Turn on the Lights Podcast

What does it take for a healthcare organization to adopt new technology without losing the trust of patients and staff?

In this episode, Dr. John M. Cho, Executive Director and CEO of AMSUS, The Society of Federal Health Professionals, explores why data, AI, cybersecurity, and digital trust are leadership responsibilities rather than simply technology issues. Drawing on his experience as a physician, retired U.S. Army Medical Corps brigadier general, and healthcare executive, he explains how organizations can make technology a strategic asset through strong governance, risk management, and clear communication. Dr. Cho emphasizes that successful change...

Civic health is an integral part of whole-person health, yet it is often overlooked in traditional healthcare settings. When healthcare organizations actively empower patients to participate in the democratic process, they can help address the 80% of health outcomes determined by social and environmental factors.

In this episode, Lizette Escobedo, Vice President of Government Relations and Civic Engagement at AltaMed Health Services, discusses how healthcare organizations can take responsibility for the civic health of their communities. She shares the origins and success of AltaMed's "My Vote. My Health." initiative, a nonpartisan campaign that transforms clinics into vote centers...

AI is rapidly transforming how people access health information, but its greatest value will depend on whether it strengthens, rather than replaces, trust, equity, and human connection.

In this episode, Dr. Karen DeSalvo, a physician, public health leader, and former Chief Health Officer at Google, explores what healthcare needs from technology now. She shares how digital tools can help people manage their health, reduce administrative burden for clinicians, improve access to information, and identify inequities in care. Technology is only as effective as the systems and people using it, she emphasizes. Drawing on her work in post-Hurricane...

What would it take for AI to make health care more accessible without making it less human?

In this episode, Bill Hudson, Chief Information Officer at Hippocratic AI and former health system CIO, explores how healthcare leaders can move beyond AI hype and focus on solving meaningful problems. He explains why responsible implementation starts with a clear use case, the people who will benefit, and an understanding of how technology fits into clinical workflows. Bill discusses how AI can improve patient follow-up, expand access, and reduce administrative burdens while emphasizing the importance of clinical...

What happens when false narratives about Latino communities become a public health threat?

In this episode, Dr. Vincent Guilamo-Ramos, Leona B. Carpenter Chair in Health Equity and Social Determinants of Health at the Johns Hopkins University School of Nursing, explores how harmful narratives can shape policy, fear, trust, access to care, and health outcomes. He explains why portraying Latinos as outsiders, a burden, or undeserving ignores their central role in the U.S. economy, workforce, caregiving systems, and civic life. Dr. Guilamo-Ramos calls on health care organizations to move beyond neutrality by building meaningful relationships with Latino...

What would change if healthcare listened more deeply to Black breast cancer survivors and built systems around their experiences, expertise, and lives?

In this episode, Ricki Fairley, co-founder and CEO of Touch, the Black Breast Cancer Alliance, joins Philip McAdoo to discuss trust, science, and collective action in the fight against Black breast cancer. Drawing on her own journey as a triple-negative breast cancer survivor, Ricki explains why the science of Black breast cancer must be treated differently, how the "purple cape" of accountability shapes Black women's experience of illness, and why doctors, pharma, and health systems...

What would change if health care truly organized itself around what matters most to older adults, patients, families, and caregivers?

In this episode, Alice Bonner, a nationally recognized leader in age-friendly care and person-centered systems, joins Dr. Philip McAdoo to discuss ageism, dignity, caregiving, and what it takes to make health care more responsive to older adults. She explains how ageism shows up in everyday assumptions, communication, workflows, physical spaces, and care decisions, and why it must be treated as a health equity issue. Alice also highlights the importance of age-friendly care, the 4Ms framework, listening deeply...

Patient safety and workforce safety are not separate priorities. They are different, but deeply connected outcomes of the same health care system.

In this episode, Patricia McGaffigan, Senior Advisor for Safety at the Institute for Healthcare Improvement and President of the Certification Board for Professionals in Patient Safety, explains why health care organizations cannot deliver consistently safe, compassionate care without also protecting and supporting their workforce. She discusses why leaders must move beyond reacting to individual errors, distinguish burnout from moral injury and compassion fatigue, and create systems that encourage people to speak up, report risks, and...

What is public trust in nurses worth if it does not lead to voice, protection, and authority?

In this episode, Dr. Ernest J. Grant, Clinical Associate Professor and Vice Dean for Diversity, Equity, and Inclusion at the Duke University School of Nursing, reflects on a nursing career shaped by bedside care, burn prevention, public policy, and national leadership. He shares how nursing found him, what decades of caring for burn patients taught him about dignity and presence, and why prevention became an extension of bedside care rather than a departure from it. Dr. Grant...

What can four decades of HIV/AIDS response teach public health about preparing for the next crisis?

In this episode, Dr. Eugene McCray, a physician, epidemiologist, and longtime public health leader, reflects on the lessons HIV/AIDS has taught about trust, stigma, data, prevention, equity, and community engagement. He explains how community advocacy helped accelerate surveillance, drug development, education, and access to care, and why effective interventions mean little if they do not reach the people who need them most. Dr. McCray also explores the importance of transparent communication, timely, locally relevant data, and the creation of...

Healthcare can’t ask communities to trust systems that haven’t earned their trust.

In this episode, Harold Phillips, the CEO of NMAC (formerly the National Minority AIDS Council), discusses what HIV reveals about stigma, trust, racial justice, and the communities still being left behind by healthcare. Drawing on his lived experience with HIV and decades of public health leadership, Phillips explores why healthcare must treat the whole person rather than simply the diagnosis. He explains how stigma, misinformation, and mistrust can keep people from accessing care even when effective treatments and prevention tools are available. Phillips also...

What if the key to leading change isn't having all the answers, but knowing how to listen?

In this episode, Sue Hassmiller, a nationally recognized nurse leader, leadership coach, and health care strategist, talks about the human side of leading teams through change and what it takes to build trust, psychological safety, and true ownership. She explains why deep listening and genuine relationships are more effective than simply telling people what to do. She also explores the difference between compliance and ownership, and how leaders can help teams take greater responsibility for improvement by connecting change to...

What would health care look like if nurses had the power to shape the systems they work in?

In this episode, Dr. Beverly Malone, President and CEO of the National League for Nursing, discusses why nurses must be recognized not simply as health care workers, but as healers, leaders, educators, and system shapers. She explains how nursing's unique combination of scientific expertise, empathy, advocacy, and whole-person care gives nurses a critical perspective on what patients and health care systems need. Dr. Malone calls on health care organizations to invest in nurses by providing career pathways, supporting well-being...

What does health care truly need now, and who is already showing us the way forward?

The newest season of Turn On The Lights centers on one defining question: What does health care need now? Host Philip McAdoo speaks with experts and changemakers about workforce well-being, public health, HIV prevention, aging, technology, AI, cybersecurity, patient advocacy, and health equity. Rather than focusing solely on problems, each conversation highlights practical strategies, innovative thinking, and the leaders driving meaningful improvement across the health care system. Together, these stories reinforce that better care begins with trust, safety, dignity, and a...

Welcome back to a special encore presentation of Turn on the Lights!

As we continue our transition series, our new host, Dr. Philip, has selected one of our most impactful and widely listened-to conversations from the archives to revisit. He introduces this timely discussion with Chris Van Gorder, which explores how cost shifting, regulatory mandates, and Medicare Advantage risk transfer are pushing healthcare toward structural unaffordability.

Summary:

Leading a major health system today means juggling patient-first ethics with a financing model that keeps tightening the screws.

In this episode, Chris Van...

Welcome back to a special encore presentation of Turn on the Lights!

As we continue our transition series, our new host, Dr. Philip, is revisiting some of the most impactful conversations from the archives. For this episode, he selected a standout discussion with Dr. Michelle Schreiber and Brenna Rabel, exploring how quality measures are developed, adopted, and implemented across Medicare and Medicaid programs.

Summary:

How do we decide what “good care” looks like, and who gets to choose the scorecard?

In this episode of Turn on the Lights, Kedar Mate speaks with...

Welcome back to a special encore presentation of Turn on the Lights!

As we continue our transition series, our new host, Dr. Philip, has hand-selected one of our most-listened-to and impactful conversations from the archives to highlight once again. Dr. Philip brings back to attention this conversation with Dr. Ben Sommers on how Medicaid work requirements and reduced ACA subsidies are driving coverage losses through administrative barriers, with far-reaching consequences for patient health and the stability of safety-net hospitals and communities.

Summary:

Millions of Americans could lose health coverage in the coming years...

Welcome back to a special encore presentation of Turn on the Lights!

As we continue our transition series, our new host, Dr. Philip, has hand-selected one of our most-listened-to and impactful conversations from the archives to highlight once again. Dr. Philip introduces this essential dialogue with Professor Charles Vincent, reflecting on why its core message, moving past basic compliance toward true, real-time healthcare improvement, is so vital to where the podcast is headed next.

Summary:

Blame rarely makes care safer, but understanding the system usually does.

In this episode, Professor Charles...

Welcome back to a special encore presentation of Turn on the Lights!

As we continue our transition series, our new host, Dr. Philip, has hand-selected one of our most-listened-to and impactful conversations from the archives to highlight once again. Dr. Philip introduces this essential dialogue with Dr. Vivek Garg, reflecting on why its core message, moving past basic compliance toward true, real-time healthcare improvement, is so vital to where the podcast is headed next.

Summary:

Quality measurement matters only if it helps patients and clinicians deliver better care in real...

Healthcare improvement is never just about systems, measures, policies, or processes; it is fundamentally about people. In this special transition episode, Dr. Philip McAdoo introduces himself as the new host of Turn on the Lights, a podcast by the Institute for Healthcare Improvement (IHI). He honors the foundational work of previous hosts Don and Kadar while laying out an expansive vision for the podcast’s next chapter.

To bridge where the show has been with where it is going, Philip announces a summer series re-broadcasting the five most popular episodes from the past year. These episodes cover cr...

What happens after 150 conversations about the future of health care?

In this episode, co-hosts Dr. Don Berwick, Former Administrator and CMS President Emeritus at IHI, and Dr. Kedar Mate, Founder & CMO of Qualified Health-genAI for Healthcare and Former CEO of IHI, look back on more than 150 conversations exploring health care reform, patient advocacy, medical debt, AI, and global health systems. They discuss how the podcast evolved into a platform for making complex health care topics more understandable through candid conversations and personal storytelling. The hosts also announce a transition as the podcast continues under the Institute for...

What happens after 150 conversations about the future of health care?

In this episode, co-hosts Dr. Don Berwick, Former Administrator and CMS President Emeritus at IHI, and Dr. Kedar Mate, Founder & CMO of Qualified Health-genAI for Healthcare and Former CEO of IHI, look back on more than 150 conversations exploring health care reform, patient advocacy, medical debt, AI, and global health systems. They discuss how the podcast evolved into a platform for making complex health care topics more understandable through candid conversations and personal storytelling. The hosts also announce a transition as the podcast continues under the Institute for...

Health care should not be designed around fragments of a person’s life. It should be built around the whole person, with data, intelligence, and ownership working together.

In this episode, Nasim Afsar, author of Intelligent Health and former Chief Health Officer at Oracle Health, joins Don Berwick and Kedar Mate to discuss how technology can transform healthcare from reactive and fragmented to personalized and proactive. Drawing on her experience as a hospitalist, quality leader, health system COO, and health tech executive, Dr. Afsar explains why healthcare systems often fail when they prioritize institutional needs over patient re...

Health insurance policy is complicated, but the consequences are deeply human.

In this episode of Turn on the Lights, Professor Jonathan Gruber, Ford Professor of Economics and Chair of the Economics Department at MIT, joins Don Berwick and Kedar Mate to explore the history, structure, and future of health reform in the United States. Drawing on his work shaping Massachusetts health reform and the Affordable Care Act, Gruber explains the three-legged stool of reform: ending insurance discrimination, requiring broad participation, and making coverage affordable through subsidies. He also reflects on the political battles behind the ACA, the...

AI may be the breakthrough that finally helps a deeply strained health care system do what clinicians and patients have needed all along.

In this episode, Dr. Bob Wachter, Professor and Chair of the Department of Medicine at UCSF, examines why artificial intelligence marks a pivotal shift in health care and what it means for clinicians, patients, and care delivery. He draws on past transformations, like hospital medicine and electronic records, to explain why AI stands apart as a fundamentally different force. The conversation highlights where AI is already adding value, including medical scribes, chart summarization, and...

Public health is easiest to overlook when it is doing its job well, and hardest to defend when uncertainty is unavoidable.

In this episode, Dr. Rochelle Walensky, former CDC Director and infectious disease physician, reflects on the leadership challenges, pressure, and public scrutiny she faced during the height of the COVID-19 pandemic. She discusses the difficulty of communicating evolving science in real time, preparing for congressional hearings, and rebuilding morale within an agency under intense strain. Dr. Walensky also highlights lesser-known public health efforts, including the CDC’s work to prevent measles spread during the Afghan evacuation. Sh...

Why does public health so often get neglected until a crisis makes its value impossible to ignore?

In this episode, Dr. Tom Frieden, President and CEO of Resolve to Save Lives, former CDC Director, and former New York City Health Commissioner, reflects on a career spent trying to close the gap between what we know saves lives and what we actually do. He shares how his father’s example shaped his commitment to evidence-based medicine and public service, and he explains the framework behind his new book, The Formula for Better Health, see, believe, create. The conversation ex...

What if one of the biggest barriers in health care is not access to treatment, but access to your own data?

In this episode, Hugo Campos, patient advocate, creative strategist, and participant ambassador, shares how his diagnosis with hypertrophic cardiomyopathy led him to advocate for patient agency and access to personal health data. After receiving an implantable cardioverter defibrillator, he discovered that data from his own body was shared with clinicians and manufacturers, but not with him. This realization sparked his work in data liberation and his challenge to traditional health care models. He explores how withholding...

What happens when a practicing surgeon, health economist, and federal policymaker brings all those perspectives into one leadership role?

In this episode, Dr. Meena Seshamani, Secretary of Health for Maryland, discusses how her journey across clinical care, health system leadership, and public service has shaped her approach to health care transformation. She reflects on leading Medicare during a time of major change, including expanding support for caregivers and community health, improving prescription drug affordability, and advancing drug price negotiation. Dr. Seshamani also explains how Maryland’s unique global budget model is helping shift hospital incentives toward keeping pe...

If public health is the foundation for individual health, why is it still treated like a “nice to have” until a crisis hits?

In this episode, Michelle Williams, an epidemiologist and public health leader, and Linda Marsa, a health care journalist, discuss what public health actually is, why it matters for human thriving, and how it differs from medical care that treats one patient at a time. They unpack how incentives often push resources toward reactive, profit-driven care instead of prevention, even though social determinants like housing and clean air drive most health outcomes. The conversation traces recu...

Blame rarely makes care safer, but understanding the system usually does.

In this episode, Professor Charles Vincent, a clinical psychologist and leading patient safety researcher, explains how harm often emerges from a chain of small breakdowns, not from a single “bad” decision, and why the better question is “what in the system allowed this to happen?” He unpacks how the fixation on individual error can miss deeper contributors, such as fatigue, poor supervision, weak monitoring, clunky equipment design, noise, distraction, and communication that is not truly heard. You will hear why disrespectful behavior and hierarchy are safety risks, h...

Stories can help people understand why health care keeps failing both patients and clinicians. 

In this episode, Shantanu Rai, a primary care physician and novelist, discusses how his medical thriller, A Dangerous Diagnosis, became a way to explore moral injury, physician burnout, concierge medicine, worsening access to specialty care, fragmented treatment, and the financial and administrative pressures reshaping modern practice. He reflects on what he sees in safety-net primary care, why more physicians are considering escape routes from traditional medicine, and how payment models can make care feel rushed and transactional. Shantanu also explains why he chose f...

How do we decide what “good care” looks like, and who gets to choose the scorecard?

In this episode of Turn on the Lights, Kedar Mate speaks with Dr. Michelle Schreiber of the Centers for Medicare & Medicaid Services and Brenna Rabel of Battelle about how quality measures are developed, adopted, and applied across Medicare and Medicaid programs. They explore why measurement is essential for accountability, patient choice, and improvement, while also acknowledging its vulnerability to politics, feasibility constraints, and “teaching to the test.” Using diabetes and sepsis as examples, they explain how performance cutoffs are established, why “all-or-non...

How do health care quality measures get created, and are we measuring too much?

In this episode, Jeff Geppert, Senior Research Leader at Battelle Memorial Institute, discusses the lifecycle and future of health care quality measurement in value-based care. He explains how measures move from multi-year development and evidence testing through endorsement and CMS rulemaking before being implemented in federal programs. He addresses concerns about measurement overload, noting that health care complexity has driven the growth in measures but that rising infrastructure costs, interoperability demands, and AI adoption may force greater focus and parsimony. He also shares...

What would it look like if aging in America came with a real plan instead of a quiet free fall?

In this episode, Dr. Joanne Lynn, a longtime geriatric and hospice physician and elder-care policy leader, explains how longer lives have outpaced the systems people rely on when disability arrives. She highlights how ageism and invisible, unpaid caregiving strain families, often forcing them to drain savings before support becomes available. She also examines staffing shortages in nursing homes, limited geriatric training for clinicians, and gaps in long-term care infrastructure. Finally, she shares promising solutions, including community villages...

Leading a major health system today means juggling patient-first ethics with a financing model that keeps tightening the screws.

In this episode, Chris Van Gorder, President and Chief Executive Officer of Scripps Health, explains why health care is becoming structurally unaffordable amid soaring premiums, uncompensated emergency care, and rising input costs. He describes how hospitals have become the default safety net as county systems disappear, while underpayment by Medicare and Medicaid forces cost shifting onto employers and commercially insured patients. Van Gorder also highlights California’s seismic rebuilding mandates, which create massive capital pressure without matching reimbursement. He...

What does it take to reimagine aging services in a complex health and social care system?

In this episode, Marta Corvêlo, President & Chief Executive Officer at Somerville-Cambridge Elder Services, talks about her journey into health and human services and her approach to transforming community-based aging support. She shares how her upbringing in Portugal and early work with refugee families shaped her commitment to social impact and equity. Marta explains the mission of SCES and how its home-based, wraparound services help older adults, people of all abilities, and caregivers age with independence and dignity. She also discusses o...

America’s drug crisis isn’t a science problem; it’s a pricing and policy problem that blocks patients from medicines that already exist.

In this episode, Dr. Jerry Avorn, a professor of medicine and leading expert in pharmacoepidemiology and medication policy, discusses why many patients still can’t afford essential treatments even as breakthrough drugs for cancer and inflammatory disease proliferate. He shares a personal case where “nonadherence” was really unaffordability, then unpacks how US exceptionalism in drug pricing, patent “thickets,” and delayed competition keep costs unsustainably high. Dr. Avorn also contrasts access failures with overuse concerns, explor...

Mindfulness isn’t a “nice-to-have”; it’s a low-cost public health lever that changes how people handle pain, emotions, and community life.

In this episode, Brother Phap Luu, a monk in the Plum Village tradition founded by Thich Nhat Hanh, discusses how mindfulness can be practiced as “everyday meditation” through breathing, walking, eating, and even cultivating awareness of dreams. He shares his personal journey from activism and disillusionment to depression, and then to healing through mindful breathing and finding community at Plum Village. Brother Phap Luu explores the roots and global reach of Plum Village, why mindfulness naturally fo...

Quality measurement matters only if it helps patients and clinicians deliver better care in real time, not just prove compliance after the fact.

In this episode, Vivek Garg, President and CEO of NCQA, reflects on how growing up with an immigrant physician father, living with his mother’s undiagnosed bipolar disorder, and training in internal medicine shaped his commitment to patient-centered improvement. He explains why he pursued “edge-case” primary care roles at innovative organizations and how those experiences led him to focus on quality, value-based care, and complex populations. Vivek also clarifies NCQA’s role in convening standard...