In-Sight PublishingPatient-Centered Care, Health Equity, and Medical Innovation
Author(s): Scott Douglas Jacobsen
Publication (Outlet/Website): The Good Men Project
Publication Date (yyyy/mm/dd): 2025/06/30
Pat Merryweather-Arges, Executive Director of Project Patient Care and former Rotary International Board Vice President. They explore critical issues in U.S. healthcare, including deprescribing, sepsis awareness, health inequities, and implicit bias. Janice Dru-Bennett is a business development and marketing leader associated with Orange Biomed, a South Korean health-tech startup advancing rapid A1C testing for diabetes care. She also leads initiatives at BDMT Global, focused on strategic partnerships and digital health expansion in underserved communities. Merryweather-Arges emphasizes patient-centred innovation, like Orange Biomed’s OBM rapid A1c test, and the importance of trust, especially in underserved communities. Drawing from her leadership and personal experience, she advocates for relational care, bidirectional communication, and systemic reform to reduce harm and elevate patient voices. The discussion also touches on physician burnout, technology’s role, and the transformative power of empathy in care.
Scott Douglas Jacobsen: Today, we are joined by Pat Merryweather-Arges. She is a seasoned healthcare leader and humanitarian with over three decades of experience in healthcare quality improvement, nonprofit leadership, and global service. She is the Executive Director of Project Patient Care (PPC), a nonprofit organization dedicated to improving healthcare quality, safety, and equity by engaging patients, families, caregivers, and healthcare professionals in collaborative initiatives.
Her work emphasizes national healthcare transformation and authentic patient engagement across all care settings. Pat has made significant contributions within the Rotary community, having served as Rotary International Director (2022–2024) and Vice President (2023–2024). She currently chairs the Water, Sanitation, and Hygiene Rotary Action Group (2024–2025) and sits on the Mental Health Rotary Action Group Board (2024–2026). Additionally, she serves on the board of the International Rotary Fellowship of Healthcare Professionals. She has held various leadership roles in Rotary District 6450, including District Governor.
Her broader leadership includes international humanitarian work focused on clean water, healthcare, sanitation, women’s empowerment, and peacebuilding in India, Jordan, Haiti, Kenya, and others. This aligns closely with the 25th anniversary of UN Security Council Resolution 1325, which highlights the role of women in peace and security—a cause she actively supports.
Pat Merryweather-Arges: I have also been involved with projects in Ukraine, primarily virtually. However, we have undertaken significant initiatives to support Ukrainian healthcare and hosted delegations in the United States.
Jacobsen: Thank you for your service. These conversations can be significant, especially when you are on a call with someone in Kyiv and there are Wi-Fi glitches. It becomes more than just a tech issue—it is a reminder of the situation.
Merryweather-Arges: Yes, especially at midnight when they dial in for critical discussions from cities under stress. It is genuine.
Jacobsen: What prompted Orange Biomed to sponsor this special edition of the Boston Live Webinar Series, and how does it align with its mission?
Dru-Bennett: That is a great question. Orange Biomed is a healthcare technology company focused on advancing community engagement and bridging the gap between healthcare leaders and the public, particularly for those at higher risk for chronic diseases. Their flagship product, the OBM rapid A1c, is the world’s first pocket-sized, microfluidic-based A1C analysis device, designed to make diabetes monitoring more accessible, accurate, and user-friendly.
Sponsoring this webinar is part of their larger effort to promote early detection, patient empowerment, and healthcare innovation. This event, and others to come, aim to educate the general public, engage underrepresented communities, and support early intervention to reduce long-term health risks.
Merryweather-Arges: I recently participated in a panel discussion at the Deprescribing Research Group at the American Geriatrics Society annual meeting. We focused on the importance of deprescribing—a crucial topic when addressing the needs of vulnerable and older populations. Despite being vocal about their healthcare challenges, these groups often lack the support they need. Providing them with accessible, evidence-based technology can significantly impact their outcomes.
So, the only way to effectively deprescribe is to understand the pattern—when the prescribing began, whether the medications are still necessary, and whether the patient is improving. That is why I believe the A1C tool discussed here will be a real change agent.
Jacobsen: How much faster is the OBM rapid A1c in measurement compared to prior tools, and how much more accurate is it?
Merryweather-Arges: In terms of speed, the OBM rapid A1c delivers results in just a few minutes. It is significantly faster than traditional at-home A1C tests that must be mailed to a lab, which can take several days or weeks if mailing delays occur. Also, current at-home tests that do not require lab submission tend to be less accurate. The OBM rapid A1c closes that gap. While the time difference may be only a few minutes compared to some home tests, the key benefit is the increased accuracy, achieving lab-level results. That is what makes this tool a significant advancement.
Jacobsen: Regarding patient care, how does this device improve outcomes?
Merryweather-Arges: For many patients, even a few minutes can feel like a long time, but it is not just about speed. The real advantage is that you can do the test at home. By the time someone gets an appointment at a clinic and then waits for lab results, it could take days. This device gives people immediate results, allowing them to make timely decisions about their health.
Also, many people do not want to be on medication if they can avoid it. If a tool like this can help them see positive changes in real time, based on lifestyle adjustments, it can encourage healthier habits. Traditionally, A1C tests are done every six months, or every three months if advised by doctors. However, with this, you do not have to wait to visit the doctor and can test your status anywhere. If you are making progress, you can track it sooner, and in some cases, that could support deprescribing.
The panel I was on at the American Geriatrics Society meeting focused on deprescribing. As people age, they are often placed on multiple medications—what we call polypharmacy. I have worked on projects where patients were on a minimum of 13 medications. In some cases, we saw individuals on as many as 17.
Jacobsen: That sounds overwhelming—almost Ray Kurzweil levels of supplementation.
Merryweather-Arges: [Laughing] Yes, it is a lot. However, seriously, the cost can be enormous, and more importantly, being on that many medications increases the risk of adverse drug interactions. We found that by working with prescribing physicians and pharmacists and conducting regular health assessments, many patients could be reduced to five or eight medications, significantly improving their quality of life.
What often happens is that a medication is prescribed that contraindicates another condition. It can become a back-and-forth cycle. However, when we reduce the number of drugs, we often see improvement in the health and overall well-being of the patient. So anytime we can deliver healthcare solutions more quickly and directly to patients at home, they will appreciate it. Many patients genuinely want to be in control of their health. That is why having at-home testing is so important, especially when it is accurate.
Jacobsen: Do people become more concerned with controlling their health and well-being as they age or transition into retirement? Is that sense of autonomy more prominent?
Merryweather-Arges: It starts earlier, especially in vulnerable populations. Instead of spending time helping people change their lifestyles or providing coaching and counselling on healthier approaches, it is often easier to prescribe a medication, a “one-and-done” solution.
But people change. They change their health plans. They change their primary care physicians. Many transitions happen. Moreover, people of all ages and communities want to be in control of their lives. It is not just older populations who feel this way. Our challenge is that the technology, services, and support systems are unavailable in many vulnerable communities.
I chair the board of a hospital in Englewood, one of the most underserved communities in Chicago. It is often ranked at the top in terms of poverty and violence. According to a New York Times report, the average life expectancy in Englewood is just 62 years.
It shocked even the Governor of Illinois, who was so disturbed by the data that he awarded us a Healthcare Transformation Grant. We are now working to create a Center for Better Aging in Englewood to change the community’s cultural and health trajectory. Now compare that 62-year life expectancy with the Gold Coast area of Chicago, which is 92 years. That is a 30-year gap. Moreover, that disparity is unacceptable.
That is why empowering people to manage their health at home is so critical. Englewood is a healthcare workforce shortage area and a pharmacy desert, meaning there are few healthcare workers and almost no pharmacies nearby. So, tools like at-home testing and access to telehealth for coaching and consultation can make a real difference.
Jacobsen: One physician I spoke with—formerly in the States and now practicing in Canada—noted a growing trend in the U.S. of patients over-attributing blame to doctors. When things do not go exactly as hoped, the assumption is often that the physician was at fault, when medicine operates within a range of probabilities and uncertainty. Do you think this dynamic affects patient-physician relationships, especially in preventive care?
Merryweather-Arges: There is a significant buzz around the idea of “hear my story.” Patients want their experiences understood. However, physicians are under enormous pressure—they are pressed for time, jumping from one patient to the next, and listening to the patient becomes challenging, even though it is essential.
Physicians often do not fully hear what the patient is trying to communicate, which is a big part of the challenge. There is a movement in healthcare called “What Matters Most” for older adults. It centers around asking: What matters most to you right now? What can you control, and what can you not?
This personalized care approach is crucial, so AI can only play a limited role. Physicians sometimes miss subtle but critical aspects of a patient’s story. Studies suggest that patients are not fully heard about 10% of the time. So, I would not frame this as an “us versus them” situation between patients and physicians. Instead, we need collaborative relationships.
There is a tool called Teach-Back. It is primarily used when a physician or pharmacist prescribes medication. They explain the drug, its purpose, dosage, and timing and then ask the patient to repeat that information to ensure understanding.
However, I believe in bidirectional Teach-Back. That means the patient shares their symptoms, goals, and what they think they can achieve. The physician then repeats that back and builds a care plan accordingly. In other words, both parties need to be heard. The healthcare system is under much strain right now, and better communication is part of the solution, not blame.
I spoke with the second-in-command of Ireland’s national health service—she is just below the Minister of Health. What struck me was that in Ireland, the highest-paid physicians are geriatricians.
Jacobsen: That is surprising.
Merryweather-Arges: Yes! It is. However, their rationale is that geriatricians make a significant impact: They help control costs, listen carefully to patients, and get people the care they need. It is a brilliant, patient-centered model. Honestly, I said at the time, “We’re probably going to lose our geriatricians to Ireland—the contrast was that stark.” In the U.S., reimbursement for primary care, geriatrics, and pediatrics is typically much lower than for specialists. That is part of why our system tends to lean toward specialty care—the payment structures incentivize it. We are not Canada and do not have universal access to care.
Jacobsen: No, access remains a huge issue. Even in Canada, though, the wait times are getting long. That is a whole conversation in itself. We could spend an entire session on that. Moreover, we’re also seeing political shakeups—Jagmeet Singh is gone. From what I’ve heard, he lost his seat. Pierre had been campaigning for two or three years and lost to someone who had only been running for a few months. That’s quite a shift. That’s how offended Canadians were. I mean—I’ve never seen Canadians like this. It was wild.
Merryweather-Arges: [Laughing] Anyone from the U.S. witnessing it was stunned. Honestly, it was disappointing—some even said disgusting.
Jacobsen: Canadians were so offended that they probably went out and bought two Tim’s double-doubles in the morning to support local businesses. Canadians suddenly became nationally proud—they became American for a moment! And the Americans? They started apologizing like Canadians. It was adorable.
Merryweather-Arges: [Laughing] Yes, it was.
Jacobsen: Let’s discuss it since we focus primarily on patient care. You mentioned bidirectional communication. There is a knowledge gap between experts, like physicians, and patients. But even among physicians, there’s a range of training and communication styles. They’re credentialed professionals and licensed. So, how do you maintain respect for their expertise while ensuring patients feel heard?
Merryweather-Arges: That’s an excellent question. During COVID, there was a rebalancing—almost a backlash—against healthcare systems. At times, it got a bit ugly. But I do not think we’re in that place anymore. It is not that physicians are being disrespected. It is more than patients want their voices heard.
We know medical errors happen, and Canada has addressed this, too, not just in the U.S. They’ve even established commissions to examine them. And yes, there were some jokes—”too many Timbits,” as someone said—but the issue is serious.
Most medical errors are due to communication, or rather, the lack of it. That is where the problem lies. The system needs to foster environments where collaborative listening is the norm. That benefits everyone—patients and providers alike.
Communication—within the organization, between healthcare professionals, and in discussions with patients, their families, and caregivers—offers a vast opportunity for improvement.
Do you know what a nosocomial infection is?
Jacobsen: No.
Merryweather-Arges: A nosocomial infection is a healthcare-acquired infection. For years, physicians would say, “Oh, you have a nosocomial infection,” and that often came with a very bleak prognosis. In truth, many infections acquired in hospitals are treatable, but the key is early identification. It makes a real difference. Take sepsis, for example—I am sure you have heard of it. Sepsis is a critical global issue. In the United States, about a third of patients who die in hospitals die due to sepsis. That is, an infection always triggers sepsis, whether it originates in the hospital, at home, or is a continuation of an existing infection being treated.
Here is where the bidirectional aspect comes in. Sometimes, a patient is discharged from the hospital with an underlying or emerging infection. By policy, they are supposed to receive clear instructions before discharge about signs and symptoms of sepsis and guidance to seek help immediately if they notice any. But sometimes, that communication fails. The patient may wait at home, be unsure, and reach the emergency department too late. That is why most ERS are now on sepsis alert protocols. If a patient arrives early and treatment protocols—known as sepsis bundles—are initiated immediately, they can often be saved.
But if the symptoms are missed or the protocols are not followed correctly, the risk of death increases dramatically. And yes, hospitals are now publicly reporting on whether or not they have these sepsis bundles in place and how consistently they use them. So, it is a two-way street. Healthcare is a partnership between the system and the patient. I worked on a project funded by a PCORI award, the Patient-Centered Outcomes Research Institute. This nonprofit organization, funded by nationwide health plans, supports research on quality and safety improvements in U.S. healthcare.
Our project was called Patients as Partners in Healthcare Research. Over two years, I worked with about 20 patients referred through national organizations representing conditions like diabetes and Lyme disease. I gathered 300 clinical researchers, and zero patients got up and shared their stories, each in under two minutes. Their messages were powerful. Many began with “What if…”
- What if the physician had heard me?
- What if they had acted on my symptoms?
- What if they had not made assumptions about my diagnosis?
It always came back to listening. These were not angry stories. They were thoughtful reflections on how miscommunication or bias led to avoidable harm. If we shift from blame to partnership, we could transform healthcare. There was one woman I’ll never forget—young, African American. She was suffering from excruciating headaches. She returned to the doctor, saying, “None of this is working.” And instead of taking her concerns seriously, he said, “I think I know what’s wrong—you have anger management issues.” He said that because she was visibly upset—understandably so. So what did he do? He sent her to anger management classes.
Jacobsen: That’s gaslighting.
Merryweather-Arges: Exactly. Then—she had a massive stroke. She had not been adequately tested. No imaging. No follow-up. Nothing. Sometimes, assumptions are made too quickly, especially when someone is of a different age, race, or ethnicity. Another case involved a young athlete from Penn State—a top performer. He went in complaining of severe anxiety and a range of symptoms he could not explain.
But the physicians dismissed it. They said, “Well, the playoffs are coming up—you’re probably just nervous about that.” It went on like that for a while. He knew something was wrong. But again, no one was listening. Eventually, it turned out he had severe hypertension, so bad that his kidneys failed. He ended up on dialysis and later required a kidney transplant. Fortunately, an alumnus donated a kidney. But he was a college athlete, in peak physical condition, and all of this could have been avoided.
These are the types of stories we hear over and over. We use them as teaching moments so people understand that listening is a two-way street, and so is responding. This is not about blame. It is about asking, “How do we fix the system so people are heard—and responded to—in a timely, compassionate, and evidence-based way?”
Jacobsen: Some of these large language models, like GPT, could be used with care in this space. If you start a chat with one of these tools, it starts from a blank slate. But if you build a specialized layer on top of it—something explicitly trained for healthcare applications—you could input objective symptoms and histories. Then you would get a sort of “dry read”—an analysis without human bias, potentially offering a second opinion or flagging things that a physician might overlook because of prior assumptions.
Merryweather-Arges: And that kind of tool could be helpful. I think you’re right to point out implicit bias—that was at the core of the case with the woman who repeatedly went to the doctor with severe headaches. No one tested her. There was an implicit assumption that her symptoms were not severe.
Jacobsen: That’s the danger. Anthony Greenwald and Mahzarin Banaji pioneered implicit bias research. Before becoming a journalist, I had dinner with Anthony once while studying psychology earlier in my career. I do not know if that counts for anything, but it sparked my interest in the field.
I also recall that he and Banaji later acknowledged some overreach in how their work was interpreted and applied. I always try to be cautious about biases and over-attribution of supposed bias, particularly when using individual case studies to conclude population-wide dynamics.
Merryweather-Arges: I understand that completely. But when I send you the YouTube link, you will see that this issue is more common than people think. Errors often stem from a lack of listening and recognition—not just bias but inattention to what patients are trying to communicate. AI could be beneficial, especially in bridging those listening gaps. What we hear as providers may not be what the patient is trying to say.
Jacobsen: While most current AI systems are language-based and not visual like facial recognition tools, it’s worth noting that visual datasets have been shown to carry bias. So I do wonder—could patterns of speech, particularly those tied to subcultures or regional dialects, introduce a similar risk of misinterpretation? I had not thoroughly thought that through, but you’re right. Those biases could surface in speech-based AI models, too.
Merryweather-Arges: Let me give you a personal example. I had a pretty severe case of skin cancer. It was extensive—I had multiple surgeries all on the same day, in different areas. My primary physician, whom I adore, referred me to a specialist.
Now, this specialist had been in surgery for seven hours. He’s a plastic surgeon, and he was clearly exhausted when he came to me. He said something, “Hasn’t someone else handled this?” And I thought, “Oh no, I’m scared.” His tone was off, and I was nervous.
Then I asked, “Are you from South Korea?” He said yes. I told him, “I was there recently for Rotary.” And he said, “My father’s a Rotarian.” And that changed everything. We connected. But here’s the larger point: building trust in healthcare is arduous when a patient only sees someone for a few minutes. That’s why I always say—if you want to influence health behaviour, encourage lifestyle changes, or deprescribe medications—go through the trusted messengers. These can be community organizations, faith-based groups, or other culturally embedded institutions. That was my message at the American Geriatrics Society meeting, too. Start with trust to recruit people into health programs or studies.
I asked, “How did you co-design these programs? How did you co-create them?” Well, it turned out that they never included patients in the design process. So once again, they missed the language and the experience of what it means to live through the healthcare system as a patient. Then they said, “Well, we put out a call—we included it in newsletters.”And I asked, “Did you partner with any community organizations that patients trust?” Because if you work with trusted organizations in the community, patients are much more likely to participate.
That’s why establishing trust in one or two minutes is nearly impossible. I do it when I can, because I want to understand the background of the person in front of me. I want to relate to them and form a real connection. But that is hard in healthcare, when you only get five minutes with a clinician, and they’re already thinking about the next patient. And think about this—patients wait. Especially chronic care patients. Many build their entire month around a single medical appointment. And that is why we have to meet both patients where they are and physicians where they are. Not all physicians are the same.
Jacobsen: What’s the most important thing patients remember about their relationship with physicians, and vice versa?
Merryweather-Arges: Preparation is key for patients, especially those with chronic conditions. Many do prepare already—they think about the visit for weeks. I recommend they write down their conditions, document their symptoms, and prepare specific questions. If their clinic has an online portal, they can submit questions beforehand. That gives physicians a chance to review and prepare more thoughtfully. Physicians begin by examining the patient’s chart on a computer or a printout posted outside the exam room for a routine visit. This tells them what to expect.
It is different in the hospital for routine visit settings. Patients are more vulnerable, less likely to feel well, and often need a caregiver present. Physicians—especially specialists—might be in and out quickly. However, primary care physicians spend more time with their patients in that relationship. It is the same with pediatricians and geriatricians.
For specialists, it is more transactional—they’re focused on the intervention they provided and whether it worked. The relationship aspect is less emphasized. Part of the problem, I always say, is that medical training doesn’t assess communication skills. I have family members who are physicians. When they entered the profession, they were evaluated based on their exam scores, not their bedside manner.
That is why some physicians struggle with communication—it is not always a skill that gets developed. Fortunately, initiatives are trying to change that. One example is the Kern National Network for Flourishing in Medicine at the Medical College of Wisconsin. Their medical school has programs designed to improve physician communication and empathy while encouraging healthcare facilities to better support physicians.
Because let’s be honest—physician suicide remains a crisis. The rate of physicians dying by suicide is higher than the general population, and much of that is tied to stress, burnout, and emotional overload. Sometimes it takes something personal to understand the stakes. My father died from a medical error—this was almost forty years ago. He was a leukemia patient and had been enrolled in a clinical trial. After spending some time in the hospital, he was sent home, but had to return for additional testing.
They needed to do a liver biopsy, because chemotherapy often lodges in the liver. But no one performed a coagulation test beforehand. At that time, there were no electronic health records. Everyone just assumed it had been done.
He bled to death.
The nurses who had been with him, some for over sixty consecutive days, named him, knew him, knew my mother, knew our family. They cried with us. It wasn’t just a procedural failure—it was deeply human.
His primary care physician, who wasn’t his oncologist, used to visit him regularly. They were both World War II veterans, and they talked about the war and sports late into the night. I would see them and find them deep in conversation. When physicians develop relationships with their patients, a loss like that affects everyone—nurses, doctors, and staff. It is not just the family that grieves.
So when people say physicians don’t care, I struggle with that. They put their lives on the line. They sacrifice years of study and endless work hours to care for others. And yes, sometimes patients arrive in a bad mood, in pain, or emotionally overwhelmed. It often takes a nurse, a physician assistant, or another team member to de-escalate the situation.
So when people say, “Oh, they’re attacking the doctor,” it is usually not an attack. It is an expression of desperation. People are hurting and want someone to help them—someone to offer something close to magic.
Jacobsen: Patricia, thank you so much for your time today. I appreciate it. It was terrific to meet you.
Merryweather-Arges: Good to meet you too. And best of luck with your work.
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