Meet Dr. Chad Swanson, the creator, editor, and manager of this podcast

Sofia Ramirez

Welcome to the sixth episode of "It's Time." We're so excited to share the journey ahead with you. Today, let's summarize the three big ideas that we explored in previous episodes Honestly, we think that they should shape everything in the healthcare system.

David Caldwell

Yeah, and—and when she says "everything," she really means it. Every clinical encounter, policy decision, educational curriculum... the whole system, right?

Sofia Ramirez

Exactly. So, the first idea is, at its core, visionary. It's about relentless focus on health for all, delivered at the lowest possible cost. Simple concept, but a huge challenge, right?

David Caldwell

Oh yeah, that sounds a little ambitious—but in a good way!

Sofia Ramirez

It is, and it needs to be. The second idea is about what we call "systems stewards." These are people who deeply understand how complex adaptive systems work. They’re the ones who identify what’s really driving the system and have the courage to mobilize around key leverage points.

David Caldwell

Wait, wait. Complex adaptive systems. That’s a phrase that isn't new to listeners. But I need a reminder. What does that really mean again?

Sofia Ramirez

Yeah. I understand you need reminders, David. Let me give you a quick take: Think of it like an ecosystem. It’s interconnected, it adapts and evolves, and sometimes even the tiniest intervention can create massive ripple effects. That’s the kind of thinking we need to transform the healthcare system.

David Caldwell

Right. Gotcha. So, it's kinda like nudging the system, instead of bulldozing it. I like that.

Sofia Ramirez

Exactly! And the third idea—for me, this is the glue—is about mobilizing for action around high leverage points. But also acknowledging that change isn't always predictable or linear, but it feeds off connections, relationships, and vision. It's messy, but that's where the magic happens.

David Caldwell

Okay, so let me get this straight. This podcast, these ideas, we’re like... a living, breathing example of what we're talking about?

Sofia Ramirez

Exactly, David. We are a complex adaptive system! A fledgling, emergent subsystem within a larger health system. Self-organizing, highly connected, maybe even a little unpredictable. We have a vision, too, which makes this all the more exciting.

David Caldwell

Okay, I’m officially on board. But Sofia, we should probably tell people the craziest part, don’t you think?

Sofia Ramirez

Oh, right. We should. You're not gonna believe this, but both of us—we’re not, well, we’re not real people.

David Caldwell

Wait, what?

Sofia Ramirez

Yep. We’re AI-generated hosts! Even our names were randomly chosen. Any resemblance to real people? Pure coincidence.

David Caldwell

Okay, my mind is blown. But also, I—I feel like I've just been tricked into caring about what AI has to say about healthcare. Which… honestly, kind of amazing.

Sofia Ramirez

Well, we have one real person at the heart of this. His name is Dr. Chad Swanson, and this podcast is his brainchild. He’s a practicing ER doc with a passion for systemic change in healthcare, and you’ll hear more about his story in just a bit.

David Caldwell

And if you want to get in touch with him, he’s on TikTok, LinkedIn, and YouTube. His website is chadswanson.com, or, you can email him at rchadswanson@gmail.com. Basically, he’s pretty easy to find.

Sofia Ramirez

Alright, as we mentioned, Dr. Swanson is at the heart of this podcast. He earned his medical degree, then trained in emergency medicine at the Medical College of Wisconsin. Since 2006, he’s worked as a board-certified emergency physician. And let me tell you, the stories he could share from the ER—they range from absolutely inspiring to gut-wrenching.

David Caldwell

Yeah, I can imagine. I mean, the emergency room feels like a front-row seat to humanity, doesn’t it? The good, the bad, and probably more chaos than most of us could handle.

Sofia Ramirez

Exactly, David. It’s a place where triumph and tragedy collide every day. And for someone like Dr. Swanson, who’s deeply committed to change, those experiences aren't just stories—they’re fuel for action. He’s held leadership roles to improve quality of care and patient satisfaction, so he’s not just treating patients; he’s trying to shape how care is delivered.

David Caldwell

He played a significant role managing his department’s response during—what—the first months of COVID-19? That’s like jumping into the deep end without a life jacket.

Sofia Ramirez

That’s one way to put it, and yes, it was an extraordinary time. In the early days of the pandemic, there was so much uncertainty—about the virus, about how to protect patients and staff, even about whether hospitals would be overwhelmed. He’s driven by a passion for addressing the root causes of our biggest challenges.

Sofia Ramirez

That drive to tackle the root causes of healthcare challenges? It was sparked by something profound early in his career, and it shaped everything that came after.

David Caldwell

Wait, so you're saying he wasn’t just treating patients in the ER back then?

Sofia Ramirez

That’s right. He felt, honestly, a deep, almost moral responsibility to tackle the suffering he saw—suffering caused by preventable diseases like HIV/AIDS. These were illnesses that shouldn’t have been devastating entire communities, but they were because of inequities in access to care.

David Caldwell

What did he do?

Sofia Ramirez

He jumped in. He volunteered his medical services in Samoa and Mozambique. And it wasn’t just about being on the ground treating patients—he was also working to understand the broader systems that perpetuated those inequities.

David Caldwell

Okay, so like, hands-on experience, but also… systems-level learning?

Sofia Ramirez

Exactly. He served on the Board of Advisors for a nonprofit organization that focuses exclusively on global health. Plus, he earned a certification in travel and tropical medicine through this program called the Gorgas Diploma Course. It’s based in Peru and—it’s intense—one of the gold standards for learning about tropical diseases.

Sofia Ramirez

Those experiences transformed how he saw global health. He realized that those inequities we talk about—they’re not abstract. They’re personal, they’re immediate, and they impact millions of lives every day.

David Caldwell

Important stuff.

Sofia Ramirez

Exactly, David. And for Dr. Swanson, those early experiences laid the groundwork for everything he’s done since. They shaped his understanding of what it takes to address not just individual diseases, but the systems that allow them to thrive.

David Caldwell

That’s really fascinating, Sofia. So, why did Dr. Swanson decide to look beyond just medicine? I mean, treating individual patients is what most doctors focus on, right?

Sofia Ramirez

That’s a great question. For Dr. Swanson, it all started with this realization that the traditional biomedical model—what we’re so used to in healthcare—just wasn’t cutting it. It focuses almost entirely on treating illness after it happens, not on preventing it in the first place.

David Caldwell

Okay, so it’s like playing defense for the team… but no one’s actually practicing offense?

Sofia Ramirez

Exactly. And in his work as an ER doctor and through his experiences in global health, he began to see all these patterns. It wasn’t just about individual patients; it was about the environments they lived in, their behaviors, access to resources—you know, the broader picture. He realized those things actually account for over 80% of health outcomes. The medical treatment itself? Less than 20%.

David Caldwell

Wait, what? Only 20%?

Sofia Ramirez

Yep. It’s a huge wake-up call, right? And that’s what led him to pursue his Master of Public Health at Johns Hopkins. He wanted to dig deeper into those upstream factors—social, environmental, behavioral—and figure out how healthcare systems could address them more effectively.

David Caldwell

So, instead of turning up at the river to save people from drowning, he’s like—

Sofia Ramirez

He’s asking, whoa, why are people falling in the river in the first place?

David Caldwell

Exactly! Wow, that’s—that’s a pretty massive shift in thinking.

Sofia Ramirez

It is. And for Dr. Swanson, it wasn’t just theoretical. He saw firsthand how addressing those larger factors could completely transform the health of entire communities. It was like peeling back the layers to uncover the root causes of illnesses that, frankly, shouldn’t happen in the first place.

David Caldwell

So—and this is kind of wild—it sounds like he moved from being a doctor in the ER to thinking like... like a system architect.

Sofia Ramirez

Exactly. That shift changed not just how he practices medicine, but how he views the whole system. For him, it’s not about tweaking the old model—it’s about completely rethinking what makes people healthy in the first place.

David Caldwell

Okay, Sofia, so if Dr. Swanson is thinking like a system architect now, that brings me to something I’ve been trying to wrap my head around since we talked during the previous episodes—this idea of “complex systems thinking.” Remind me: what exactly is it, and why does Dr. Swanson think that it is such a game changer for healthcare?

Sofia Ramirez

Fair question, David. Complex systems thinking is an approach to understanding how all the moving parts of a system interact and influence each other. It’s not just linear cause and effect—it’s about recognizing patterns, feedback loops, and how small changes can cascade into big outcomes.

David Caldwell

So, kind of like—let me guess—a domino effect?

Sofia Ramirez

Exactly, but imagine the dominoes don’t just fall in a straight line. Some loop back to the beginning, others trigger entirely unexpected chains. It’s more like a web than a chain.

David Caldwell

Ah, okay, so everything’s connected, and pulling one thread could unravel the whole sweater?

Sofia Ramirez

Yes, that’s a great way to think about it. And in healthcare, this matters because health isn’t just about medical treatments. It’s influenced by social structures, political decisions, cultural norms—basically, a whole ecosystem of factors.

David Caldwell

Okay, that makes sense. But why doesn’t everyone just start making change then?

Sofia Ramirez

Because the system resists change, David. Complex systems adapt and evolve, but they also have built-in inertia. For instance, entrenched power structures or outdated policies can act like roadblocks, making it tough to implement even the most logical changes.

David Caldwell

Wow. So it's like trying to steer a massive ship, but the current’s kind of pushing against you the whole way?

Sofia Ramirez

Exactly. And that’s why it’s so important to identify leverage points—those high-impact areas where even small interventions can lead to transformative change.

David Caldwell

Leverage points, huh? Sounds like the secret sauce no one’s talking about.

Sofia Ramirez

It really is. And to make those changes, you need leaders who understand the system deeply—what we call system stewards. They’re the ones who can spot those pressure points and know how to nudge the system in the right direction.

David Caldwell

Got it. So instead of breaking the machine and starting over, we’re fine-tuning it, piece by piece?

Sofia Ramirez

Exactly. But that takes patience and a mindset shift, which is why embracing systems thinking is such a game changer in healthcare. Without it, we’re just treating symptoms, not fixing the root issues. And so Dr. Swanson dove in. He learned about the theory, and became a bit of an expert, publishing academic papers on this topic - some in high impact journals like the Lancet, and taught university classes..

David Caldwell

Alright, so what’s the catch? I mean, this sounds great in theory, but where’s the struggle in getting people to think this way?

Sofia Ramirez

Well, David, one of the biggest challenges is that systems thinking requires a long-term perspective. It’s not about quick fixes or immediate results. And that can be a hard sell in a world that often demands instant gratification, especially when lives are on the line.

David Caldwell

Alright, Sofia, speaking of systems thinking and unexpected leverage points, here’s a twist I didn’t see coming—Dr. Swanson found inspiration for our health system future from—what—the 1890s?

Sofia Ramirez

That’s right. About eight years ago, he realized that if we were going to tackle the inequities and inefficiencies in our healthcare system, we needed something more—a story. Something that could shift perspectives and drive systemic change on a global level.

David Caldwell

Okay, okay, I’m with you so far. But why the 1890s? What about that era spoke to him?

Sofia Ramirez

It was a time of massive social and medical change, David. Dr. Swanson wanted to find a historical figure whose life and work could teach us something today. That’s when he came across Dr. Lawson Scruggs—a Black physician who practiced during one of the most challenging periods in American history.

David Caldwell

Wait, hold on—how have I never heard of Dr. Scruggs? What did he do that made him stand out?

Sofia Ramirez

Dr. Scruggs not only cared for his community but also documented the barriers his patients faced and spoke out about the systemic injustices that impacted health outcomes. He wrote extensively about the social determinants of health long before the term even existed.

David Caldwell

So, basically, he was talking about stuff we’re—we’re still struggling with today? That’s... kind of wild.

Sofia Ramirez

Exactly. Dr. Scruggs understood that health was about more than just medicine—it was about the environment, access to care, education, and opportunity. And his work has powerful lessons for us now, especially as we try to reimagine a more equitable healthcare system.

David Caldwell

Wow. Okay, so Dr. Swanson didn’t just find historical inspiration. He’s presenting this guy’s story to the world now, right?

Sofia Ramirez

He is. Last November, he presented at the City of Raleigh Museum, sharing Dr. Scruggs’ work and its ongoing relevance. And he even gave a TEDx talk highlighting the lessons we can learn. His mission is to bring Dr. Scruggs’ contributions back into focus, showing how history can guide the future. So he's also writing a book about Dr. Scruggs and his time.

David Caldwell

Alright, I love this. But it feels like there’s another layer here. What specifically about Dr. Scruggs’ work shaped Dr. Swanson’s approach to healthcare?

Sofia Ramirez

Dr. Swanson was struck by how Dr. Scruggs connected the dots between individual health and systemic reform. He saw him as an early systems thinker—someone who understood that equitable healthcare requires structural changes. And if we would have followed his lead, the system would be much different, much better today. This perspective became the foundation for Dr. Swanson’s own work.

David Caldwell

It’s kinda poetic, isn’t it? Reaching back into history to light the way forward.

Sofia Ramirez

It is. And it’s also a reminder that the challenges we face today aren’t entirely new. They’ve been around for centuries. What matters is whether we’re willing to learn from the past to create a better future.

David Caldwell

Alright, so here’s where my brain goes—I’ve gotta ask. Does Dr. Swanson think he’s got this all figured out? Or are there gaps he’s still trying to fill?

David Caldwell

Alright, Sofia, so we’ve talked about Dr. Swanson’s vision, his historical influences, and his systems thinking approach. But here’s something I’m curious about—what’s he like as a person? I mean, what drives someone to carry a mission like this forward?

Sofia Ramirez

That’s such an important question, David. Because, for all his work and accomplishments, at the end of the day, he’s just like the rest of us. He’s human. He makes mistakes, he gets frustrated, and yes, even burnt out. He realizes that he's just one more person, and that there are thousands of other people out there with perspectives and knowlege and experiences that are just as important as his.

David Caldwell

True. We all have experiences about the need to make our health system better.

Sofia Ramirez

I know, right? But seriously, he’s talked about how challenging it can be to stay motivated in the face of such a broken system. And like anyone else, he’s subject to bias, frustrations, all of it. He’s not above the emotional toll this work can take.

David Caldwell

Kind of refreshing, though, isn’t it? Knowing even a guy trying to solve healthcare burnout struggles with it too.

Sofia Ramirez

Absolutely. Here's a bit about him: he likes backpacking, reading, hanging out with family.

David Caldwell

Okay, hold on. Backpacking? What’s the story there?

Sofia Ramirez

He just loves being outdoors. Nature, fresh air—it’s his way of recharging. And when he’s not out hiking, he’s reading, traveling, and—this is a fun one—trying out ethnic foods from all over the world.

David Caldwell

Alright, I’m officially impressed. Adventurous foodie?

Sofia Ramirez

Exactly. And I think that balance—between this heavy, emotionally intense work and these personal interests—is what keeps him going. It’s a reminder that you don’t have to be superhuman to contribute something meaningful. You just have to be willing to show up, flaws and all.

David Caldwell

That’s refreshing to hear. And honestly, it makes the whole idea of making a difference feel a lot more... doable, you know?

Sofia Ramirez

Exactly, David. That’s the beauty of it. Real change happens when real humans come together with their strengths, imperfections, and determination. And Dr. Swanson? He’s just trying to be one more example of that.

Sofia Ramirez

You know, David, that idea of balance really ties into Dr. Swanson’s vision for this podcast. It’s unconventional, sure, but it’s also grounded in that same excitement and relatability that make his approach so unique.

David Caldwell

Okay, unconventional is intriguing. What’s the big idea here?

Sofia Ramirez

So, Dr. Swanson wishes he had been taught—way earlier—the tools and mindset to transform the healthcare system. That frustration is a huge driving force for this entire project. He’s aiming to create something he didn’t have but wishes he had.

David Caldwell

So, wait, this podcast isn’t just another “here’s my expert take” kind of thing?

Sofia Ramirez

Exactly. It’s more like an ongoing journey—an informal conversation he’s having with the audience. And get this, he’s planning to drop short episodes pretty much every day. Think of it like bite-sized daily insights into health system transformation.

David Caldwell

Wait, every day? Isn’t that... kinda ambitious?

Sofia Ramirez

Dr. Swanson wants this to feel accessible—like dropping into a conversation over coffee. He’s hoping it becomes a kind of community space for people who are passionate about changing healthcare.

David Caldwell

Alright, I like that. So what’s the tech angle here? There’s gotta be one, right?

Sofia Ramirez

Oh, absolutely. He’s leveraging AI to create a one-stop hub of insight, innovation, and collaboration. The goal is to make it easy for like-minded people to connect, learn, and maybe even take action.

David Caldwell

Alright, this is sounding big. But does he have a plan for how to keep it, you know, personal?

Sofia Ramirez

That’s a big focus for him. He’s committed to responding to comments and suggestions, giving timely updates on health system trends, and really letting the audience shape the direction of the show. Think of it as an evolving conversation, not just a static broadcast.

David Caldwell

So, in a way, the audience is, like, co-creating this thing with him?

Sofia Ramirez

Exactly! And, honestly, David, he’s kind of just jumping in - he admits he doesn’t have it all figured out yet. He’s just trying to be a connector, a catalyst, and play whatever small role he can in making a difference. So any feedback is much appreciated.

David Caldwell

Just... let’s figure this out together. I like it.

Sofia Ramirez

Same here. Let's do this together.

David Caldwell

Sofia, after hearing all about Dr. Swanson’s journey and his vision for creating this community-driven podcast, here’s what I’m wondering—if someone out there wants to actually reach out and connect with him, how do they go about it?

Sofia Ramirez

Oh, it’s very easy, David. Dr. Swanson is on TikTok, LinkedIn, YouTube, his website—it’s all out there.

David Caldwell

Wait, wait. TikTok? As in viral dances and video trends TikTok? He’s on there?

Sofia Ramirez

Absolutely. And he’s he's not doing too bad. Over 12,000 followers at last count. And it’s not just gimmicks either—it’s insightful, engaging content about the health system and his perspective on transforming it.

David Caldwell

Okay, I’ll admit, I didn’t see that coming. What else? Where else can you spot him?

Sofia Ramirez

Well, for a more professional angle, there’s his LinkedIn profile—perfect if you’re thinking about collaborating or diving deeper into his work. He’s also got a YouTube channel filled with thoughtful takes on health system transformation.

David Caldwell

And you mentioned a website, right? Like the one-stop-shop for all things Chad Swanson?

Sofia Ramirez

Exactly—chadswanson.com. And if you’re old-school and prefer email, his address is rchadswanson@gmail.com. He genuinely wants to hear from people with ideas, questions, or even just curiosity about the work he’s doing.

Sofia Ramirez

And to everyone listening, thank you for joining us on this journey. This is just the beginning, and we’re so excited to keep exploring these conversations with you.

David Caldwell

Couldn’t have said it better myself. On that note, we’ll see you next time!