Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

Board-certified pediatrician and certified coach Jessie Mahoney discusses her article, “Why self-care must become medicine’s new standard.” She challenges the long-held belief in medical culture that self-sacrifice is noble and that self-care is an indulgence. Jessie argues that caring for oneself is not a luxury but a responsible, non-negotiable standard of care for anyone in medicine. She explains that a physician’s energy is their most critical resource, and its chronic depletion leads to poor decisions, burnout, and negative ripple effects. To change this, she introduces a powerful new framework: viewing self-care not as an emergency “oxygen mask” for when things go wrong, but as the “required maintenance” that happens between flights to prevent accidents. This shift redefines rest and replenishment as foundational to safe, effective, and sustainable patient care—as essential as a surgical time-out—and calls on the culture of medicine to make time for it as an expectation, not an afterthought.

Careers by KevinMD is your gateway to health care success. We connect you with real-time, exclusive resources like job boards, news updates, and salary insights, all tailored for health care professionals. With expertise in uniting top talent and leading employers across the nation’s largest health care hiring network, we’re your partner in shaping health care’s future. Fulfill your health care journey at KevinMD.com/careers.

VISIT SPONSOR → https://kevinmd.com/careers

Discovering disability insurance? Pattern understands your concerns. Over 20,000 doctors trust us for straightforward, affordable coverage. We handle everything from quotes to paperwork. Say goodbye to insurance stress – visit Pattern today at KevinMD.com/pattern.

VISIT SPONSOR → https://kevinmd.com/pattern

SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome back Jessie Mahoney, a pediatrician and certified coach. Today’s KevinMD article is “Why self-care must become medicine’s new standard.” Jessie, welcome back to the show.

Jessie Mahoney: It’s a pleasure to be here.

Kevin Pho: All right, so tell us what this article is about.

Jessie Mahoney: I don’t like the word “self-care,” and I think that’s really where this article comes from. People often say, “I’m going to take a self-care day,” and then they have to justify what that is. For many people, when we use the word “self-care,” it means massages or treats. I had in my mind this idea that self-care should be like the standard of care. I really like that phrase. And yet, for people who work in medicine—physicians especially, but really anyone who works in medicine—we don’t see it that way. We also see it as maybe just your to-do list. The reason I wrote this article was to be a little feisty and express my frustration.

Getting your teeth cleaned is not self-care. The idea of charging an electric car came to mind. People ask about that all the time, “Where can I charge?” And we just consider that something that we do. I think that for people who are working in medicine, this idea of taking care of ourselves shouldn’t be an anomaly. It shouldn’t be a special thing. It should literally be what’s considered the standard of care. When we have to give this explanation or put this effort and energy around, “I’m going to do my self-care and prioritize my self-care,” it’s because it’s not the norm.

While I also recognize that that is not what we do, and therefore it does take effort to do it, my hope is that ultimately it will go beyond just this idea of “self-care” and become our responsibility—and perhaps also the responsibility of the institutions we work for. I know that many institutions want you to do all your appointments on your day off, whatever day off that might be. Even if you work full-time, you could still do it on your day off if you’re a shift worker. There’s this idea that we want our patients to come in and see us, but we don’t go see our doctors. That shouldn’t be self-care. It really is the standard of care for every adult, including those providing the care, to care for themselves.

That’s really where the message came from, wanting to really raise the idea that it’s our responsibility—ours and our organizations’—if they want us to be there and not drop dead of heart attacks and cancer and all the things we know. Physicians generally are not the healthiest people because we don’t take care of ourselves.

Kevin Pho: In medicine, instead of self-care, it glorifies self-sacrifice, right?

Jessie Mahoney: Yes.

Kevin Pho: And it’s always been that way, as long as I can remember. Do you feel like the tide is turning a little bit? Because I know we’ve been talking about issues similar to this on our many episodes together, and I’ve talked to other physicians as well. Do you feel like the tide is turning?

Jessie Mahoney: I do think the tide is turning. But it’s turning, and maybe that’s the point of this article, to “OK, let’s use a lot of energy to advocate for why we need self-care.” I would like it to be the default, not something that we’re advocating for. We’re shifting from this self-sacrifice to, “OK, well now we are going to advocate and have boundaries about self-care,” when really the next step would be that it’s the standard. It’s what we do, and it’s really what we expect.

Interestingly, we expect our patients to do it. I’m in primary care, so we tell patients all the time, “Take care of yourself, do these things. You should exercise, you should do this.” We don’t tell them, “Oh, take a self-care day,” or make a big deal of it. And yet we have to for ourselves because it’s not considered standard; it’s considered an anomaly.

But I would say we are making progress. One of the things that I have found is that so many doctors have trouble putting on their oxygen mask first or doing their own self-care. Can you just do it? Are you not equally important or equally worthy? And I think hopefully this idea that we are all humans—all humans need health care, all humans need to move their bodies, all humans need to eat healthy, all humans need to sleep—is gaining traction. It’s just interesting that we’ve had to call it out as “self-care.”

Kevin Pho: Now you work for different health organizations. Just from across the spectrum of where you’ve worked and what you’ve seen, how are different places prioritizing self-care?

Jessie Mahoney: It’s interesting. I don’t know that any health care organization is truly prioritizing it yet, but it’s almost done as a to-do. Like, “Make sure you see your doctor, make sure that you do these things.” Or they will offer, for example, health coaches. We all have different names for it, but employee assistance or employee wellbeing. There are resources there, but the system is not inherently set up for us to have time to use them. While the culture is changing, I still don’t think there is acceptance for it. If you said, “I need an hour on Thursdays to meet with my therapist,” in most systems, that would be difficult to coordinate unless Thursday afternoon was your afternoon off.

I think the language is there and people understand it’s important, but it’s still kind of seen as a checkbox. In non-medical disciplines like law—my husband works in law—they actually get discounts on their insurance if you do X, Y, and Z, and they have these checkboxes and they encourage people to do that. I’m betting that the companies that provide the insurance for the care we provide also do that, but it’s not woven in for physicians and health care providers.

I also come from a very strong belief that when we do these things ourselves—we’ve gotten our mammogram, we exercise, we practice mindfulness, we do yoga—it’s much easier to advocate for your patients to do that. When you practice lifestyle medicine, it’s much easier to explain it and to give people ways and thought patterns that would help them change their habits. There’s actually tremendous benefit for the organizations if they are willing to take that step. I think you’re 100 percent right that the tide is turning, but I think we also have to support each other in doing it. While we all think it’s important, if it means that you have to cover for someone or something else happens, there are conflicting feelings about it. I don’t think anybody doesn’t want to do it, but the way the system is set up, there isn’t wiggle room for people to take care of themselves, and so then it has to become this fight to be able to get self-care.

Kevin Pho: How much of that culture of self-sacrifice is because medicine self-selects those who sacrifice the most? The people who get into medical school, the people who get into these competitive residencies, tend to be the ones who self-sacrifice the most. In order to create that sea change of culture, I think it’s going to be difficult because everyone who becomes a doctor, they’re really groomed in that culture of self-sacrifice.

Jessie Mahoney: Right. And I think the word you just used there is the right one: groomed. Because I think that’s a really difficult question. Did we start out this way, or were we groomed this way? I believe there’s a combination. Many of us are high achievers who were always the over-responsible one, so we began sacrificing very early on, and you can’t get into medicine if you didn’t do that. But then we also have this conflicting knowledge that these other things are really important.

I think that we are at a tipping point where people are recognizing that you can’t continue to self-sacrifice forever and ever and that it does have a cost. I might say it’s just like our patients not doing their preventive care. I’m going to call self-care now “preventive care”—mental health preventive care, physical health preventive care. When we don’t do that, then we have people out with cancer and people out with other long-term autoimmune diseases and whatever else. It’s not that if you don’t do X, Y happens, but population studies would show us that. The downstream cost of it is huge.

Hopefully, we can begin to say, “Wow, if we actually take care of ourselves upfront and we encourage our colleagues to do the same, it will in time be better for everyone.” But that’s always hard to convince people to do, no matter what it is. It’s hard to convince our patients, but as physicians, we do know better. It’s just the tug-of-war and the way that we were raised in medicine. Culturally, I think many of us were raised in our families that way. And that’s not to blame our families; it’s just the types of people who go into medicine are sacrificers.

I like to change the language. Is it caring? We are also carers and we’re also healers, and you can’t care and heal from empty. Taking it out of the emotional realm, I think about charging a battery. When the battery is out, it takes time to charge it. Like when your phone dies, you actually have to wait, and there’s this lag. That is less efficient than charging it before it’s empty. Or filling your gas tank. This idea of recharging and refilling and not getting below empty and not causing ourselves harm. If we don’t consider it a problem to plug in our cars or our phones or get gas—I mean, actually sometimes we’re like, “I don’t have time for that,” but we make the time—this should be similar to that.

Kevin Pho: So what are some simple ways physicians can take care of themselves?

Jessie Mahoney: Yeah. The basics of what I would call lifestyle medicine, but I think we make it really hard. We’re all-or-none people, so it’s, “I have to do all this exercise.” Some people have to do it according to a schedule or a ritual. My thought is that tiny little moments can make a big difference. And so can you, and this sounds a little rote, but can you park a little bit farther, or can you take a five-minute break? I really like to think about it as managing your energy. If you get to the end of the day and you’re just done, you don’t make good choices then. So how can you put little moments in your day that help you feel better?

Breathing with your patients is one that’s super simple. Five minutes of mindfulness, or we often say a moment of mindfulness—one moment of mindfulness shifts your physiology. When you are not depleted, we make better choices about eating and exercising. If you need that extra push, you can also really begin to think, “Well, if I do this myself, I’m going to be able to help my patients.” If you’re in the realm where that is more important to you, use your brain for you, but make it easy.

There’s tons of science about relationships and there’s tons of science about nature. So can you just stop for five minutes on your way home from a shift? I do a lot of yoga and teach yoga, and there’s a lot of work in restorative yoga. One pose can be helpful. For shift workers, for example, if you do a feet-up-the-wall pose, it actually resets your physiology. Five minutes, and it will help you sleep better, for example.

I think sometimes we overcomplicate it. “I don’t have time to go to a yoga class. I don’t have time. I don’t know what breathwork is.” And it’s just: take three deep breaths. Or strategically set yourself up to have to go pick something up at lunch. I used to order myself a coffee. I would pay for it on my phone, so therefore I would feel guilty and I would go pick it up. I remember my medical assistant one day saying, “You don’t have to rush to go get that. I’ll get it for you.” The whole point was not for the coffee; it was to get myself to go outside.

I think we have to work with our brains and know what motivates us and also enlist help. Have a colleague go for a five-minute walk with you. Have your spouse go for a five-minute walk with you. If you have kids, they’re exceptional at mindfulness. I think we think, “I have to start training for a marathon to have good health care,” and instead, just do one thing. That one thing can make a huge difference. Tiny little things.

Kevin Pho: How about health care organizations? If they’re listening to you here, what are some things that they can do to support the idea of required maintenance? Is it forcing doctors to take their paid time off? What are some small things that they can do?

Jessie Mahoney: Yeah. I do think that if they incentivized getting your own care and made it super easy. When I was doing institutional wellness, we often toyed around with the idea of on your birthday every year, you had a day to do your appointments, or you could have two half-days to do your appointments that were paid time to get that done. It would actually benefit health care organizations. Making it accepted is the other thing. Not only encouraging, which I think everyone is kind of at that point, but making it easy.

Making sure that there’s honestly enough staffing so that you can backfill and that when you take that time to go to your appointments, someone else isn’t actually suffering or struggling. Because I think that’s the real issue. People say, “Well, I can’t let my colleagues down, so therefore I can’t go get my colonoscopy.” Although I would say, if you wait and you have colon cancer, you’re really going to let your colleagues down. But our brains aren’t thinking that way because we’re so compressed. Could we have just a little bit more space in the system?

A lot of health care organizations have, for example, gotten providers access to the Calm app or something similar. But sometimes if there’s no time to use it, it has to be more of a full plan that isn’t just, “Here’s this thing, you figure out how to make it happen.” I also think, and we’ve talked a lot about effective wellness, that coaching is something that really helps people. I remember having a conversation with one of my wellness colleagues and it was like, “Well, why is coaching better than educating people on the plant-based diet or getting them a physical trainer?” My thought is that coaching is what allows you to eat a plant-based diet if you decide you want to. It allows you to stop drinking. It allows you to make more intentional choices so you’re not a victim of all these things. Then you can decide what matters most to you.

We have tons of evidence that coaching is really helpful for physicians. I would say not coaching within the system with another agenda. It’s not like health care executive leadership coaching where you are within the system, being coached by someone who has another agenda. It’s really helping people. We talk about life coaching, but I would say it’s life, career, relationship, and parent coaching, and allowing people to find the things that work for them. Maybe offering a fund where you could then fund personal development or personal health and wellness. I think that would be another way that would allow people to do the things that were really helpful to them. Because you can talk the talk, but if you don’t offer the backend support, nobody’s going to do it.

Kevin Pho: We’re talking to Jessie Mahoney, pediatrician and certified coach. Today’s KevinMD article is “Why self-care must become medicine’s new standard.” Jessie, as always, let’s end with some take-home messages that you want to leave with the KevinMD audience.

Jessie Mahoney: My take-home message would really be that we all need to invest in ourselves, not just pick up the pieces when we fall apart. That is actually caring more and is really our responsibility. In a perfect world, our organizations would help support it. But until they do—and maybe they will and maybe they won’t—we really can do that ourselves. We can create a culture where that’s OK for other people to do it.

Perhaps we could think about it as this should be the standard of care. Standard of care for our patients and standard of care for ourselves, with the hope also that if we do it, we’ll be much better advocates for others to do it. We believe in preventive care, so practicing what we preach is going to be the most helpful for us to be able to stay in medicine and to be able to do what we trained so hard to do, presuming that’s what we want to do.

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

Jessie Mahoney: Thanks again for having me.