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Pediatrician and certified coach Jessie Mahoney discusses her article “Leading with love: a physician’s guide to clarity and compassion.” Jessie shares how a personal crisis involving her husband’s severe depression forced her to abandon her training in logic and control for a more intuitive approach. She explains how the simple question “What would love do?” became a compass that transformed her decision-making in both the clinic and the boardroom. The conversation challenges the misconception that love is too soft for health care, arguing instead that it provides the necessary strength for boundaries and honest leadership. Jessie details how this shift from managing to connecting can fund wellness programs and heal the broken culture of medicine. Discover how a pause and a breath can offer the clarity that data alone never will.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome back Jessie Mahoney, pediatrician and coach. Today’s KevinMD article is “Leading with love: a physician’s guide to clarity and compassion.” Jessie, welcome back to the show.

Jessie Mahoney: Delight to be here.

Kevin Pho: All right, what is this latest article about?

Jessie Mahoney: So this latest article is actually about something that is really my super passion. I wrote it now because it is something that we just need in medicine and the world right now, if that makes sense. Also because I gave a TED Talk on it in the fall.

It is something that because it is about love and I think in medicine we are a little hesitant about approaching things that way, but now it is out there in the world. So I might as well share it more broadly. What I have found is this tool is actually most effective in medicine and is something that we really need in health care and in the world right now. It is this unifying and clarifying way of showing up with compassion when things don’t make sense. Health care doesn’t make sense and the world doesn’t make sense right now. This is a way of filtering these really difficult decisions and finding clarity when we can’t use those tools that we were taught in medicine to find clarity.

Kevin Pho: All right, so tell us a little bit more about this. What does it mean to lead with love?

Jessie Mahoney: So what it means to lead with love is filtering your decisions through essentially heart-based decision making or love-minded decision making. I like to think of love. It is not self-sacrifice, it is not martyrdom. In some cultures it is couched that way, but that is really people-pleasing and martyrdom and all of these other things. It is not actually love.

Love is honest and courageous and direct. It doesn’t do things that cause you harm essentially. Just like in medicine we take an oath to do no harm, if you lead from a place of love you are literally doing no harm to yourself and others. It doesn’t also disregard the data. I think sometimes people say: “Well, if you’re going to lead with love, you won’t pay attention to the studies or the evidence or the science.”

Actually, it takes all of that but filters it through this lens of humanness and the complexities and nuances of being human and perhaps different opinions and different ways of approaching things. It gets us out of that angsty fighting energy and it is more of a peaceful and calm approach.

I really see it as a clarified approach. I have seen this approach work for people in the ER. It works for people whose parents are in end-of-life care. It gets us out of all the other noise about what I should do or what I am supposed to do, or in the health care system, what other people should do or how it is supposed to be. It really gets into this lens of what is most caring for you and for those you care for and for the system.

Kevin Pho: In your article, you shared a very personal story that guided you to this particular approach. So if you feel comfortable, share that story with us, and how did that lead you to this conclusion?

Jessie Mahoney: Yeah. So the story which I shared in the article and I shared it in my talk also is really what I would say is a universally resonant story because we all have these moments in our life where they shift the way we see the world.

The story that I shared is that about 10 years ago I was a busy physician leader with three kids and multiple leadership roles in a full practice in a big health care system where we worked fast and furiously. I had a job that I loved, but my husband developed some pretty significant depression. When that happened, it was sort of the tipping point. All the balls that I had been juggling were hard to juggle. Ultimately I ended up taking time off and this was after I spent a very long time trying to do the things that we do in medicine.

So I tried to fix everything, manage everybody, get him the right care, and make sure my children weren’t going to have long-term complications and everything was going to work out OK. What that got me was just in more of a snarl. So I ended up actually taking time off, which for physicians is a really hard thing to do.

In that time off, I went to yoga. I don’t know if listeners here know, but I also teach yoga as a result of this experience. It helped me regulate my nervous system. It helps me sort of pause and breathe and completely shift my perspective. What I realized is that in this more calm state where you have access to inner knowing that you cannot have when your brain is spinning, which is where we live most of the time in health care, I was able to see solutions that I couldn’t see otherwise.

What became clear was that my husband was actually neurodivergent, which is amusing because I am a pediatrician who diagnoses autism all the time. But I didn’t see it in my own house until I really slowed down and I hadn’t slowed down until that point. What happened with that is that once I explained to him what it was, he was like: “Oh yeah, well that is clearly what’s going on.”

And that is clearly how we got down this road of managing things. We were a doctor and lawyer family with three kids living in the city doing all the things. It gave us paths of approach that were different and ways of relating to one another and ways of seeing our differences that weren’t me explaining it in the way that my brain worked. It allowed us to actually have a much more open, kind, and compassionate perspective, which this same tool applies to when we work with people in health care. It is really seeing things not through our medical lens but through the human lens.

So in that whole saga is where this question really began to serve me. What I found is that it actually works so well everywhere else. It works well with your teenagers. It works well with your aging parents. It works well as a health care leader, where there are things that are just inherently in conflict or there are inherent differences. In our relationship case, it was inherent differences in the way that our brains worked, and you can then find common ground in those because love is common ground and it is common humanity, which is something that Kristin Neff talks about.

When we find that common ground, we can more easily see solutions to difficult problems. So if it is an end-of-life care decision, you can ask the same question, using love-based decision making: “What would love do for this person, for their inner family, for the outer family, and for the world?” You can go the whole way out where I think we in health care really struggle because we always leave ourselves out. We are happy to express love and compassion for everyone else. But you have to include yourself in this or we get bogged down in those same patterns of over-functioning and over-giving.

Heart-based and love-based decision making and really leading from a place of love is what we are all about in health care anyway. It is potentially easier for me because I am a pediatrician so it lends itself to that, but this works in any specialty. It is clarifying when there are all these nuances and conflicting pressures. Even around issues as a leader like budget or scheduling, love would not leave it unstaffed. But love would not have one person do it all. It can get at these nuances and outside-the-box creative solutions. Sometimes love sets a boundary and says: “We need per diem and nobody here can do it. That will cause harm.” It allows you to advocate in a more effective way.

Kevin Pho: Do you feel that sometimes physicians mistake the concept of love for sentimentality, vulnerability, and weakness?

Jessie Mahoney: Yes, absolutely. I would say that real love or love-based decision making isn’t sentimentality or the rom-com TV version of love. In some cultures, love is self-sacrifice and martyrdom and giving all, and we couch that as love. But if you look at what love actually is, it is this universal, positive, “do no harm,” and “help one another as human beings” energy.

What I am encouraging here is really tapping into that. For some people, you might couch it as heart-based decision making. There was a book in Vietnam written a while back, and I met this lovely physician with a Vietnamese background who shared this with me, that there was a movement there to have hospitals be called “Houses of Love.” There is a book about Houses of Love that was written during the revolution, and to me that is this idea. What if the energy of a hospital healing was about love? It would be so different than our current hospitals which are about efficiency and money and moving people through as quickly as possible.

It is just always remembering this. It is funny because physician and leadership training run so deep. People ask: “Well, but doesn’t it mean that you don’t do the important things?” Love wouldn’t have a non-functional hospital. Love wouldn’t provide terrible quality of care. It just wouldn’t. It helps you navigate the nuances of the costs on all sides and how you can do it in a way where we are not sacrificing one party versus the other. It takes the conflict out of it.

Kevin Pho: Give us an example where a physician would approach what you are describing, leading with love and asking what love would do, and having it solve a typical clinical problem or a conflict in a physician workplace.

Jessie Mahoney: Yeah, the easiest one is the late patient. This is sort of a non-emotional one, but I find it really helpful especially for women physicians who have this conflict. Maybe they have to pick up their child. Our training says you see them no matter when they come and you put the patients first. But love wouldn’t necessarily do that if your kids were waiting or were going to be left unattended or you are going to have to pay 20 dollars a minute.

So the idea is: “What would love do about this late patient?” Sometimes you would see them because maybe you can fit them in, but sometimes you don’t see them because all your other patients have to wait or you have something urgent at the end of the day. It also opens up this idea that if it is somebody who has transportation issues or really has to be seen that day, you might ask for help. It gets you out of that guilt, blame, and shame conversation.

Similarly, you can use it in end-of-life care. I have seen physicians use it in the ER a lot because there are just these really complex and nuanced decisions about where to be or what level of care to offer. We are often put in situations in health care where there is no good choice. When you lean into this human spirit and human compassion, it can tell you where to put your energy and how to get help. Do you call in someone extra? How do you manage the budget?

I had a physician once whose health care organization lost about 50 percent of their doctors in their clinic. This was a situation of night call. So the people left were still covering all the nights. In that case, love would give them a deadline: “Two weeks, you’ve got to find someone. We can’t take call every other night just because we are short-staffed.” Again, that is loving for you as a human being because that is not sustainable. It is actually also loving for the patients because they are not going to get good care eventually and something is going to happen and nobody will have your back as a physician.

It gets you out of the challenge of asking: “Is this a problem with me that I can’t handle this every other night call?” When you advocate from that energy, it is also much more effective. Physicians advocate from injustice and complain that this shouldn’t be and we are being badly treated. That is not usually the winning argument. Even if it is true and even if it should be different, when we advocate from this place of love, it works better. For some people they will shift it to kindness or compassion or whatever word works for them. I really do wish the world would lean into love.

Imagine if we made decisions in health care and we paused and we took a breath and had this thoughtful connection to the energy from which we want to make the decision. Then you get that kind of result. That is a coaching tool that I work with people on. If you make decisions from fear, you get answers that lead to more fear and you do not get good solutions. So that is where this filter of love-based decision making can help you navigate really tricky situations.

Kevin Pho: And I want to emphasize that leading from a place of love doesn’t necessarily mean saying yes to everything. It is a way to definitely set boundaries, right? And have that self-compassion, right?

Jessie Mahoney: Yes. It allows you to say no actually, but not from a place of anger and from a place where it costs you a lot to say no. I think we have this movement to say no and establish boundaries, and for many of us in health care, that is tremendously costly. It drains us. We are anxious about it. We feel shame and guilt about doing it, and we have a lot of inner conflict. I think when you make a decision from this love-based decision making, which is about the greater good and a world that you would like to see, then that sort of washes away. It allows you to show up in a much more authentic and aligned place.

Kevin Pho: We are talking to Jessie Mahoney, pediatrician and coach. Today’s KevinMD article is “Leading with love: a physician’s guide to clarity and compassion.” Jessie, as always, let’s end with take-home messages that you want to leave with the KevinMD audience.

Jessie Mahoney: The most important thing here is to recognize the energy by which you are showing up and choose that with intention. Let go of these previously held notions of what you should do and lean into this positive, “do no harm” energy. That filter, while it might seem like fluff and it might seem like it is going to disregard some things that you hold dearly, love doesn’t do that. We ultimately are here to heal in health care. Leading with love and compassion allows you to do that from a place where you are not bypassing what matters most to you.

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

Jessie Mahoney: My pleasure.