J Health Behav Med Hist 2025-23.
Healthcare is still a patient itself
Robert C. van de Graaf, MD, director
MEDTCC Institute for Health, Behaviour, Medicine and its History, The Netherlands
“Patients do everything they can to burden healthcare as little as possible. The patient as a ‘Little Miss Greedy’ doesn’t exist. What they do ask for is: ‘Good guidance, especially when it comes to self-care and lifestyle.’” – Arthur Schellekens, Dutch Patients Federation [1]
A reassuring message, you might think. Patients don’t want more care – they want to learn how to take better care of themselves.
Until you read where they seem to be asking for that help: within healthcare itself. And that’s where it starts to chafe.
Because if there’s one sector that struggles with lifestyle and self-care, it’s healthcare itself. Anyone who knows the field up close knows how thin the line is between caring and burning out.
Healthcare professionals who teach others about balance often lack it in their own lives. We preach recovery, yet take on extra night shifts. We advise movement, yet sit for hours behind screens. We advocate rest, yet live on adrenaline, coffee – and sometimes our children’s methylphenidate.
At the end of the day, we drink to relax. We take pills from our own workplace to sleep. We take painkillers to keep going. Within healthcare, alcohol and medication misuse are more common than in almost any other sector. We numb what we can’t heal, and live off our reserves.
Healthcare is a sector full of people who care for others – and lose themselves in the process. It has become its own mirror – cloudy, yet honest.
That’s no coincidence. Healthcare was never designed to create health, but to repair disease. For centuries, “health care” was about damage control: setting bones, stitching wounds, removing tumors, fighting infections. Repair care – meant to get people back on their feet.
But the better that care became, the bigger it grew – and the further we drifted from the true source of health itself. We have come to rely on what lies outside us, and forgotten how to care for what lives within us.
Self-care became secondary, because healthcare could always fix it. Now we’re paying the price. Not because healthcare has failed us, but because we have overused it. We’ve mistaken repair for health.
And yet, it’s not strange that people seek help with lifestyle change. We’ve become so far removed from our natural self-regulation that change can even be risky without medical supervision.Those who quit smoking or drinking, or suddenly start eating healthier, can become physically destabilized.
That’s why we do need healthcare – not to do the work for us,
but to guard against the risks of recovery, and to increase the chances of success.
At the same time, healthcare itself is unwell. It has sacrificed its own health to the ideal of repair. It keeps working when the body protests. It pushes through when it’s empty. It has become a patient itself.
Perhaps that’s why healthcare is now developing the field of lifestyle medicine – not only as help for patients, but as a form of self-therapy. We are learning again how to live, how to recover — as a sector and as human beings – from our own exhaustion. Only when we master that can we truly teach others to take better care of themselves.
The patient is not a Little Miss Greedy. They’re not asking for more care, but for direction. Not for pills, but for guidance.
That direction lies outside the realm of medical care – in rest, rhythm, relationships, nature, and meaning. There grows what healthcare has been trying to restore all along.
Perhaps this is the moment to reverse the order: not care first, then healing, but healing first — and only then, caring.
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