During an emergency department visit, my father, calm, coherent, and confident, expressed respectful disagreement with the physician’s recommendation to admit him. He didn’t feel it was necessary. He knew his body. He knew what felt right.
The physician’s response?
“I’m a board-certified emergency medicine doctor and know what is best for you.”
This dismissive reply was a stark reminder that, even as the healthcare system generally shifts toward more compassionate and respectful care, power dynamics still shape how people make decisions in healthcare. Titles, training, and clinical settings often overshadow lived experience. When physicians easily dismiss patient voices, care often misses the mark, not just emotionally, but clinically.
The cost of dismissal
When participants aren’t fully engaged or their preferences aren’t central to care plans, the consequences can be significant: over-treatment, misaligned interventions, unnecessary costs, and poor outcomes.
This is where PACE has an opportunity to lead. PACE already offers a model rooted in whole-person, team-based care. By embracing participant partnership as a core practice, treating individuals not just as the focus of care, but as collaborators in shaping it, PACE can deliver care that is more humane, more aligned, and more cost-effective.
From centered to partnered
Over the past several years, the movement toward patient-centered care has made a meaningful impact. It brought dignity, compassion, and respect to the forefront. It encouraged providers to see patients as people, not just conditions they need to treat.
PACE already exemplifies this approach, with care that is:
- Holistic and individualized
- Culturally responsive
- Seamlessly coordinated across settings
- Rooted in long-term relationships
- Designed to support physical, emotional, social, and spiritual well-being
To truly lead the next era of value-based care, PACE must move from patient-centered to participant-partnered, where individuals are not just included in decisions, but are true active, empowered collaborators in shaping their care.
From informant to interpreter
Too often, even well-meaning care teams fall into the “informant” role, laying out options, risks, and tradeoffs without fully interpreting them through the lens of what matters most to the participant. This can leave people overwhelmed, disengaged, or unsure of how to advocate for themselves.
In contrast, a participant-as-partner model invites individuals to bring their expertise into every decision: their experience of illness, their risk tolerance, their definition of a good quality of life.
It requires the care team to shift from informant to interpreter:
- An informant presents information, vs.
- An interpreter who listens first, then helps the participant navigate choices that align with their goals, values, and preferences.
This is shared decision-making in its truest form.
PACE can model the future
PACE programs already have the structure and philosophy needed to deliver this kind of care. With interdisciplinary teams, comprehensive services, and ongoing relationships, the infrastructure is there. So is the philosophy.
Now is the time to take the next step, strengthening the participant’s role as a partner, not just a recipient.
- Invite deeper involvement in care planning
- Respect lived experience alongside clinical expertise
- Build trust and communication that supports autonomy
- Recognize the participant as a constant on the care team, even when staff changes
A genuine partnership built on trust, mutual respect, and shared knowledge yields powerful results. It goes beyond improving satisfaction and quality of life; it directly reduces the significant costs of care that don’t align with a participant’s goals.
Imagine: Fewer unnecessary hospitalizations, more appropriate interventions, and care plans that reflect what matters most to the individual. This leads to more sustainable, efficient, and ultimately, more humane care.
By leading with these values, PACE can show the rest of healthcare what real partnership looks like and why it’s not just the right thing to do, but the smart thing too.
The future of care: empowered participants, better outcomes, and smarter spending
We’ve come a long way in reshaping how care is delivered to older adults. But the next step is clear.
When participants feel empowered, engaged, and heard, not just in theory, but in practice, care becomes more aligned with what matters, more responsive to real needs, and more effective overall. It results in better outcomes, stronger relationships, and fewer interventions that don’t serve the individual’s goals.
PACE has the foundation, the philosophy, and the flexibility to lead this shift.
By deepening our commitment to participant partnership, we can build a future where care is not only compassionate, but also coordinated, efficient, and deeply aligned with each participant’s values.
The journey to truly participant-partnered care can begin now. Let’s collectively champion this shift within PACE, demonstrating to the broader healthcare landscape what genuine partnership truly looks like.
