Healthcare navigation is commonly treated as a practical matter of finding services, following instructions, and completing administrative steps. This framing underestimates the psychological work required to transform a fragmented healthcare system into a usable sequence of actions. Patients may need to locate information, interpret competing instructions, remember deadlines, coordinate professionals, evaluate digital messages, tolerate uncertainty, and repeatedly decide what deserves attention while simultaneously managing illness and everyday life. These demands are not distributed equally. Health literacy, financial and material resources, digital access, language, social support, illness severity, organizational design, stigma, and continuity of care can alter both the workload imposed by healthcare and the capacity available to manage it. This article develops a proposed Navigation-Capacity Model that treats care engagement as the product of a dynamic relation between system-generated workload and context-dependent capacity rather than as a stable patient characteristic. It distinguishes administrative complexity, informational complexity, cognitive demand, emotional exhaustion, fragmentation, and social redistribution of work while preserving their interactions. The model further proposes that disengagement can emerge from accumulating workload-capacity mismatch without implying deficient motivation. This perspective shifts improvement efforts toward reducing avoidable navigation work, strengthening usable support, and designing care pathways whose demands remain feasible under real-world conditions.
