What If the 'Patient First' Model Is Built on a Flawed Assumption?

We often hear that healthcare should be patient-centered. That we need to embrace a Patient First model. But… what if that idea is built on a false assumption?

What if we’ve misunderstood what patients actually show up with?

Because here’s what happens in the real world: people don’t arrive at the doctor’s office armed with knowledge or ready to make complex decisions. They don’t usually bring a list of questions. Many don’t even know what to ask.

They come in with a problem. And that’s it.

Not a plan. Not a roadmap. Not a goal for their health journey. Just a concern—sometimes vague, sometimes urgent—and a quiet hope that someone will help them make sense of it all.

So why is the system so quick to position itself as a facilitator instead of a guide?

Why do we keep putting patients in the driver’s seat when many don’t even know where they are on the map?

Maybe we’ve confused empowerment with detachment. Maybe being truly “patient first” means not assuming the patient knows what’s best for them—but stepping in, leaning forward, and helping them discover what’s best together.

Because if the system keeps waiting for patients to lead… and the patients are waiting for the system to lead… who’s actually moving things forward?