A New Book by Jen Vonderau: Why Healthcare Needs a New Architecture

Hello to the PA Jobs community! My name is Jennifer Vonderau, and I'm one of the co-owners and co-founders of PA Jobs, LLC. This role as an entrepreneur and business owner is a novel one for me; really, I'm a physician associate (PA) with years of experience in complex medical environments. I know firsthand the rigor of the PA role: the pressure to see more, do more, and fill gaps; the administrative frustrations; and the deep, often invisible, labor that keeps our patients safe.

Like many other advanced practice providers (APPs), I've lived the incredible professional opportunity of being a PA, growing in a career I love that fulfills me, and advocating for patients who truly need care. However, I've also experienced burnout, changed roles, left institutions, and found camaraderie in other APPs who've felt unseen by a health system that often fails to recognize the full scope of our value. We're vital to the health system but not readily included in its structure. That tension - the difference between the vital role we play and the outdated system we work within - is the reason I'm writing my book, Health by Collaboration (working title).

A placeholder cover (not the final book!) for Health by Collaboration (working title) by Jennifer Vonderau

The Book’s Theme: Your Frustration is Not Personal, It’s Structural

When APPs entered the workforce, the lack of categorization was quickly remedied by assigning us as "mid-level providers." For those swayed by biases and stereotypes, if physicians are the standard, and nurses are assistants, where else would APPs go? But "mid-level" is not only pejorative, it is fundamentally a category error. Our expertise is not a half-measure of a physician's; it is a different, parallel, and essential component of modern care.

My book is a deep-dive diagnosis of the broken hierarchy in medicine. Using many clinical stories and objective data, this book aims to show that the system is fundamentally flawed. Modern medical practice simply cannot be fully encompassed by a system built before antibiotics, non-physician providers, and sterile operative techniques. Worse, as its currently built, the health system silences the very voices that are necessary for safety and efficiency.

Health by Collaboration is organized around two core questions:

1. What’s Broken? I trace the "Anatomy of a Broken System," examining everything from the financial reimbursement pyramid that devalues non-physician work to the "Myth of the Savior" that forces physicians to carry a burden of knowledge no human can bear. I show how new roles (like ours) are forced into the same rigid system, leading to the daily chaos we experience.

2. What’s Next? I propose the "New Architecture," a strategic, actionable plan to transform the hierarchical structure into a collaborative ecosystem. This includes concepts like the "Flat Line Strategy" for leveraging insights from practicing providers and "Investing in the Invisible" to quantify the true value of coordination, communication, and deep patient work that PAs perform every day.

Why This Book Is for the PA Community

This book aims to validate all of the diverse APP experiences, and it is a call to action for PAs to recognize their power as collaborative leaders. PAs are not just filling gaps; we are strong advocates and determined clinicians who understand the complexities of care better than anyone. We are critical to the modern health system.

The ultimate goal of Health by Collaboration is to provide PAs and all APPs with the objective language and data to:

• Validate frustrations as a systemic failure.

• Advocate for structural changes, not just personal career advancement.

• Empower PAs to lead, regardless of title.

  
  

Progress and How to Follow Along

It turns out I love writing, and working on this book has been so exciting and fulfilling! I'm working with an agency that facilitates writing, editing, and publishing on a structured timeline. The core writing is underway, and the goal is to finish a rough draft by late Spring. Ideally, the book will be published and ready to read by late 2026 or early 2027. I'd love if you followed along with the progress!

To stay informed on our progress, get early access to excerpts, and be the first to know about the final launch date, please follow me on LinkedIn or sign up for the PA Jobs newsletter on our home page!

Thank you for everything you do. Being a part of the PA community has changed my life for the better. Let's keep working together!