Beyond Patient Autonomy: cultivating Agency for True health & Flourishing
for years,healthcare has championed patient autonomy – the right too make your own decisions. But a subtle misstep has emerged.Many well-intentioned physicians, in striving for neutrality, inadvertently leave patients feeling more burdened, not empowered. Thay present options without guidance, at precisely the moments you need a trusted expert to listen, recommend, and share the weight of complex choices.
This isn’t a criticism of intent, but a recognition of a fundamental truth. As Atul Gawande brilliantly articulated in his 1999 New Yorker essay, “Whose Body Is it Anyway?” patients frequently enough want to relinquish some of that freedom - to benefit from a clinician’s expertise and feel supported, not abandoned, in navigating difficult health decisions.
We can update that concept with the term ”agency” – your capacity to influence your own future for the better. And building that agency is becoming a central focus in a new wave of healthcare innovation.
The Limits of Autonomy & The Power of Agency
The customary emphasis on autonomy assumes you always want to be fully in charge. But life, and health, are rarely that simple. You might be facing a daunting diagnosis, overwhelmed by details, or simply lacking the confidence to make a life-altering decision alone.
True empowerment isn’t just about having choices; it’s about feeling capable of making those choices, and confident in the path forward. This is where agency comes in. it’s about fostering a sense of control, self-efficacy, and the belief that your actions can positively impact your well-being.
A new Breed of Health Companies Focused on Agency
Fortunately, a growing number of companies are recognizing this need and building solutions around the psychology of behavior change. These aren’t just apps that track your steps; they’re tools designed to actively enhance your agency.
Here are a few examples:
* Lore: Focuses on personalized support and guidance to help you navigate complex health challenges.
* SlingshotAI: Leverages artificial intelligence to provide tailored insights and empower you to take proactive steps towards better health.
* And others: A burgeoning ecosystem of innovators are exploring ways to build agency through digital tools and personalized interventions.
These companies are attracting extraordinary talent becuase they’re tackling a deeply human problem - how to help people feel more in control of their health.
The Future of Health: A Holistic Approach
My conviction is that the greatest impact will come from integrating this agency focus with two other critical elements:
- Biometrics: Objective data about your physical health – from wearable sensors to lab results – provides a foundation for informed decision-making.
- Connection & Meaning: Healthcare isn’t just about treating disease; it’s about supporting your overall well-being, including your social connections, purpose, and values.
Flourishing Health: A Three-Part Framework
Imagine a model where these three domains – physical function, meaningful connection, and personal agency – work together to support flourishing health. (See diagram below)
[Image of the diagram from the original article – Flourishing Health with three interconnected circles: Physical Function, Meaningful Connection, and Personal Agency]
Currently, few organizations are designing healthcare solutions that address all three. Most focus on one or two, leaving a notable gap in the overall experience.
Why This Matters – And Why It’s Exciting
This is more than just a professional pursuit; it’s a deeply satisfying one. It’s a far cry from the endless cycle of maximizing billing or engaging in defensive AI battles between healthcare systems and insurance companies.
Patients – and those proactively seeking to stay healthy – are already leading the way, demanding a more holistic and empowering approach.
We, as healthcare professionals and innovators, have a duty to meet them where they are. by leveraging technology, grounding our work in evidence, and leading with compassion, we can build a future of health and healing that truly honors the ideals that brought us into medicine.
Let’s build an approach to health worthy of your trust and your well-being.
Dr. Shaywitz is a physician-scientist,lecturer at Harvard Medical School,adjunct fellow at the American Enterprise Institute,and founder of KindWellHealth,an initiative focused on advancing health through the science of agency.
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