Dr. Mary Ann Pefanco, M.D.
Geriatrics, internal medicine, EvergreenHealth Geriatric Care
By Seattle Mag July 29, 2025
This article originally appeared in the July/August 2025 issue of Seattle magazine.
Every year, we ask a few of Seattle’s Top Doctors to share what inspires them to practice medicine, the advice they give most often, and what they think the future holds for healthcare. These interviews are part of Seattle magazine’s annual Top Doctors feature, created in partnership with Castle Connolly. None of the doctors paid to be included — all are nominated by their peers.
What inspired you to become a doctor?
The desire to help others and make a difference in this world. I believe everybody has a purpose in life, and I believe that all of us are equipped with talents and skills that we have a lifetime to explore, learn, nurture and share. I feel like being a doctor is like being a protector of the best gift that we are all blessed with: life.
What’s one thing about being a doctor that most people misunderstand?
Most people think of doctors as knowing everything medical-related and unable to commit mistakes. Many folks think that we should always know the right answer to every question, or know the right thing to do at all times, but doctors are human, too, and have our own strengths and weaknesses. It is such a daunting task to protect and prolong human lives. We do try our best to always do the right thing and give the right answers.
What’s something in medicine you believe will be totally different in 10 years?
Artificial intelligence is now taking over every aspect of our lives. It is doing the same in the medical field. Thus far, we’ve seen that artificial intelligence can definitely improve precision of disease diagnosis and intervention. However, I still believe that it can never replace the significance of human touch and interaction in the healing process.
Have you ever had a patient diagnose themselves correctly?
Yes. Patients are incredibly intelligent, and a lot of patients are also very much in tune with their bodies and their health. They do know when something is wrong. Nowadays, medical literature is available at everyone’s fingertips. Although we always warn people about the use of the internet to diagnose their medical problems, fairly simple diagnoses can be easily recognized.
What’s one myth about health or medicine that you wish would go away?
The one misconception about dementia that I hope people would stop believing is that it is part of the normal aging process. Age-related memory lapses do happen, but dementia is an encompassing term that is not only characterized by memory loss, but also has associated language, mood, behavioral and functional changes that compromise your ability to live independently. It is a manageable but progressive disease. Early detection and intervention may help improve your quality of life following your diagnosis.
What’s the most unusual case you’ve ever encountered?
Having done my medical education in a developing country like the Philippines, I have seen exotic parasitic infections such as elephantiasis, which is an infection with filarial worms that lodge in lymphatic vessels, causing severe swelling of lower extremities, and with chronicity causes skin thickening and hardening, like that of an elephant. In my practice in geriatrics here in the U.S., I have seen a patient with frontotemporal dementia (FTD) go blind in spite of having healthy eyes, due to the brain’s inability to process visual information.
What’s one piece of advice that you wish every patient followed?
I wish every patient would advocate for themselves. This means to take charge of their health. More than anyone else, you know your own body. Accurate diagnosis always starts with adequate description of symptoms. Good compliance improves outcomes. One should be an active participant in their health care plan. Prevention is always better than a cure, and health maintenance screenings and immunizations are key.
If you could change one thing about the health care system, what would it be?
The medical field is becoming more fragmented due to the emergence of more specialized care, technical limitations, a lack of focus on comprehensive care, complex payment systems that incentivize more specialty care, and differences in rules and regulations across health care systems. As a result, continuity of care is compromised. This can also lead to inefficiency, increased healthcare costs, poor patient satisfaction and physician burnout. Proper care coordination, interoperable electronic medical records, and policy changes and reforms that do not sacrifice patient privacy and promote improved communication and outcomes are important to address this concern.