Modern healthcare now demands executive-level coordination. A single senior managing multiple chronic conditions may see five specialists, take eight or more medications, navigate insurance authorization protocols, interpret laboratory trends, and weigh probabilistic treatment decisions — often within 20-minute appointments structured around documentation requirements. We would not assign this level of systems management responsibility to a junior hospital administrator. Yet we routinely assign it to aging patients whose cognitive bandwidth and physiologic reserve are changing. The result is not an isolated failure. It is structural strain.
