Funding physician wellness: a guide to getting programs approved [PODCAST]

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Pediatrician and certified coach Jessie Mahoney discusses her article “How to get physician wellness programs funded: a proven path forward.” Drawing on nearly two decades of experience navigating institutional hurdles and five years designing wellness programs, she provides a practical roadmap for securing funding. Jessie asserts that funding is possible, countering common skepticism by highlighting diverse funding sources like philanthropy grants, departmental funds, leadership development budgets, and CME dollars. Key strategies include: starting with the belief that funding is attainable, advocating effectively by personally experiencing and embodying the benefits of wellness, engaging leadership by having them participate directly in programs, thinking creatively about funding streams beyond wellness committees, prioritizing high-impact programs led by credible experts over ineffective ones, and considering cost-sharing models. Jessie emphasizes that institutions will fund experiential, connection-focused, and implementable programs that demonstrate tangible change and have leadership support.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at kevinmd.com/podcast. Today, we welcome back Jessie Mahoney. She’s a pediatrician and physician coach. Today’s KevinMD article is “How to get physician wellness programs funded: a proven path forward.” Jessie, welcome back to the show.

Jessie Mahoney: Thank you so much for having me.

Kevin Pho: All right. So, we were talking offline. You were last on the show about four-plus years ago. Now, for those who didn’t listen to you back then, just briefly share your story and then talk about the KevinMD article.

Jessie Mahoney: Wonderful. So, as you mentioned, I’m a pediatrician, and I worked at Kaiser or the Permanente Medical Group for about twenty years. And there, I was a physician wellness leader. About five years ago, I pivoted and went off on my own to do physician wellness, because I really wanted to be in a position where I could be more nimble. Large organizations want to do so many things, but they are huge container ships, and therefore, it’s very challenging.

I made the decision to found my own business called Pause and Presence, where since then, I’ve been doing physician coaching and retreats. I give a lot of keynote talks. I have a podcast called The Mindful Healers Podcast, and more recently, I’ve been doing a lot more work circling back to institutions and helping them bring wellness that works to their doctors and teams.

That was really the inspiration for this article. I hear all the time, “There’s no money. We can’t get it. Can’t make it happen. My organization says that they prioritize wellness, but they don’t.” And I actually believe that all organizations want to fund wellness. They just don’t know what to do. They don’t know what works. And we kind of have to make it easy for them by using the right language and showing them things that work and make a difference.

So, I thought I would share what had worked for me, especially recently, because I have seen this pattern, and I feel like for physicians out there who really want to make a difference, it seems clear that there is a path that works repeatedly. I thought this article could share that.

And really, what I share in the article, for those who didn’t read it, the key points are, one, that you have to believe it’s possible, because our doctor brain always says it’s not possible, it won’t work, they haven’t done it in the past. Without that belief, you don’t get anywhere. And then the second piece is actually doing it yourself. What I have found is that people who help bring things to their institution do coaching first. They’ve come on a retreat first, and they come back and they are the model. So they’ve changed, people see that they’ve changed, they see how it’s changed the environment, and then they want to bring it forward.

The other piece then is inviting leadership. So many of those people then talk to their leaders and say, “I did this great thing, you should try it.” Their leader may or may not do it, or they may or may not have been a leader, which is often the key linchpin piece. But bringing leaders in is really helpful, and even when you get something funded, making sure that your leaders come. I like to say, as a participant, the leaders always want to audit. They just want to say, “I’ll just watch and see what’s happening.” So really getting them to experience it themselves, that’s where you can really make things happen.

And then once you’re there and you have a program, and I’ll say a program that works, because I think a lot of wellness programs are really just a talk here, or they’re not what I call true wellness, because they’re talking about wellness but not embodying it or gifting you wellness. But then it’s really getting super creative. I think very often people say, “Well, my wellness committee won’t fund this,” or “The wellness funds are limited.” And I like to think about wellness as much more broad reaching, because wellness fixes retention. So therefore there’s HR funds. It’s about patient satisfaction and quality of care. So, you can actually start looking at all those different opportunities as places that have funding, and often a lot more funding than wellness, and target your program with that in mind. And so, speaking the same language as the leaders and helping them solve their own problems.

I think I lean toward this particularly because I used to be a department chief and a physician leader. So it’s really helpful to understand the things that they have behind them, the metrics they have to meet, so you can help them do what they need to do and have whatever you’re trying to bring to your group meet some of those needs.

And then I think the last piece, which many people don’t want to do, is to offer to organize it yourself. I would say that while it seems like a lot of work, it’s often not. And one of the things when you’re working with someone who’s done it or knows how to do it, it makes it easy. But also, many of the people who I have worked with who’ve then gone and stuck their neck out to bring things back, many of them ended up getting promoted into leadership roles and all kinds of things, so that they actually now have roles that they love, because they’re getting to bring different things and they’re showing a different side of themselves. And so, I often say, it’s definitely worth your while. If nothing else, you have happier colleagues. And usually it also turns into something that you really enjoy that reawakens your own passion in medicine.

Kevin Pho: So, in general for these wellness programs, legitimate wellness programs to be instituted, what kind of numbers are we talking about when it comes to cost? Like what are some of the numbers that some medical organizations are balking at?

Jessie Mahoney: Well, they balk at, interestingly, tiny costs and big costs. It’s really interesting. It almost doesn’t matter the cost. I think it’s the idea that we are used to funding things for clinical care. But when they hear this word wellness, people get anxious, because I would say sometimes they’ll balk at a talk that’s a couple of thousand dollars. And then there are organizations that will pay $50,000, or grants that will cover that.

I think that one of the best ways is to start small, and then you have a program, then you have sort of proof of concept. And then you can double it and triple it. I’ll say I did a program last year where we started with twenty docs. And then because there was such interest, we were able to double it and do another group of twenty docs. And then because of that feedback, this year we’re able to do sixty docs. And so now you have one hundred docs over two years. While it might seem like, “Oh well, that’s not going to change anything,” it’s that ripple effect. It seeps out. But what I think is really fascinating, as you mentioned this cost, is it almost doesn’t matter the cost. There’s almost a resistance to that concept.

And you know, sometimes you can also split the cost, and many places will start with that, so that the organization might pay the deposit and then physicians will pay in to come as sort of a cost sharing. And then they see the benefit, and then they’re willing to fund more. So sometimes we do have to just decide to put a little bit of our own skin in the game. And that, I think, is also the power of the people who’ve done it themselves. They usually did it on their own. They did it because they wanted to feel better. They wanted to find wellness that works. And then when they feel well, they model that. It’s much more impactful.

I think many, many of us in medicine, and this used to be me too, I just wanted someone else to fix it and someone else to take care of it. I had given enough. And so while I know it doesn’t feel good to have to sort of put more in, I would say you get so much out of it that it’s worth it. Most people went into medicine, we want to stay in medicine. We love medicine. And so it’s like, what can we do to make it a better place to be and help our colleagues be healthier and create a healthier culture moving forward.

Kevin Pho: So, I know that there are a lot of variations in terms of what a successful wellness program can look like, but from your experience and from the wellness programs that you implemented, what exactly would that look like? What would a successful program look like?

Jessie Mahoney: Well, I think if you’re looking at outcomes, it has long-term impact. So, it makes long-term change. Oftentimes people go to a retreat, they have a beautiful day, they feel good, but they go back and within a week they’re back in their same thing. So, what I really try to bring to it is mindset shifts and different ways of returning, so that you return from whatever you do different, even if it’s a simple talk. Like, what is the different perspective shift that you can have? And so, I think that effective wellness programs focus on agency, and physician agency, and what you can do.

They do that while very clearly acknowledging that the system is broken and also needs fixing and all of that. But my personal belief, and I think effective wellness programs honor this and honor the problems, is that I often talk about Kintsugi pottery, where you’re fixing broken things with gold. I feel like that’s what an effective wellness program does. It gives people tools to make themselves stronger, so that we can either advocate for change or just even continue to practice medicine in the system as it is. And so, if it doesn’t lead to something, and I won’t necessarily say measurable, but if you don’t feel different afterwards and you’re not showing up differently, it isn’t impactful.

And to have that happen, I think we missed the boat, because very much that is a feeling. I often say it’s at the cellular level that you want to make change, because if you ignore the somatic piece, we carry so much of the medical trauma in our cells. We carry so much of the medical culture in our cells. And if we don’t teach people how to actually take care of themselves and feel what it feels like to be well, it’s really just more willpower. And so, I often say that the things that work to make change, whether it’s coaching or neural rewiring or changing habits, you have to not be in fight or flight. And so, it doesn’t really work in a quick, you know, “Let’s take five minutes and do this at a huddle.” We used to do gratitude at huddles. It’s better than nothing, but it doesn’t make long-term change.

You also can’t be below empty. Nobody changes from a place where their basic needs are not being met, if that makes sense. We also often try to sort of hate ourselves into shape or shame ourselves or blame somebody, and that is not a path to effective change. So, I feel like programs really get at the physical feeling of what being well is, and that is often taking people out of the hospital. It’s being in nature, and it’s giving them all kinds of modalities, because we’re all different. And so, I think we often say, “Well, wellness is X. Everyone needs to meditate.” And I actually am a mindfulness teacher, but it isn’t that everyone needs to meditate. They need to find a way to upregulate their parasympathetic nervous system.

And I think that’s the last thing I’ll say about an effective program. One of the things that I have found most helpful is really leaning into pathophysiology and neuroscience, because then people understand it in medicine. A lot of people are resistant to wellness because either they think we want them to do it so we can work them more, or they think it’s woo. I’ll put in quotes, air quotes. And when we can start to show them a bit of the neuroscience around it, people are much more willing to dip in and try.

Kevin Pho: So, tell us a story about a wellness program that you have seen or implemented yourself that moved the needle when it comes to the staff and was impactful in some of the measures that you had previously mentioned. Tell us a story from your experience.

Jessie Mahoney: And I will say it’s actually the story that inspired the article. Over the last couple of years, I had a client who I worked with who was a leader, and she did her coaching, and she was actually, and she says this very openly, she was going to leave her job, and it changed so that she wanted to stay. And she said, “I really want to figure out how to bring this to the organization.” So she came to me and said, “We have this grant, could you help me apply for a grant?” And so together we wrote a grant application for a one-day event for twenty people.

And we got the grant, and the grant actually had a bit of a follow-up component too. So we got the grant, we offered the program, and it filled up in two hours. They sent out an email, and it was completely full. So we went back and asked for a second grant. Could we do another one? There was so much interest, and we actually got a second grant based on that, based on a waiting list as long as the number of people that could come. And then based on those two, we reapplied for the same grant but more. We were able to get a much bigger program for the following year, and we were also able to do another key piece, which was bring in a leadership component. So we brought in a leadership workshop to explain what these programs were about and why leaders should refer physicians to them or encourage physicians, why leaders should come themselves.

And so we are actually in the midst of that. I’m not quite sure what the next step is, but I would say that that is really sort of how you see these things play out. I see time and time again where someone has done the work themselves, and then they maybe want to bring a coaching program to their institution. I’ve done a similar thing for fellowships, where one person had a great experience and said, “Do you think we could build something?” And so when you’ve experienced it and you advocate from that standpoint, you’re much more likely to get funding.

Interestingly, both of those programs, the funding came from completely different piles of money. And so again, it’s the creativity of, does GME have funding? Does philanthropy have funding? Does patient satisfaction have funding? Does retention have funding? Looking at every organization is different, so you kind of have to figure out where are the full pockets in your organization. And I know many people will say there’s no full pockets right now, but I think that the cost of losing doctors is really high. And so the benefit of wellness, if it retains doctors.

And I will say I think that was one of the most powerful things in our grant. This person could literally say, “I was going to leave my job and now I’m staying and I love it.” And now she actually has a much bigger leadership role and loves that. And so I think that when you can tell personal stories like that, it makes it much more powerful.

And then measuring it to some degree. I think we get very fancy in thinking we have to do burnout surveys, we have to do official research projects, which makes it a lot more expensive and a lot more time-intensive. I have not done that. I literally get written feedback, written personal comments, and then ask for them later of how it’s helped. Circling back to people. And you don’t get great feedback two to three months later, but if you get a few people, it’s helpful. And ongoing year after year, then you have a lot of personal comments.

And so maybe simple questions like, “One hundred percent of people think this is worthwhile. One hundred percent of people think it should be offered long-term.” So you ask questions like that on your survey that are super quick and super fast. And then a personal comment, that language from individuals about how it helped them, is incredibly powerful for leadership.

Kevin Pho: We’re talking to Jessie Mahoney. She’s a pediatrician and physician coach. Today’s KevinMD article is “How to get physician wellness programs funded: a proven path forward.” Jessie, let’s end with some take-home messages you want to leave with the KevinMD audience.

Jessie Mahoney: My take-home would really be to start with yourself. And then to believe in the possibilities, that instead of thinking about why things won’t work, think about how they could or would or might. And then maybe also just that wellness is really a critical piece of organizational function. And if you can think about it like that rather than as woo, you’ll be a lot more effective in advocating for effective programs.

Kevin Pho: Jessie, thank you so much for sharing your perspective and insight. Thanks again for coming back on the show.

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