From Sick Care to True Healthcare: Bridging the Gap with Compassionate, Preventive Care

"True healthcare is not about fixing what's broken but nurturing what’s whole—fostering connection, prevention, and compassion at every level of care." - Mary Coughlin

From Sick Care to True Healthcare

The U.S. healthcare system is often called a “sick care” system, one that thrives financially on illness and crisis rather than health and wellness. This profit-driven model undervalues prevention and holistic care, and nowhere is this more evident than in the ongoing shortage of primary care physicians (PCPs). Yet, this problem doesn’t just affect the doctors—it ripples across patients, families, and communities, deepening inequities and compounding stress for clinicians.

As someone who advocates for trauma-informed developmental care (TIDC), I see a profound parallel between the gaps in the broader healthcare system and the challenges facing primary care. Both reflect a need to rethink how we approach health, moving beyond symptom management to a system rooted in prevention, connection, and compassion.

Why Primary Care Is Failing to Thrive

Primary care sits at the heart of health promotion and disease prevention. PCPs are the frontline defenders against chronic disease, offering early intervention and continuity of care that can transform lives. Yet, our system undervalues their role:

Incentives favor interventions, not prevention:

• The fee-for-service model prioritizes treating illnesses over preventing them. In the NICU, for example, countless resources go into managing complications in fragile newborns—yet there’s limited investment in supporting protective, trauma-informed practices that could mitigate long-term health challenges.

Burnout and barriers:

• PCPs face administrative burdens, high patient volumes, and lower pay than specialists, creating a workforce shortage that leaves vulnerable populations underserved. Similarly, NICU clinicians operate under immense pressure, where systemic inefficiencies and limited emotional support can erode their ability to provide care that centers connection and healing.

Reactive over proactive care:

• Just as a trauma-informed framework emphasizes proactive strategies to prevent developmental harm, the PCP model should shift toward promoting health before disease takes root.

The Role of Trauma-Informed Care in Shifting the System

Trauma-informed developmental care provides a framework for what true healthcare could look like—care that is proactive, preventive, and compassionate. Here’s how the principles of trauma-informed care align with what primary care (and healthcare as a whole) should strive for:

Safety:

• Both patients and providers need environments that feel physically and emotionally safe. For NICU babies, this means reducing stressors like excessive light and noise. For PCPs, this could mean creating workflows that support work-life balance and reduce burnout.

Trust and Transparency:

• Trauma-informed care builds trust with patients through open communication and consistent care. Similarly, PCPs who are given the time and space to build meaningful relationships with their patients can foster greater adherence to preventive measures.

Healthy Relationships and Interactions:

• Connection is at the heart of healing. Trauma-informed care prioritizes meaningful relationships, whether it’s between a baby and their caregivers in the NICU or a primary care provider and their patient. By fostering empathy, collaboration, and mutual respect, we can create environments where everyone feels seen, valued, and supported.

Empowerment, Voice, and Choice:

• Just as families in the NICU benefit from being empowered advocates for their babies, patients in primary care need to feel heard and supported in making decisions about their health. Providers, too, need systems that empower them to care for patients holistically.

Equity and Anti-Bias:

• Trauma-informed care emphasizes cultural humility and equity—an approach sorely needed in primary care, where historically marginalized communities often experience the worst disparities in access and outcomes.

The Ripple Effect of Compassionate Care

When we invest in prevention, we see dividends that extend far beyond individual health. Trauma-informed developmental care shows us the power of buffering against adversity—whether it’s providing nurturing touch for a preterm infant or supporting a stressed-out parent. Similarly, strengthening primary care could create a ripple effect across society, reducing chronic disease, lowering healthcare costs, and improving quality of life for all.

What Can We Do?

We need to reimagine healthcare systems that honor both the science and the soul of care. In my work, I’ve seen how trauma-informed developmental care offers a blueprint for building a more equitable, compassionate approach. What if we applied those same principles to primary care? What if we empowered clinicians, supported families, and prioritized connection as much as intervention?

The shift from “sick care” to “healthcare” will require courage, advocacy, and systemic change. But just as we’ve seen in the NICU, small, intentional actions—like creating environments that feel safe and empowering—can have transformative effects.

Together, we can move toward a healthcare system that values prevention over profit and connection over crisis. The work starts with asking ourselves: What would it take to put the human back in healthcare?

With gratitude and a heart full of hope,
Mary

P.S. I’d love to hear your thoughts! How do you see the shift from “sick care” to true healthcare impacting your work or community? Share your reflections in the comments—I can’t wait to connect with you!