Starting with the needs, preferences, experiences and input of patients and families has been my mantra since my professional beginnings, and it seems even more imperative to emphasize this today. The rush to "solve" our problems via digital app, wellness programming, and frantic investment in the latest "hot" company has intensified, fueled by the pandemic, rising evidence of mental health needs and a popular, albeit not always authentic, focus on equity. Research, delivery and payment of world-class healthcare must be informed from the beginning by the expertise of patients and their families. If we intend appropriate, high-quality care that actually leads to health and well-being, those with political and financial power must consistently establish the patient’s seat at the head of the table. Some of my favorite advocates talk about this in the opening article of this edition, but I’m struck by the need for such commentaries, as their call to action isn’t new. At the start of a new year and a new administration, there is hope for a culture shift that prioritizes and authentically elevates the lived experience of patients to direct practice and policy. Let’s get it right, starting now.