I spent 3 days at a conference for women in Health IT despite lacking the professional credentials and approximately half the necessary chromosomes. I came home thinking differently about healthcare insiders, patient communities, and one surprisingly consequential pronoun.

American healthcare has insurers, hospitals, pharma, PBMs, employers, lobbyists and trade groups organized to protect their interests. The patient has a portal password. After 30 years inside the system, I think patients need something we’ve never had: a constituency.

Patients have always had the numbers. What they have never had is a shared political identity. After 30 years in patient advocacy, Matthew Zachary argues that the next chapter may be transforming shared healthcare experiences into civic and political power.