditions like hypertension, type 2 diabetes, and heart disease now account for most patient visits.

As medical students, we are trained to find what’s broken and fix it, to be reactive. We’re not trained to nurture the conditions that keep people well in the first place, to take a more preventative approach. When a patient comes in with high blood pressure, the physician’s reflex is to prescribe lisinopril, not to ask what their diet, stress, or sleep look like.

This is not due to a lack of care from physicians, but rather a culmination of many factors deeply rooted in our nation’s health care system. Medical students get an average of 19.6 to 20.37 hours of nutrition education over four years, physicians have only 15 minutes to visit with patients, and nutritional counseling is rarely offered, let alone reimbursed when it is. This leads to a culture of reactive disease management rather than proactively combating the causes of the illness. The longer we rely on medication alone and ignore the core foundations of health, the further we drift from the art of true healing.

The cost of the medication-first approach

This medication-focused approach may control disease, but it rarely restores health. Patients are given one, or many, medications to treat their diagnosis with the possibility of being on that medication for the rest of their life. If that’s not anxiety-inducing enough, the medications usually come with a list of side effects that may be worse than the symptoms they were originally dealing with.

This flawed approach also has detrimental effects on physicians. It shifts them into a position of “manager of disease” rather than “healer,” which can lead to burnout. This, along with the added stress of working for a system that rewards procedures and prescriptions over prevention, forces the physician into a plan of care based on reactivity. Change is possible. The path to true healing begins where medicine first found its purpose: in prevention, nourishment, and the power of human connection.

Redefining success in health care

First and foremost, the health care system, along with the people who work in it and the people who receive care from it, needs to redefine what “success” means. Instead of focusing mainly on disease management metrics, success should be tied to clear improvements in patients’ functional health, preventive outcomes, and long-term well-being.

This shift can begin with specific policy changes. Hospitals could integrate lifestyle-centered care pathways into their electronic health records, create required referral processes for dietitians and health coaches, and include prevention-focused metrics in clinician evaluations. National organizations such as Quality Improvement Organizations and The Joint Commission could update accreditation standards to require hospitals to track outcomes related to nutrition counseling, physical activity programs, and chronic disease reversal rather than only tracking disease control.

Reforming medical education

Secondly, medical education needs to place far more emphasis on teaching future physicians how to counsel patients on behavior change, nutrition, and lifestyle modification. This shift should begin at the level of accreditation. The Liaison Committee on Medical Education could require a standardized and measurable nutrition curriculum as part of medical school accreditation, including competencies in counseling, motivational interviewing, and evidence-based lifestyle interventions.

The Accreditation Council for Graduate Medical Education could extend this emphasis into residency by requiring programs to provide structured education in nutrition and preventive care, along with assessments of a resident’s ability to apply these skills in clinical settings. In addition, continuing medical education requirements could include regular courses on nutrition and lifestyle-based interventions so that practicing physicians remain up to date on the evidence and more confident in counseling their patients. Together, these changes would ensure that the entire physician training pathway reinforces the importance of lifestyle-based care.

The role of the patient

Lastly, patients also play an essential role in this transformation. By asking their providers about options beyond medications for managing chronic conditions, including structured nutrition programs and exercise prescriptions, patients can show that there is real demand for comprehensive preventive care. As patient expectations shift, health systems and policymakers will be encouraged to prioritize lifestyle-centered approaches on a larger, system-wide level.

We stand at a crossroads in medicine. One path leads to more technology, more medications, and more management. The other leads us back to the roots of healing, including prevention, nutrition, and care that treats people rather than only their lab results. The future of medicine depends on whether we have the courage to choose this second path.

Jenna ODonnell is a medical student.