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Why the Future of Healthcare is Collaborative: A Physician Associate's Perspective on Redesigning Our Health System
- Jennifer Vonderau
- 8 hours ago
- 5 min read
June 18, 2026 | By Jennifer Vonderau, MMS, PA-C
The Physician Associate/ Physician Assistant (PA) profession has grown tremendously in the last 20 years; it is now represented by over 200,000 clinicians (NCCPA Statistical Profile). However, growth in number is not evidence that the profession is well-incorporated into the health system as a whole.
While PAs were recently marketed as "The 2nd Best Healthcare Job in America," the reality of clinical practice for PAs and other Advanced Practice Providers (APPs, such as Nurse Practitioners [NPs] and Clinical Registered Nurse Anesthetists [CRNAs]) is highly variable (US News and World Report). APP practice is dependent upon broad definitions of scope by federal and state practice law, and it is also impacted by individual clinicians (especially supervising or collaborating physicians) and institutions.
In some circumstances, APPs are viewed as extenders of care rather than equitable participants of the patient care team. In other places, APPs are valued but still may not be strategically included in leadership or organizational structures.
The health care hierarchy is centuries old, and it has been relatively unchanged, despite the nearly simultaneous growth of technology, medical evidence, scientific research and discovery, pharmaceutical invention, and, importantly, diverse health care teams. A medical team in 1910 was a physician and maybe a nurse. In 2026, a health care team includes a physician, a PA, an NP, a physical therapist, an occupational therapist, a speech therapist, a pharmacist, a dietitian, a case manager, a nurse, a nursing assistant, and more.
The hierarchy of student - novice - master - teacher, running concurrently with corporate hierarchy of laborer - manager - executive, cannot adequately contain the varied experience and positions now prevalent in the health care space.
Expertise isn't best when it's broad - not when knowledge is now the fullest and most comprehensive it's ever been. Expertise is narrow, deep, and assigned specifically to certain health care professionals. Which means we cannot put ownership of medical decisions on a single provider. Furthermore, we cannot leave public health entrusted to executives with no clinical experience.
Equitable, comprehensive, evidence-based care is provided by a team who practices according to their scope, experience, education, and legal authority. The best patient outcomes arise from spaces of respect, humility, and bidirectional advocacy.
In my upcoming book, Health by Collaboration, I argue that the future of medicine relies on a redesign of power that recognizes all clinicians as equal contributors to a collective intelligence. The patient remains an essential contributor to that intelligence.
The Evidence for a Collaborative Team
The hierarchical model of current medical systems struggles to strategically incorporate the ideas of those outside of executive leadership. This structural inertia isn't a matter of professional ego; it is a direct threat to patient safety and system sustainability. Consider the evidence:
The Myth of the Solo Provider: Research from the University of Chicago found that a primary care physician would need 26.7 hours per day to provide comprehensive, evidence-based care to a standard day’s cohort of patients alone. With a collaborative team, that time drops to roughly nine hours (UChicago Medicine).
The Cost of Miscommunication: The Joint Commission found that 80% of serious medical errors result from miscommunication between team members. Hierarchies worsen communication (HIPAA Journal).
Optimal Team Practice: When teams utilize "Relational Coordination"—prioritizing shared goals, shared knowledge, and mutual respect—patient outcomes improve, hospital stays shorten, and provider burnout decreases (Learning Health Systems).
Why Collaboration Matters for PAs
The transition from "Physician Assistant" to "Physician Associate" is more than a semantic change; it is a declaration of the role as collaborators. Collaboration implies that clinicians work better on parallel planes of expertise rather than on a ladder where one voice is preferred over another.
In Health by Collaboration, I discuss how PAs, NPs, nurses, therapists, and pharmacists are valued as a commodity but not hired as a strategy. We are the invisible labor: the ones who manage the communication, the logistics, and the "finishing touches" that keep the system from collapsing. By embracing collaboration broadly, we move toward a system where the provider with the most practiced insight is heard, regardless of their title.
Reclaiming Our Voice: A Call to Action
The health system is currently collapsing under the weight of its own mistakes. I don't view its current existence as intentionally short-sighted or maliciously built. But the system has not been revised as a whole and, importantly, financial incentives for productivity and clinician value persist as intransigently opaque and uneven.
Lacking support, fair representation, appropriate compensation, and humble leadership, burnout rates among many health professionals - including PAs, NPs, and physicians - exceed 50%. Worse still, patients are increasingly dissatisfied, spending less time with their clinicians and more money for their care.
Health by Collaboration is the first book published by a PA specifically addressing the systemic failures and necessary redesign of the U.S. health system. It is a call for all participants of the health system - from physician to nurse to therapist to PA to pharmacist to NP to patient - to share their voice and experiences with humility, respect, and authenticity. Better starts in the exam room and in the hallway. And then it changes everything.
To support this mission, secure your copy, and join dozens of other clinician supporters, please visit the book website to explore the available purchase packages:
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$25 | A copy of the full manuscript in a digital format PLUS:
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Launch Event - Durham, NC and Chicago, IL $100 (1) or $150 (you plus 1) | A signed copy of the full manuscript in print and digital format PLUS:
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A signed copy of the full manuscript in print and digital format PLUS:
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Thirty (30) signed copies of the full manuscript and an interactive CME event with your team/ institution PLUS:
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Virtual Launch Event Live Panelists:
Viet Le, DMSc, PA-C, FACC, FAHA, HF-Cert - Associate Professor and Cardiology PA at Intermountain Healthcare
Kenneth Botelho, DMSc, PA-C - Doctoral Program Director at the College of St. Scholastica
Marilyn Hanon, DNP, RN - Transplant Nurse Coordinator at University of North Carolina Health
David Gerber, MD - Chair of Surgery and Distinguished Professor at the University of Cincinnati
The Pre-Sale in June
The Pre-Sale for Health by Collaboration runs through June, 2026 exclusively. In order to receive a signed copy first, join the author community and be recognized in the book, and support the first book published by a PA on this topic, purchase a package anytime in June! By supporting this Pre-Sale, you are directly funding the research and editorial process that brings this vision to life.
The book will be published and in print by February 2027. A book tour and author signing events will be announced in early 2027.
Jennifer Vonderau, MMS, PA-C is a Physician Associate with over thirteen years of experience in complex surgical specialties and PA education leadership. She is co-founder of PA Jobs LLC. Her work focuses on translating systems and evidence to improve provider wellbeing and patient outcomes.
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