Beyond Enhanced Care Models of Healthcare: Why Patients Must Be True Collaborators in their Care

Beyond Team-Based Healthcare: How About Healthcare that Depends on Collaboration with Patients Like Me?

“Healthcare today is in the midst of profound transformation.” Is anyone else tired of reading headlines like this? Healthcare has been undergoing a “profound transformation” for the last 30 to 50 years. Yes, healthcare systems—from Stanford University to Idaho’s own St. Luke’s Regional Medical Center—are constantly working diligently and with intention to improve access, standardize care, and reduce unnecessary variation, all while trying to support their respective workforces, who are currently facing unprecedented change. These efforts matter. They are necessary. And they deserve recognition…to a point.

The reality of “profound transformation,” or the latest “Enhanced Care” models, is that we are not transforming how care is delivered—we are only redesigning how healthcare shares responsibility among itself. A profound transformation would be a “Collaborative Care” model that includes patients working with healthcare as experts too.

While Enhanced Care models clearly define how clinicians and other providers collaborate with each other, they do not describe how patients want and need to actively collaborate with their healthcare teams in goal setting, decision-making, and ongoing care management. After all, most of my healthcare is practiced and executed outside of a hospital, doctor’s office, or any other formalized healthcare setting. Healthcare is practiced within life; it’s not a transaction, as our system is currently designed to be.

As we continue to move toward so-called value-based care and increasingly complex patient needs, outcomes will depend not only on how well healthcare coordinates with itself—but on how effectively it partners with patients as co-creators of their care.

The Unspoken Assumptions in Modern Care Models

At first glance, healthcare appears increasingly “team-based.” Physicians, nurses, advanced practice providers, behavioral health providers, pharmacists, and care managers are brought together into integrated workflows. Polished visuals are created with fancy graphics, and words like “accountability” and “transparency” are produced and slapped onto everything from brochures to websites. Internally, huddles replace silos. Templates are redesigned, and schedules are standardized under the umbrella of improved access.

Don’t get me wrong—these changes represent progress. It’s at least an attempt to remember that care is a major component of healthcare.

But embedded within these models—we can argue later whether it’s intentional or not—is a persistent assumption: care teams consist only of doctors, nurses, and other professionals, while patients sit just outside the circle as recipients of what their team produces.

Even in care models described or promoted as patient-centered, patients like me are frequently positioned as the endpoint of coordination rather than as participants in care. We are constantly improving care around patients, but not organizing care with them.

This distinction might seem subtle at first, but it is foundational to why we are constantly bombarded with calls for profound transformation.

Working For Patients Is Not the Same As Working With Patients

Participation matters.

Most doctors—and especially nurses—would say they partner with their patients. As a chronic patient, I would agree. As much as possible, they believe in shared decision-making, mutual education, and informed consent. Yet structurally—and culturally—patients are rarely named as members of the care team itself.

That omission has consequences.

When I’m not explicitly included as a partner in care design and delivery:

• Goals are often defined clinically rather than by my definition of quality of life.

• Care plans may succeed medically while failing me practically.

• No one is more engaged in my health than I am, yet healthcare still feels the need to “create” engagement with me.

• Responsibility for outcomes falls disproportionately on me—as if I must have done something wrong when my health does not improve.

Healthcare, under these circumstances, becomes something I experience rather than something I meaningfully participate in.

The Reality of Outcomes: Care Is Co-Produced

Health outcomes are not delivered the way services are delivered in other industries. For example, I am not a healthcare consumer; I am a reluctant participant. A doctor cannot prescribe an outcome for me—they can only partner with me with the goal of improving my quality of life.

Once again, patients like me live with our conditions long after appointments or hospital stays end. We manage medications, navigate barriers in real time, weigh trade-offs, and make thousands of decisions daily that no care team—however well “Enhanced” or AI-enabled—can control or replace.

When patients are co-collaborators in their care:

• Care plans reflect their quality of life, constraints, and priorities.

• Behavior change becomes achievable rather than aspirational.

• Engagement happens across the entire team, not just the patient.

• Outcomes improve because care aligns with what matters most to the patient receiving it.

When patients like me are positioned as passive recipients, results are treated as something a doctor or hospital must prescribe. Even the most efficient or Enhanced Care team structures will struggle under the weight of expectations that teams cannot realistically fulfill alone.

Provider Burnout and the Cost of Excluding Patients

Too often, burnout is framed as an issue of workload, staffing, or efficiency. Those factors are real, but they are not the whole story.

When patients are not considered part of the team, providers quietly assume responsibility for outcomes they do not fully control. They are also robbed of the chance to truly get to know me as an individual. They carry the cognitive, emotional, and mental burden of making care work in an environment where my capacity, readiness, and willingness are not fully integrated into the equation.

True collaboration redistributes more than just tasks—it shares responsibility, agency, and meaning. In other words, all members of the care team are recognized as experts in their area of contribution.

Why Language Matters More Than We Think

Culture follows language. What we name, we prioritize.

When Enhanced Care models list providers but not patients, they reinforce the old hierarchy—patients as dependents, doctors as decision-makers. However, if these models explicitly named patients as partners, trust would deepen. Accountability would become shared. Most importantly, care would become more humane.

Attention Leadership: It’s Past Time to Move From Coordination to Collaboration

This is not a “profound transformation”—this should be the minimal standard for all healthcare models and systems. The answer is clear: care teams should collaborate with their patients. It is that simple.

The question is: are you ready to fully embrace the truth that patients are experts too—and that no one is more engaged than they are?

Enhanced Care models show us how providers of all types can work better together. Healthcare must ensure that patients are invited—not implicitly, but explicitly—to work alongside them as fellow experts. When that partnership becomes real, and not just marketing material, we can move from delivering care to creating health for patients like me.

In the end, my quality of life does not care about profound transformation models, Enhanced Care, efficiency, transparency, or medical economic theory. It just wants to feel better than it did yesterday.