Ep20: Kevin B. Mahoney, CEO of Penn Medicine, on Healthcare Leadership, Innovation, and Lessons from COVID-19

Hills and Valleys is a podcast that uncovers stories from leaders in healthcare, tech, and everything in between. Straight from the heart of Silicon Valley, we give you a look at the good, the bad, and the future, one episode at a time. Brought to you by Potrero Medical.

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About Kevin B. Mahoney

Kevin B. Mahoney is Chief Executive Officer of the University of Pennsylvania Health System (UPHS). He assumed this role on July 1, 2019.

Beginning in 1996, Kevin’s leadership posts at Penn Medicine have included serving as Executive Vice President and Chief Administrative Officer of UPHS, Executive Vice Dean of the Perelman School Medicine, and Senior Vice President of UPHS. He also served as Executive Director of Phoenixville Hospital, as Executive Director and Chief Operating Officer for Clinical Care Associates, and as Director of Network Development.

Kevin’s operational portfolio at Penn Medicine has included information technology, strategic planning, the primary care network, human resources and capital planning. He has led several transformative construction projects which have expanded and enhanced Penn Medicine’s clinical care, teaching and research missions, including the Smilow Center for Translational Research and the Henry A. Jordan M’62 Medical Education Center. He oversaw the implementation of a common electronic health record platform across five hospitals, numerous outpatient clinics, and home care – the only comprehensive system of its kind in the Philadelphia region.

He directs the development and construction of a new $1.5 billion hospital, The Pavilion, on Penn Medicine’s West Philadelphia campus, which will house inpatient care for the Abramson Cancer Center, heart and vascular medicine and surgery, neurology and neurosurgery and a new emergency department. The Pavilion, which will be the largest capital project in Penn’s history, is expected to be completed in 2021.

Prior to joining UPHS, Kevin served as Vice President for Johnson & Higgins, where he provided leadership to the Health Group, including risk transfer and alternative risk management strategies. He also served as Vice President for Administration for nine years at Bryn Mawr Hospital, and as Director of Administrative Services for Episcopal Hospital for three years.

He is a graduate of Millersville State College, where he earned a bachelor’s degree in Economics, and he holds an MBA and a doctorate from the Fox School of Business at Temple University.

Follow Kevin on Twitter @kevinbmahoney

Transcription 

Khateeb: Hi everyone. Omar M. Khateeb, Director of Growth here at Potrero Medical , and we have a fantastic interview lined up for you today. I’m very fortunate and lucky to grab a little bit of time with Kevin Mahoney who’s the CEO of Penn Med. We got lucky and connected on LinkedIn and after seeing his story and the wonderful things that him and his organization are doing, I knew that we had to have him on the show today.

So Kevin, thank you so much for joining us.

Mahoney: Omar, I’m really pleased. And I’m going to enjoy the next  60 minutes or so that we spend together and hopefully informative to your audience.

Khateeb: Definitely, definitely. It’s going to be a lot of fun. So let me ask you the first question that I think is on a lot of people’s minds.

So, you know, Penn is a  $7.8 billion healthcare system. And historically, in my opinion, one of the most historic hospitals in the United States, I know some of my friends at Hopkins and Harvard might get upset with me, but it was the first hospital in the United States. You were there for 23 years dedicated, patient, and you just took over the helm in July.

And now we get hit with a pandemic your first year, right? What kept you at Penn for 23 years when you could have very easily gone anywhere else that you would’ve wanted to go.

Mahoney: Yup. So thanks for the kind words on, on Penn Medicine, as you said, the nation’s first hospital, we still operated down at eighth and spruce, and that has given us inspiration during this pandemic because  the Spanish flu in 1918. We have a history of stepping up and helping our country. So this was definitely in our wheelhouse. What, what I think is important from my perspective is this first year of being the CEO, I’ve seen an acceleration of trends. You know,  we hear “Oh, the new normal”, the rules are never going to be the same.

And what I think COVID actually did was accelerate trends that were already underway. And we’ve had a number of hospitals close in the Philadelphia area. And financially that hits it just been huge over the last six months. And I think you’re going to see an acceleration of hospitals closing, which means we have to do more home care, more ambulatory care, more virtual care because we’re not going to have that traditional inpatient capacity that is defining the American healthcare system.

The trend to tel ehealth, you know, it was well underway before COVID it’s not like Google woke up and said, let’s start virtual health. “Well, man, it’s your accelerated it, you know, w we had done, I think I quote 150 telemedicine visits in the first two weeks of March. And by the end of April, we’d done 400,000 telemedicine visits.

So again, we have the infrastructure in place it’s not new, but it’s certainly accelerated the, uh, the trend, uh, significantly. I think I know in other. Uh, topic on more that, um, I get asked a lot about is work from home and, you know, we spend over $55 million a year on office leases and our solution had been put everybody in smaller and smaller cubes, open work, you know, work benches, trying to get more people into a smaller and smaller space because of the cost of the annual leases.

And again, I think. We recognize that was an undue burden that cost COVID as pointed to remote. Working at home, uh, properly organized has been beneficial to us financially and to many of, many of our employees. And we’ve been following that trend now for, uh, you know, almost six months. And we learned a lot out of that.

Khateeb: Amazing. Now. One thing. I’m, you know, a lot of times when I look at a hot hospital executives, especially at, you know, America’s top institutions, I like to see it. I’m a sports fan site. I see it very much like, um, you know, great, uh, college football coaches are called basketball coaches where, you know, if you’re at a one at a very top tier program, it’s very easy to say, you know, I’m kind of eager to lead and let me go, you know, take over the, you know, the head at somewhere else.

And so you were at Penn, you know, since 1996. And so w the best part about that is that, you know, their organization inside and out culturally, from a business standpoint, you know, what, what, what kept you there? And did you see yourself at what, at what point did you see yourself taking over the helm? Well, um, I, I, you know, I’m a man of great confidence in my ability.

Mahoney: So I thought like the first day they should name me the CEO, but it took them a couple of decades to, uh, uh, to get around to that. But, but let me just, if I can address your question directly, Penn medicine has a unique culture and we’re, we are one of the few private, uh, health systems that’s owned by the university.

So we’re not, we’re not separate from the university. We are part of the university. If our of our health system gets a bond, upgrade, the university gets an upgrade. If we get a downgrade, they get a downgrade. So we are tightly, tightly linked. 60% of the operating margin from the health system goes back to fund research at the university.

25% goes back to fund education. So. You have a culture and an ethos where, uh, I, I read a lot, uh, Omar, we were talking about this earlier, our love of reading, military history and some things, and general Dempsey has a new book out. And he was the chair of the joint chief of staff. When he took over Fort Riley in Kansas, it was the first time they put an armor unit with a Calvary unit, with a military police and everybody worked.

All of a sudden thrown together. And it was her first time in the army that reorganized trying to save money and break down these silos. So they, you know, they all were California hats and he was having a hard time getting everyone together. And he said, what is it mean if you’re in the calendar? And it said, we’re a scout.

And he said, whenever I stopped somebody at Fort Riley, I’m going to ask them what they do. And they’re going to answer. I am a scout. So if I asked the infantry, man, I’m a scout, the armor, the kitchen, everybody says, I’m a scout. I translate that to Penn medicine. We are all cancer researchers. I might be doing revenue collection.

I might be cleaning the rooms. I might be a nurse, but if 60% of everything I do goes back to cancer research and heart disease. I’m a researcher. So when one of our guys wins a Nobel prize, we won’t get to. Go to the party, but we can say to our grandkids, we can say to our neighbors, we can say to the guy at the sporting events or, you know, in the future, hopefully back in inside the restaurants that I was part owner of that Nobel prize, I made it happen.

And, and I think that ethos Coles everybody in the same direction at Penn. It’s a glue that has kept me there and has kept so many of my colleagues there. I’m not the only lifer at Penn. Well, you know, I was going to say some of these towards, uh, towards the end, but you know, this is actually kind of a perfect one.

So, uh, you’re very popular on LinkedIn. I did a post just last night, not even, you know, a couple of days ago I did a post last night and we had, um, Well over 50 people engage with it, ask some questions. So I have an interesting question regarding Penn’s culture. So this is from my close friend, uh, Giovanni Laura sella, uh, make people know him as mr.

MedSeq cause of his, uh, fantastic posts on the medical device industry. His question is what is Penn’s top three. Talent retention points that drive employees to not only stay, but turn down opportunities that approached them during this pandemic. In other words, what makes people stay at Penn medicine? I can, if I can have thought of a better question.

So, Giovanni, thank you. Your question. What are those top three things? So, uh, again, I first is the culture and then it is a culture. That’s spans. You know, I went to every employee by, by video because we couldn’t do town halls in person anymore. And I said, I will get you whatever PPE you need personal protective equipment.

And we will spare no costs to make sure that you have all the PD that’s needed. At one point we had 33 FTEs tracking down personal protective equipment. So we wanted them to know when they arrived. At work that our first, our first and overarching was that they would be safe. Uh, we stood up a behavioral health app and it’s been paying now 50,000 times because you talk about a stressful time.

I’m trying to take care of the patients in the emergency room. I’m worried about my, my dad who might have cancer. And am I going to bring the term home to him with a visit? I worry about my kids in school. I mean, you’re talking about. So many things being thrown at our employees at one time. So in 10 days we, we stood up a, uh, behavioral health app and you know, it, it’s sort of like open table where it’ll get you to a provider virtual because we weren’t, but it’ll get you to a licensed social worker, a psychotic, whoever you need just remarkably fast.

And so culture, I think, is what keeps people there. Number one, Interesting. But the second thing that keeps everybody there, I believe is we, we make a lot of money. We’re not ashamed of it, but we reinvest that money and resources. We have very strong nurse ratios. We, we we’ve spent a bloody fortune on EMR.

People have the supplies, they need to do their child because who, who doesn’t, who wants to go in and not be able to do a fantastic job because. You don’t have enough supplies or you’ve got to ask for, you have to go through that. And I think that, um, so that would be number two. Number one would be, we care for our employees and they know it.

And, and if they don’t know what, I’m not doing a good job, second, they have the resources, they need to do their job. And then third, and I think it goes partly to our Quaker founding, but it is team-based and it is, um, Whether it’s team, the science team based care. And I think humans, I can tell you, I have missed more than anything over the pandemic being with other people.

And I think people want to belong to a team and they, they, they, they feel passionate when I come into founder’s 12 and I always come into founders 12. I’m not getting moved around from unit to unit to unit, like that’s my home base and that’s stability. And that teamwork, I think is. It keeps people together.

Khateeb: Absolutely. And I think, I think, you know, at the end of the day, even, you know, many of us, we go to high school college. If you grew up here in America. I mean, the idea of having a team, you know, it’s indoctrinated in all of us. And I think you’re very lucky, you know, I’m lucky because I have that with Potrero.

Um, but it seems like the employees at Penn and at least this is me as an outsider observing, um, cause you’re not the only, uh, Penn med, uh, connection. I have, I had a couple of classmates from medical school who did, who did their residency there. And I have other employees at Penn who I’m connected with and I got the sense from them.

You know that there’s this, this pride in team pride in, in, in, in the, the flag that they, that they’re under. Um, and I love that you just said, cause you know, again, I’ve, I’ve interviewed many, uh, healthcare executives over, over the last couple of years, you know, industry and whatnot. And of all the things that you could have picked you, you picked culture first and then specifically talked about behavioral health, which I think in the middle of a pandemic, right.

That was the last thing on a lot of people’s minds. But in fact it was probably one of the most important things, maybe right after, uh, controlling a risk of infection. What made you make that decision and how, how did you come? How did your team come around rallying to do that? Especially again, pandemic hits, so things are going awry.

Mahoney: How did that happen? So I think our team, uh, it’s not as diverse, ethnically as we want it to be. And I’m working on that our leadership team needs to better represent, uh, the workforce and the communities that we take care of. So when I say we’re diverse, it’s not a diversity of ethnicity, but diversity of thought, trust me, behavioral health.

Wasn’t the first thing that I thought of in the middle of the pandemic, but dr. Delaney and our innovation center. And human resources. Like they, they, they bang me quick. And so we gotta take care of this and I say, go with it. And you know, the supply chain, people were all over the supply chain. So our, our strategy of hiring exceptional people and putting them in a leadership team so that we’re always poking, poking at each other.

That’s not a great management term, but. We’re always, we’re always testing. We’re always testing each other. Um, because if you’re just, if everybody was just like me, it wouldn’t work. So, um, so dr. Blaney and dr. Maria and Kendo, um, the innovation center, you know, they, they quickly said we need to respond to, um, the behavioral health part.

I also, um, I think unique to our culture is we don’t mind. Uh, following trends, instilling trends. So we, we benefited and it’s weird to say, um, in the outbreak, but we benefited from New York city, New York city, New York city was overrun, uh, before we did. And we were able to watch and learn and, uh, unfortunately, um, you know, a, a very young.

And beloved physician up in New York city in the emergency room, committed suicide. So it w you know, we didn’t say that’s never going to happen here. We, you said it did happen in New York, Italy, Spain, you know, it can happen here. So we don’t mind I’m learning quickly from other people. Absolutely. You know, I’m.

Khateeb: I never believed that things happen by coincidence. And I think that we live, you know, the world that we live in the universe said we occupied works in a very interesting way. And, you know, with the pandemic hitting, you know, uh, the coronavirus Krone, crown crowning, like birth, and it’s in the year of 2020 vision.

And you mentioned something earlier that, you know, the pandemic was kind of a, a bit of a catalyst. To accelerate things that are already happening. There are trends. We’ve all known about a clinician that means, you know, both physician and nurse and staff burnout, um, the rising suicide rates with something that’s that a lot of people don’t want to talk about and it’s being, you know, there’s a lot of, uh, um, lectures on it at conferences has always been talked about, but not a lot of action.

And so I, I admire and really applaud that your team. Recognize that immediately. And you know, there’s no saying that no one really knows how many people were saved, you know, from mental health standpoint, even from a suicide standpoint, just from that, from that, that thinks is a lot of times people, they don’t attend to these things because, because of access, you know, um, and I think even for a physician, for me, I went to medical school.

I have a father as a physician, you know, even me when it came to mental health, You know, many years ago, it was kind of like, well, I have to go to my, uh, primary care. I have to get referred. I’m just not going to do that. And you made it accessible just from an app. And that by itself is huge. Okay. And are mental health providers who really stepped up and offered their services and virtually could, could see so many more patients than they could in the traditional.

Uh, set up and as you said, precertification, and all of the things you have to go through and credit to them for, um, first stepping up and helping us out. That’s amazing. Now, you, you, I want to go back, uh, to the Penn’s culture and I want to, I’m curious about specifically how it impacted you. So when you were a young man, uh, back in the nineties and getting started, you know, surely you had someone who was a mentor to you.

Um, who were those mentors? What, what kinds of things did they teach you? What did they leave you with?

Mahoney: So it’s a, it’s a great question. And one that I reflect back on often, and with permission, I’ll go back to 1978. When I actually first got into, um, into healthcare. Um, I went to college and, um, My first grade point average was 1.98.

I made the Dean’s list. I tell everybody, but who was the Dean telling you? You can stay at school. And I went to work for a landscaper and I ran into a gentleman by the name of bill Ralph, who is an incredible visionary. And he said, I want you to cut this cornfield down. I’m going to build offices out in the suburbs.

And I’m like, that’ll never work. Everyone goes into center city to work. And he said, no, I’m going to change the world. And I, I spent, you know, three or four days with this man is a 19 year old. And then I fell under the farm tractor and I was severely injured with put me in the hospital. So I always say three things happened to me that summer.

I met Bill Rouse, who said, you have to have a vision and you have to follow it. And that has carried me through. And people at Penn would tell you. I always have a, another building, another idea, another and people shake their head. That’s never going to happen. And it happens because bill Rouse taught me.

If you want to make it happen, you gotta make it happen. Second. And then up in the, in the hospital for such a long time, I loved watching how that team of nurses and physical therapists and the person that delivered the food and the doctors and the surgeons, how they came together to take care of me.

And I really, I wanted to be in that environment. It was too late to go back already established. I wasn’t a very good student, so STEM courses and biology and all that. We’d never had a fit. So I quickly pivoted to hospital administration. Um, and then also met my wife. Who’s been my, my coach and mentor throughout.

But your point Omar is every position is built on what the person before Tanya. And when I came to Penn in 1996, and dr. Bill Kelly was the, uh, the CEO and bill taught me amazing things. And, um, he taught me the forests of, uh, uh, again, vision. He also taught me that if you don’t pay attention to the money, they can get away from you in a hurry because we were, you know, full speed ahead.

And we ran into some financial difficulties in, in the late nineties. Um, A scientist by the name of Carl June would fit into my mentorship. Um, Carl was an immunologist and he wanted to take, he was in the Navy. He was an immunologist and he really wanted to take care of, uh, people with cancer. He arrived at Penn in 1996.

The same time I did. And he said, I have this idea where I can you turn the person’s immune system into killing cancer. And then 2011, he published a Sentinel paper on how we did that. And then we were able to parlay that we now have three drugs registered on a self therapy, but Carl in 1996, man, nobody believed them.

I I’m, I’m not sure he believed it, but he kept pushing and pushing and pushing and painting that vision. So I’ve been blessed at Penn to have people a vision. And, and, and people that are just unbridled and we can make the world a better place. And, and I rapidly joined that workforce.

Khateeb: Wow. And with Dr. Bill Kelly, you know, the thing. You know, I, I was very fortunate. So when I, when I left medical school, I started at this amazing company. Mazor Robotics is first robotic spine company. And I didn’t, he never realized at the time the caliber of mentors and people you work with until later on, and he looked back and he said, Oh my gosh.

And so of course, some of the best moments that I had with my mentors, uh, one of them, uh, Christopher Sells, he was a legend in, uh, our field, uh, unfortunately passed away last year. But some of my best moments with him were moments that he told me things that, that hurt, that hurt a lot. And there’s a saying that I don’t know where, where I’ve heard this, but it says that, you know, maybe it’s some military saying, I think where it says, um, you know, you have to be ruthless with your enemies, but you have to be even more ruthless with those that you love.

And so does with, with, with Dr.Kelly. Did, is there anything that stands out in your mind, something that he told you that maybe he was very personal to you? Something that he, he, he pointed out a vulnerability and use something that hurt, but because he did that and you were, became aware of it, it made you better as a person.

Mahoney: So, um, yes. And, and Dr. Kelly was always a believer in primary data. So I would bring, you know, a report on wait times in the clinics or. One of our metrics was the phone had to be answered in three rings. And I would say, you know, we made it 97.6% of the time. And he would say, show me the data. And I fumble around and I give him the data and he’d look at him and he’d say, you know, your answer was correct, but it was insufficient because the range was, you know, X or, you know, it’s skewed and this, this direction.

And. And he taught me, um, he embarrassed me in front of everybody, uh, in, in the boardroom with this point. But you have to have the curiosity, maybe your word ruthless, you have to say to the person giving you the report, you know, like, are you sure, like here are 10 questions that I want you to answer on that data to not just take the PowerPoint and back then PowerPoint and, and, you know, things were just starting to get invented.

So. You could run something on a, I think it was a Lotus one, two, three XL wasn’t even invented yet and it would spit out. It would spit out a graph and you could go show that graph. But if you didn’t know what it meant, you weren’t contributing to the discussion. So Bill Kelly always know what the primary data is telling you and don’t be superficial.

Um, it was horrible and, uh, I took it to task. But you remembered it most importantly. And I think, you know, especially for very driven type a personalities, I think that we all had that moment where, um, we get kind of a, uh, a public flanking, but it was for our own good. And I think that, um, and I, at least with all the young professionals I mentor, I tell them that when those things happen, you have to be smart enough to detach your ego and anger from things and try and understand.

What exactly was this person trying to communicate cause even, you know, and this is coming, I think, I think you can agree that all leaders, we make so many mistakes that at least we’re like lucky enough to pay attention to in those small times where we were, right. Maybe 99% of the time, that 1% that we’re not.

We paid attention. And that changed a little bit of our mental model of how we lead a change in the last is. So you took over in July. So in the last, uh, year of leading pen, what were some of those, perhaps we can call them by CS, those preconceived notions you had that you immediately pay close attention to a small detail and you say, Oh, I need to change that, that framework in my mind.

Is there anything that sticks out? Um, so I, you know, I think there, there were a couple of things. One I’m a doer. Yeah. I like to do things. And when I stepped into the role, you know, I had to, I had to map out strategy and not, not so much on the Dewar side. And I’ve had to re resist some of my urges to, to jump in on, on things.

So that was probably that today is still the hardest lesson for me. Um, Go going forward. The second thing that I learned quickly, uh, when Honamin university was, um, hospital was closing in Philadelphia and we had all the hospitals around the table and, uh, the way of representing Penn, I could really feel like all eyes were turned into us as the, how can you help us get out of this public health crisis in the city of Philadelphia?

And. No, they didn’t turn to some of the smaller hospitals because, you know, they couldn’t help. And, um, it was, it was meaningful to me to, to realize, um, how much Penn means to Philadelphia and how, how much I was looked at as, uh, the, the thing you were faced with Penn. And, uh, I, I, so that, that was probably the, the second thing.

The the very, the very last time, Omar, I just want to make sure, um, you know, as we’ve gone through anti-racism and, and as we’ve gone through, um, the, the upside down of the economy, it also, I have led a privileged life and it was a stark reminder to me that all 40,000 employees had Penn. Are looking to me to make sure that we continue to make money, that they continue to get their paycheck.

We have a no layoff pledge. We didn’t furlough anybody. And, um, and, and it was, it was important that we, we communicate to them that we are not just a healthcare provider, but we’re looking out for, for them and their families. And, um, You know, we were able to do that. Um, I’ve been very pleased with everybody’s response.

Um, but that, that extra burden, perhaps I hadn’t, um, expected quite as much that, that people would, would turn to us and, and, and, and, and look for us to put that in place. We started a million dollar employee assistance on, um, back in the middle of March when things really started to heat up. And it was a $500 grant, any employee that wanted it.

And within 72 hours, there were over $3 million. So again, a, a stark reminder that, uh, the world, the world’s tougher, a lot of our employees and we need to. We need to eliminate when we can the anxiety around, well, I have a job. Is there going to be a layoff? Um, you know, what’s the future like, and, uh, I think we were able to convey that.

Mahoney: Yeah. And you, you mentioned it briefly, but I have to, I have to go back and really point out to our audience. Um, the fact that you didn’t furlough a single employee and you have a no layoff pledge to your employees. And again, um, I don’t fall to any, um, Any other hospital for what they had to do, because every hospital’s going to be different in the middle of a pandemic.

Uh, when these things are involved, there’s a variety of, of ways that a CEO of a system and a board can justify, you know, we, we should do this because we might, we might, we might end up with a loss this quarter. There’s a variety of ways, but somehow, uh, you and the, and the board of Penn. kept that promise.

And I think that by itself tells me why there’s a lot of lifers at Penn. A lot of people stay around because there’s a strong team and leadership keeps their promises to the employees. How important is that as a hospital CEO? Well, I deliver on those kinds of things.

Mahoney: Yeah. I think it’s critical. And we learned it back in 1999 because we did a, a large layoff when we were losing money and it took us years to recover and people didn’t believe in us. They, they weren’t putting in that extra effort. They didn’t, you know, they, the bloom was off the Rose, so, Hmm. So we, we, you talked about learning things, you know, we learned in 99 that this was not the best way to, to solve the, um, the problem.

We’ll give you an example of how we did try to go about it. So how we got out in 1999 and the losses was we put in a heavily incentive compensation plan for our physicians. And for the last 20 years, it has served us really, really well until. March six when the governor of Pennsylvania says no more elective surgery, and all of a sudden you have physician saying, I want to work.

I want to, I want to do surgery, but I’m not allowed. Why am I taking a cut in pay? I know. And a huge cut. Many of them were 30, 40, 50%. Right? So, so we got a group of the faculty together, along with our leadership team. They’d come up with a plan. The plan was no reduction for 300,000 and below 5% up to 500010% over 500,000.

And we got on a zoom meeting and we presented it and we probably had 26, 2,700 physicians. And we answered every question in the chat room and we went through it and I would be lying if I said everybody cheered. Um, But they understood. They accept that. The very last thing I said was this is a withhold, this isn’t a cut in your pay.

If we can earn it back, we’re going to give it to you. And in, in fiscal 20 on may the fourth, we started seeing patients again. And by the end of July, we were back in, in, uh, in the black and we restored that. It was worth about $30 million. So we restore that back to the physician. So I think in terms of leadership, we, we told them we have a hard decision to make.

We also communicated transparently the way out they delivered them and we kept our promise. And I think that it would have been a lot easier for me to keep that 30 million in my pocket. Yeah, I would’ve looked better to the board. I would have looked better to the rating agencies, but it was a promise.

We made that if you, if we recover, you’ll get your money back. And we were really pleased to, to restore that. That’s unbelievable. And you know, the theme that I keep hearing from you is when it’s, when it’s perfectly logical and justified to do what’s easy and most beneficial. You don’t you do you, you aim to do the hard thing, which is right, which is more fair.

Um, and obviously, uh, making this kind of this, especially when there’s a lot of money involved and in the middle of a crisis, it’s very hard, but I have to tell you, that’s incredibly inspiring to hear. Um, and I can only imagine like for a lot of those employees, because I’m sure many of them, whether it’s physicians or staff or nurses, They may, they probably were not expecting that.

Cause you re you, you look in the news. I mean, it’s all over people get furloughed hospitals laying off employees. I knew that my friends who were as they call me, we all call and talk to each other like, Oh, I got my pay doc 50% this much, et cetera. Gotcha. And so I’m sure many of them were expecting that.

And yet that didn’t happen. And you took it even a step further by saying you would compensate whatever, whatever losses there were at the beginning, which you don’t have to do. Yeah, no, I mean, it’s a very virtuous cycle. Um, you know, we gave all the employees a, a thousand dollars, uh, in, uh, the, uh, in the end of July paycheck.

And, you know, again, back to what we were talking about in terms of, um, trying to take care of everybody, you know, a thousand dollars, if you’re making 70,000 a year, It is, it helps. It helps occasion for your family. It might’ve been, um, you know, a car payment or things that you needed, or you could clean up some bills.

So they weren’t, but it, again, I don’t want to paint us as being polyamorous because it’s a virtuous cycle because Emmy employees are committed that much more and they work that much harder and, and, um, and I’m just grateful for it. All the work that they did during the pandemic, the extra work, the thermal screening, the masking, the plexiglass shields, everything that we put in place that made their jobs harder. Um, and, and they, you know, they, they took it on without out complaint.

Khateeb:Yeah. I really love that. And, you know, especially for me, um, you know, so I’m, I’m a first generation American. My father’s a surgeon from Iraq, my mother’s from Turkey and they taught me these kinds of values and. You know, um, I’m very proud to live in this country and the culture that’s here.

My wife is Turkish. And so she’s, she’s really embracing American culture. And this story you told me is, um, is, is a story of American values, um, about doing what’s right. What’s fair. Um, and helping, helping, uh, fellow Americans. You know, my father did this many times in his business, um, with patients, uh, same with my mother.

And as a result for me, you know, I try my best to make those decisions in the smallest way that I can. And so it’s very, very inspiring, very refreshing to hear that, um, we have, you know, a CEO of a, of a great American hospital who embodies that same kind of American values of doing what’s right. What’s fair, even though it’s not easy.

And I think that’s a big part of being American and, and, uh, I agree, you know, we’re also in the middle of the election season. Well, I have a concern and, you know, uh, several of our young doctors and employees have come forward with the vote, ER, campaign, I think started at mass general. And, you know, we’re, we’re, we’re trying to make sure that, um, people have an opportunity independent to participate in democracy.

Mahoney: Just as you said, I don’t tell people how to vote, but I need them to vote because I think. I think we need to make sure that what our company, our country represents is what we want it to, and the way you do that is through the ballot box. So trying to make it easy on our employees to get mail in ballots or understand how they, they, um, they can go through that is important.

Absolutely. I’ll make sure, I don’t know if you have another question, but can I bring up. A topic that’s important. Um, this is, this is your show. I a hundred percent I would love, I would love you to, yes, I do have some more questions, but yeah, please go ahead. I would like you to, one of the things that we also learned during the pandemic is the value of home care.

Um, you know, our, our nurses, we didn’t miss any chemotherapy administrations. We did them at home and we send the nurses in into that. It costs us. A lot of money, but they were willing to do infusions at home. And I’m trying to remind everybody now let’s not have muscle memory and go back to the way you think we’re, uh, well, let’s look at how, how things were during the pen out.

What was, what did we do, right. That we need to continue. And some of the things that you mentioned early on of remote monitoring. So we had COVID watch and we manage several thousand patients at home. With a pulse oximeter, a blood pressure cuff, and you know, a, a chat bot that would check on them to make sure that they were submitting their, their both side.

Cause you know, COVID is one of those things where you’re doing fine. And then all of a sudden you’re in crisis and we won. If the patient was going to the crisis, we going to get them in into the hospital. So the one trend that we didn’t talk about that I think is going to just be critical is much more remote monitoring.

Much around AI and chatbots to identify the patient that needs our help, as opposed to waiting for them to call us saying I’m not feeling well. And I think we hit, we had some good examples of how that, that might work. Well, you actually read my mind cause the question. So I’m going to read a quote to you about, about you, but it has to do with technology.

And I want to talk a little bit more about this concept of home care. Because I think it’s a very important one. Um, and you’re absolutely right. And this is the thing that I tell a lot of my peers. Cause a lot of them, they, they they’re like, you know, when this, when, when, when we go back to normal, I’m like guys, we’re learning a better way of managing medicine, doing business, all these things.

Khateeb: There’s no going back. Right. This is gonna be hard, but it’s hard for a reason. So here’s the, here’s the quote. And I, I apologize, cause I don’t have the person who said this, but when you had taken over as CEO, they said that you are a champion for ideas that become tomorrow’s cures and that you are somebody who supports small scale startup efforts to larger commercial agreements.

And it sounds like one of those things and I want to, cause you’re, you’re, you’re not the idea person. You’re an innovator. So tell me more about this concept about even when the pandemic ends, how do you continue as a hospital and a healthcare system to not go back to the old way of like, okay, let’s continue treating patients in the hospital.

How do you go into people’s homes where it’s easier, comfortable, more convenient?

Mahoney: It’s going to be more expensive, but I, I, I’m going to make a guess that when we look at the data later on, it will be better. It’ll it’ll definitely better. Uh, as you mentioned, variable costs will be higher. You know, a nurse taking care of three infusion patients.

My variable cost is much lower than, uh, you know, one-on-one nursing, but the trick is I have this, uh, um, infrastructure of buildings and how do I repurpose those? So, you know, so I can capture that, that fixed cost investment that every hospital in America has made. So that the, the variable costs, um, that increase it at home is, uh, acceptable.

So we’re, we’re working on that. We, we pride ourselves a at Penn, we were founded by, uh, a pretty good inventor, Ben Franklin and, um, in, in vending we think is in our DNA and innovations in our DNA. So an example of something we did is we set aside, uh, $50 million in an investment fund. And as companies come along.

I already, I already told you guys that I don’t mind stealing ideas rather than us trying to build it ourselves. If somebody can already is halfway there, I’d rather give them an investment and get it all the way there. And if it helps us great, if it helps America better. So, uh, we, we have probably brought in 650 $700 million over the last, um, Uh, three or four years in venture capital into Philadelphia, we call it Silicon Valley, which is cell and gene therapy and connected health.

So Silicon and, um, we are trying as quickly as we can to get things into the least expensive and most patient centered location. Which is always going to be the home or the iPhone or a virtual location, reimbursements are built that away. So we’re fighting a lot of different trends, but, um, we, we do believe innovate your way forward is the only way we’re going to get 20% of the GDP down to a more manageable number.

Khateeb: Absolutely. Now I have a few more questions. I want to be mindful of your time. Of course. I’m good on time. So I’ll go as long as, as you can by, do you want to be mindful of your time? So a few questions, so, uh, perfect timing. So one of my, uh, one of the gentlemen that I mentor, Jacob Baringer. A very sharp guy as a product manager right now in the industry.

He asked this, how has Penn medicine working to make tele-health and digital care in more integrated part of the healthcare experience? This pandemic has shown us that tele-health not only alleviates barriers to care, but also reduces the cost and increases the quality looking forward to this Omar.

Yup. So, um, that is. The answer to the question is in my question, Tel telemedicine, virtual medicine, can’t be episodic and stand alone. It has to be integrated into the entire care pattern. So not, not every visit can be a telemedicine visit. Um, so, uh, a great example would be postop surgery. So almost every postop surgical visit could be a tele.

Because, unless you’re having an infection, you know, you don’t actually have to physically be with your, your surgeon. And if we’re able to do that, it’s easier. The patient didn’t have to drive down. The doctor could see, you know, six o’clock at night when it fits into, into your schedule. But the new patient visit in the surgery had to take place in the hospital.

So again, it’s, it’s one more tool in our toolkit. And how do you fit it in. In an integrated, coordinated fashion. And, and I, I think that is the key. So I won’t call out some of the national vendors that are, um, providing telemedicine. I mean, they are worthy competitors, but I think our competitive advantage is that it’s, it’s a step in an integrated, coordinated care as opposed to one episodic episodic visit.

So that virtual visits in the electronic medical record, just like all your physical visits, where your virtual visits are all in one place. So the doctor on the phone can see the entire, uh, the entire care that you’re delivered as opposed to I just called somebody. And it’s the first time that I’m meeting them.

Khateeb: Got it. Got it. Now we got five minutes to the top of the hour. I know you’re very busy. Do you have, uh, five minutes, more 10 minutes? What do we have? Let’s go. Let’s go. 10 minutes. You’ve got to, um, uh, right. I know the audience is gonna love that we got an extra five minutes, so we’re very fortunate for that.

So why don’t we use this to kind of jump into some interesting, fun, rapid fire questions. Some of them from the audience, some of it is some basic ones that I come up with. Only rule is, is that you can answer these as, as quickly or as long as you’d like. Okay. So my first question to you is this is, you know, as a leader, uh, there’s no shortage of amount of people who are reaching out to you for mentorship.

Um, whether it’s hospital CEOs, physicians, et cetera, what book do you most often gift to others and why?

Mahoney: Um, so right now it’s the Steve jobs book by Walter Isaacson. Uh, you could probably follow that up with any, any book by Walter Isaacson, I think is worth reading. Um, his book on Benjamin Franklin, some other, uh, provocative story, but I, I, um, I’ve had the privilege of meeting, um, Steve jobs selling and, um, his wife and I belong in mired.

His, um, approach. Um, so that’s probably the one that I, I use the most. I was saying it goes through the Xerox gooey interface, but he knew what he needed and he went and he got it and he brought it in. And I think most people probably don’t realize that a lot of that early Apple was, um, a Xerox product, but, but he, you know, we, that drive.

That that, that push to change the world, I think, is something that’s embedded in Penn medicine and what every leader should, uh, should have. Absolutely. And I think, you know, I want to highlight again, cause you mentioned, um, a few times during this interview, this idea that you’re, you have no shame in stealing ideas to make them better.

And I think that’s what would real innovators do is that there’s no ego about, you know, it came from here, there, um, Sam Walton of Walmart. He stole everyone’s ideas. And even the CEO of Kmart said, yes, Sam stole everything from us and made it better. So I think that’s really important. So my next question to you is for, for, for a new hospital CEOs and executives, What’s the most common mistake you see them making in terms of what they’re trying to develop themselves into or things that they’re learning.

Khateeb: What’s a common mistake that you would, you you’ve learned from your past. And you would like to gift to those people say, make sure you don’t do this.

Mahoney: Yeah. So it’s easy that the triangle is the pyramids inverted. Everyone thinks, you know, I’m going to get to the top and everyone’s going to listen to me.

And it’s actually the other way. Around audit people, call it servant leadership or things like that. But to have a position like mine is just an incredible privilege. That’s so few people forever gifted. So I don’t think of myself as special. I think of myself as being the most fortunate person around that I’m able to lead this organization.

But again, I don’t see myself at the top of the pyramid. I stated as the other way. And. As we mentioned, sometimes it’s waiting. Um, you know, if you think about you’re at the top of the pyramid, it’s pretty, pretty easy. If you think about it’s the other way around, you have a lot of people counting on you day in and day out to do the right thing and, and that, that your melody and, and, um, uh, uh, lack of hubris.

I mean, again, to, to recognize that leadership is a privilege, um, I think is the best way to approach it. And when you think you earned it, that’s when you start getting into a. Trouble. Interesting. And I liked that concept of the pyramid. It’s the first time I heard it, but at least from a physics standpoint, then yeah.

Khateeb: Makes a lot of sense because essentially all the weight and mass of the organization is focused in a singular, small surface area. For, for a lot of pressure. I do like that. That’s actually, I never heard that. That’s a really good way to look at it. Okay. Um, so my next, next question to you is, and I know we talked about this earlier, uh, with, with dr.

Uh, uh, with, with one of your mentors, but in your life. And this could be a mentor is, could be a parent. What was the most memorable thing someone’s ever told you? And how did that impact you as a person?

Mahoney: Number one I’m 61 years old. There’s been a lot of stuff, but something probably came to mind first, whatever. What’s the first thing that came to mind. That’s the, that’s the key, I think. Yeah. So I think it’s probably, um, two things. The first night, November 10th, 1979. When I met my wife. Um, and we, we were instantly, uh, together and that’s probably my most memorable, uh, night for sure.

I think, I think the thing that convinced me that maybe I was better than I thought of myself was, uh, my dad wasn’t very affectionate or very outgoing. And one time my mom said to me, you know, your dad really thinks very highly of you. And I was like, really? Cause you know, like I never. It wasn’t something that he would, um, express and, and that made me feel better about myself and started to build some of the self confidence that you need to be a leader.

Khateeb: Interesting did that. And I have two questions, but I just have to ask, did that experience the way it felt, did that influence you as a leader in terms of how you give, um, uh, uh, pot positive feedback and, and, and appreciation to others?

Mahoney: Yeah, no, no, for sure. And, um, you know, I hope if you asked anybody that, um, Works with me that they would, um, it would repeat that, you know, I try to encourage, and I try to give credit.

I try not to take credit and to make sure that people, even when I, I don’t sleep much. And when I’m emailing people at four o’clock in the morning and they answer me four or five, I’m like, you don’t have to do this. And w you don’t, we don’t have to tomorrow me, um, So I, um, I do think it, uh, it happens that when I was at Brinmar hospital, uh, Bob Weidner, who still works with me down at Penn, but Bob would always say, anytime you’re given feedback, you need three positives, every negative.

So that three to one ratio. And I think that’s probably about right. And if I don’t have three positives to, to say, when I want to. Perhaps be harsh then, you know, I try not to say it. So maybe it is like, well, if you get one of the psychiatrists and whether it’s tied to my dad or not, so now I’m gonna flip, I’m gonna kind of flip that question on you a bit.

So one thing that, uh, many people notice, whether it’s with leaders or, or executives, they already have everything. So there’s really nothing. You can give them that they need. But there’s a lot of things that they appreciate. And I think the one thing I always tell people is that for, for your organization, whoever your CEO is, they very rarely get a thank you or an appreciation or even a shout out on social media.

Khateeb: Um, my, the CEO of my company, Joe Urban, uh, remarks, remarkable leader, I, I never met miss an opportunity to shoot, to highlight, uh, highlight them. And I think that’s a big reason why our, our employees are so. Mission driven and loyal to the company, to him as, as a leader of, of Penn medicine. What’s something that you most appreciate.

Like if someone said, said, said to you, Hey, I’m so, and so really appreciates you for what you didn’t like. What’s something that you really love and appreciate whether it’s, I don’t know them commenting on a post on social media or. W w what would that be? And I need you to be like a little bit selfish here.

Mahoney: You have permission to be a little selfish. I, I, um, I’ll, I’ll use a pandemic example, you know, we’re all wearing masks now. So I pride myself on knowing every employee and, um, you’d be amazed at how many of those 40,000 people I can identify in. Call on a first name basis and talk to, and then all of a sudden we’re wearing mask and I’m wearing a mask.

And so I put on my sunglasses, you know, like  Neato. And so I think the best gift anybody gave me is, and they don’t know who I am. And I’m walking through the facility. Somebody is still smiling or winking or, um, you know, asking me if I need directions. And, um, there was an invisibility. Cause, you know, we weren’t wearing suits and, um, we didn’t have the entourage then going in and out of the facility during the pandemic and have people treating me, um, as nice as they did, even though I don’t think they knew who I was, um, was very, very rewarding to me because I think that means when I’m not around, they’re treating other people that way.

Mahoney: I love that answer. That’s wonderful. I really love that. Uh, I am, uh, the, the whole mask, um, discussion would be a whole other hour podcast, but I am also, that just means I have to have your back. Um, but you know, um, public health is something that we’ve under invested in, in the, in the nation. And. Well, there was some mass, some of the things that we have to put into place, we need to get back to public health needs to be much more important than it has been, um, over the last several decades.

Khateeb:And, and hopefully this will be a chance for us to get back there. Awesome. Last two, I’m going to give them to you both at the same time, so you can choose which one you’d like to answer and how long first question is for, for my, for my peers. Um, what’s your, what’s your advice? Uh, a message to the, you know, health tech, medical tech, medical, uh, industry in terms of how they move forward in terms of supporting hospitals like yours, with great technology and innovation, that’s going to change and elevate the standard of care.

And the second question. It’s probably my most. It’s the one I enjoy them ask the most is that if you had a billboard, okay. That goes in front of every single hospital throughout the country. And it stays there for one year. Every single hospital employee is going to read that billboard. What message would you put on that billboard?

So I’m gonna let you pick which one you’d like to answer first.

Mahoney:Um, I’ll go with the billboard and I will go with. Blessed are the healers because we, the human condition going to be there someday. I don’t know if you’re getting that feedback on Mark. Oh, no, no. I heard you. Yeah. So, you know, we all are going to end up needing someone to take care of us. And healing is a, a mission I think is just, um, You know, it’s incredible that people are willing to take care of each other people.

They don’t know. It’s easy to take care of your loved ones, but to take care of people you don’t know. So blessed, blessed are the healers. And, um, I, I just admire everybody. You know, we call them healthcare heroes during the pandemic, and I did a couple of things for the nurses and I’m like, you know, I don’t know where everybody’s been because you’ve always been my hero.

Khateeb: So I’m glad the world is waking up. That healthcare workers are special. Absolutely. Absolutely. I love that

Mahoney: In terms of the med tech. Yeah. I should have asked you one after the other. I was like, that’s such a, that’s such a fantastic, fantastic billboard message. Now let’s pivot to the technology side, but it’s really, um, it’s really important. And you know, people coming to my office, I want to be your partner.

Let’s be a partner. We should be a partner. And I’m like, what are we going to share risk? No great answer. I just wanted you to buy, you know, uh, equipment or a product from a it, the best way to approach us is how do we get the total cost of care down? Because the unit cost, it kind of is always gonna be more expensive than local hospitals, but if the total cost.

So proton therapy, we are the world’s largest proton therapy center. It’s always going to be more expensive and I am R T or radiation, photon radiation, but we strongly believe, and we’ve demonstrated that the total cost of care as well. So if someone comes to me with a piece of med tech and they want me to buy it, the easiest way to my heart and my pocket book is we can reduce.

Implementing this will reduce the total cost of care as very, very good advice. I think again, the big thing about the pandemic and it’s happened in the last few years is that the medical industry, especially people who are in marketing and sales, they have to elevate themselves to the position of a CEO of a hospital to understand what are the problems that they’re facing, because it is a harder question to answer and it’s more complicated.

But that’s the world we’re living in personally, at least for me, I don’t believe in working for CU for companies that just have a cool widget. That’s going to make healthcare more expensive. You know, if you can answer that question, my peers are going to get really angry when I says, if you can’t answer that question directly or even walk it through critically, you’re at the wrong company.

Khateeb: So, well, Kevin, I really appreciate it. Thank you so much for coming on. Uh, I’m going to S um, uh, I’m gonna stop this for a second, but hang on for one second. We have to take a, a zoom selfie together, but thank you so much for your time and incredible wisdom. I enjoyed it. Thank you very much. And one last actually not one last question.

How can people find you online? Have a Twitter and you have a LinkedIn what’s your Twitter handle? Uh, ad Kevin B Mahoney. Perfect. I’ll leave that in the show notes.

\Khateeb:Alright. Stay around for one second. Thank you all for listening. And this has been another episode of Hills and valleys. We’ll see. Next time.

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