Episode 111

Innovation as a Daily Practice

with Kevin B. Mahoney

May 4, 2023

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Kevin B. Mahoney
CEO, University of Penn Health System

Kevin B. Mahoney is chief executive officer of the University of Pennsylvania Health System, a pillar of the Penn Medicine enterprise. He leads health system operations, spanning six hospitals, 11 multispecialty centers and hundreds of outpatient facilities in Philadelphia, Delaware and New Jersey.


If innovation can be an activity in daily living, you rewire your brain to not think about the way we were doing it, but the way we could do it.



Nathan Bays: Welcome everyone to the Gary Biby Show. Nathan Bayes here filling in for Gary, and we’re honored to have Kevin Mahoney as our guest today. Kevin as we said, wish it was under different circumstances with Gary, but we’re so glad that you’re here and available to chat with us on the show and talk about your career. Kevin is the president and CEO of Penn Medicine. So Kevin, welcome to the show.

Kevin Mahoney: Thank you very much, Nathan, as you mentioned. I couldn’t wait for Sunday morning for a lot of things. One is I didn’t have to go to work. Second was, I could always read a note from Gary that would inspire me reflecting back on the week, weekend, the week forward. So I I’ll miss that connection that we had with Gary.

Nathan Bays: Yeah, no, absolutely. Look, Kevin, you’ve had just a tremendous career. Many successes. Penn Medicine, one of the leading academic medical centers, not only in the United States, but really in the world. And we cover all of that in, in the show today. Just jump.

Kevin Mahoney: Sure. So I grew up just about 25 miles west of Philadelphia. Abi Valley, forge Park, large Irish Catholic family. Not enough beds, not enough bathrooms, but great spirit and great fun growing up during the sixties and seventies and watching, a generational change and living through that. We didn’t have a whole lot of money. I went to a local state school out in Lancaster County, and that’s when I ended up in healthcare. But through a rather circuitous way, which is somewhere between my freshman and sophomore year af after having getting kicked out in my freshman year for bad grades, I was working for a landscaper. I fell off my farm tractor under my farm tractor, and the farm tractor ran over me and I ended up in the hospital for several months. And I loved every minute of being in there. I couldn’t believe. Everybody in, in nursing, physical therapists. The doctors of course, but even the person delivering the food every, all they wanted me to do was get better. And I said, this is a environment that I’m very comfortable in. So I pivoted from a ventilator to really wanting to work in, in, in hospitals. U unfortunately, I mentioned I was not a very good student. I went back to meet some of my friends. They got me in trouble as a freshman, and I met my wife and Pam has kept me on the straight and narrow ever since 1978. So she taught me how to study. She taught me how to apply myself, and went on to temple for my MBA and eventually my doctorate.

Nathan Bays: Tell us a little bit about, leadership. When did you start kind, progressing into leadership? Did you always have the desire to be a leadership, be in leadership position?

Kevin Mahoney: Yeah. Yeah. Nathan, it’s a great question and not one I’ve reflected on a lot. I will tell you, I think I was always a leader. I didn’t recognize it until, later. When I started my master’s preparation and things like that, when people in the class would be looking at me and I started to say, if you wanna put yourself out there, if you wanna think through the issue and not just yap and you really want to contribute and listen, people will just naturally follow you. So I had mentioned, I grew up in a large family. You had to be a leader because you were one of the oldest. Kids and you had to look after your younger brothers. And through college and things I started to get involved in leadership, but it was really when I first went to Temple and again, sitting with people that would be my future peers. A again, being fearless in your convictions, but listening and I ideating with each other. It’s just people naturally, I think pull towards you.

Nathan Bays: Talk about, kind of culture, the role of empathy in culture and how you think about, kinda building and perpetuating. A culture among your workforce at pin.

Kevin Mahoney: What you hear me talk about if you came to my town halls or different things is true north. I think the ethos of Penn founded on the creation and dissemination of knowledge, the founding of the nation’s first. Hospital 265 years ago. I don’t think our true north has changed. And I try to remind everybody why we chose this line of work, why we’re here and again for a mission that I believe is bigger than ourselves, which is taken care of, not just the patient today, but also trying to come up with cures and disease prevention for the patients in the future. What I also though talk about a lot and I quote the the Lincoln movie Daniel de Lewis was in it and he said, you know where true north is? And the compass will tell you where true North is. If you look at your compass, go that way. The compass won’t tell you, is there a swamp ahead of you? Is there a mountain ahead of you? True north getting there is sometimes a crooked path, and I try to remind everybody, particularly now with these headwinds we’re facing, like this is. That momentary swamp, we still know where we have to get to. We have to get there together. So using data, our ethos, our culture of patient first, look out for each other. Push, push the boundaries because that’s what Penn medicine’s about. I think that’s our true north in our culture.

Nathan Bays: You, you had just started in your role or relatively recent in your role as as president, CEO of Penn Medicine. When Covid when Covid hit, so what were some of the key, first of all, what was that like as a new, president, CEO of the organization leading through that and two, what were some of the key lessons that you really learned and took away from that, that, that are lasting and meaningful for yourself and for the organization?

Kevin Mahoney: Sure. I think it. If it’s a leadership lesson, it’s probably obvious, but, I took over in July and Hahneman University closed right after that. We had residents scramble. We had, how are we gonna deal with the 90,000 emergency room visits that were going distributed throughout the city. Shortly after that, mercy Hospital to our west announced that they were closing their inpatient services, and then March 6th, we had our first inkling of. COVID as an impacting the city of Philadelphia. So no matter how much you think you’re prepared, you get the, I think these are dramatic curve balls, but there’s always something, and that’s what I get back to knowing your core values may, having criteria upon which to make decisions. We mentioned putting our patients first and looking out for each other. We started in covid. How are we gonna take care of the patients? A great example when the entire world was, how are we gonna get more ventilators? How are we gonna create more ICU beds? Our team was inventing what’s known as Covid watch, which is there, there were a few patients in the icu. There are a lot of patients with covid in the community and how do we watch the patients in the community and again, that’s. It’s leadership I have in the right talent that they look at problems slightly differently. And with Covid watch, we were able to keep patients out of the hospital and that turned out to be the best solution.

Nathan Bays: Let’s shift and talk about something more, more exciting and positive, which is, just innovation and what’s going on in, in Penn medicine, and also how innovation, the desire to innovate also. At a high level, how do you think about, innovation as it relates to your leadership style and leadership focus? And then we would love to talk a little bit more about, some of the really interesting things that are going on AT in medicine, particularly around cell and gene therapy.

Kevin Mahoney: Yeah, I mean in innovation is in our dna. We were founded by one of the great inventors in the world, Ben Franklin, and we try to carry that through. I try to use innovation of, yeah, we’re doing it this way and it’s working, but why would we want to keep doing it that way? There’s always a better way of doing it. And, we talk about innovating in everything we do. We have great examples on the science side. First approved gene and cell therapy in the United States based on pen ip. The Pfizer Moderna vaccines are based upon pen ip, so we think innovation is big. Eye is how do we have an impact for good across the globe. Little eye might be how do we make a monotonous job more exciting, more fulfilling for the employees so that they wanna come to work and. We’re constantly pushing what new tools could we use to, to innovate the delivery system.

Nathan Bays: Yeah, so I think my takeaway is it’s a state of mind, right? That for you and your leadership team and as part of culture, what you are looking to push through the organization, everyone, regardless of how big or small role is.

Kevin Mahoney: Yeah, I think if I could just expand on that a little bit. We do the Penn Medicine Book Club and one of, one of our speakers was Katie Milkman, who’s an m i t trained engineer who does behavioral economics at Wharton. And her book how to Change One of the chapters is the human mind is lazy. Like you get used to doing things the same way over and over again. And change is hard because the brain gets wired to doing it that way. How many times have we talked about Here comes management with another campaign. It’s another, and if we just wait it out, it’ll go away. As opposed to if innovation can be an activity in daily living, you’re gonna rewire your brain to not think about the way we were doing it, but the way we could do it. Not the way we always have, but the way it should be. And I just think it, it makes for a. More energetic work environment moving forward. And that, I think that’s important. It’s cuz it’s so hard right now. There, there has to be some giddy up that makes you want to come to work.

Nathan Bays: I’ve gotta ask you go a little bit deeper on, on cell gene therapy. I, Philadelphia coined the term. And the amount of innovation that’s occurring within your city, broadly and within your institution specifically is just, is amazing. Love to hear just your take on that at a high level and then you know specifically how you think that innovation will actually change the delivery of medicine over years.

Kevin Mahoney: Yeah. Yeah. No it, it’s a great question. One that we’re quite proud of. I think one of the reasons we’ve been able to move that forward here is based on two things. One is the way we’re structured, about 60% of the health systems margin helps to fund our research mission. So when people show up and they have ideas that are not fully baked, 1999, Carl June showed up on this campus. He had an idea of re-engineering people’s t-cells, reinserting those T-cells in, into a body using the AIDS virus and that this would kill cancer. A anyone who says they knew he was onto something as lying, we thought he was as crazy as they come because, and he couldn’t get federal grants through philanthropy and support from the health system. He was able to build that idea so that in 2010 he, he published his sentinel paper on it worked. And that then allowed us to spin off companies, do licensing agreements with Novartis and other big pharma. And the second part that did is once you have a talented individual, more talent comes, it’s a magnet. And that innovation cluster of cell and gene therapies happening here. Tech is certainly out in Palo Alto because Steve Jobs and Moore and all the rest of the guys they clustered together and that Carl June, Jim Wilson, gene Bennett, our colleagues at Chop, at Steve Grup they have this innovation cluster and it just keeps attracting more talent in into Philadelphia than the VC money follows. We’ve funded about 15 startup companies and they’re all doing great. Most have converted to public and they’re located here in Philadelphia. So that cell and gene vortex I think will continue unabated in Philadelphia as we move forward. It goes back to what you mentioned about innovation, but the other part about leadership is talent acquisition, not necessarily. People that fit the widget, but the, the the innovative the the people who think about ideas that nobody else is thinking about and giving them the freedom to pursue it. Dr. Weissman and Dr. Crico on the messenger RNA would be another example of people that showed up about 23 years ago who knew when they showed up at Penn that they would. Perhaps save the world through the vaccine process. So again, it’s that innovation cluster that makes it so exciting and I do think it’ll change the world going forward.

Nathan Bays: Yeah, absolutely. Sickle cell is another where there’s been really,

Kevin Mahoney: Thank you.

Nathan Bays: No I agree completely. Yeah.

Kevin Mahoney: When. But the other thing that is fascinating and fun to be part of, dr. June has remarkable ideas, and then the young guy comes along and says, I have a better idea. Like they all wanna beat the master. And Dr. Weisman comes along and says, I don’t think we’re doing it the right way. We should use me RNA one shot. I’ll be able to cure sickle cell anemia. And, it, that friendly competition it just elevates everybody’s game.

Nathan Bays: We’d love to shift gears, a little bit, Kevin and talk about, back to leadership, which is a focus of the Bibe Show and talk about, leadership, let’s call it outside of. Of Penn Medicine, how you think about the role of your organization in the community, how you think about, health equity and other, social determinants is a buzzword, but it’s been, social issues impacting healthcare is not new. Would love to hear, your thoughts on that and how you think about, the responsibility of an organization such as yours and how you think about that as a leader.

Kevin Mahoney: So I, I’m gonna give you a very personal answer. Which is, we’re tax exempt, we’re nonprofit, and we should live that every day. And it shouldn’t be hard. If someone says to you, why don’t you pay taxes? You ought to be able to rattle it off and at Penn, I believe we can do that, whether it’s 50 million at Lancaster General to eliminate lead paint in the city of Lancaster, a hundred million from Penn to eliminate asbestos from. Of the school buildings starting our Fund for Health, which capitalizes companies that work on social determinants of health. An example, our most recent 1 28 Health is a social a digital platform for reproductive rights. Like I, I think we need to live and own the fact that we have a privileged position in the United States, which is we’re tax exempt and we need to earn that and. I think it’s something that we as a health system writ large in including Penn, but everybody, we need to do a better job of demonstrating why we deserve that privilege. And as you said, there are a lot of buzzwords out there right now. Health, equity, social we know what the issues are, we have to tackle ’em and we need to tackle ’em in a hurry or we may cure people of cancer. But the civil unrest the separation between the haves and the have nots will continue and it will not be a happy world. So I encourage all the healthcare leaders listening, particularly from nonprofits that, let’s earn our tax exemption day in and day out.

Nathan Bays: Yeah. And in many ways you, you are the hub of that, of where all of those cross currents come. ’em together. Members from the community, of all different socioeconomic status, all different, ethnic, racial backgrounds. They come to your organization and to, to health systems across the country. The health systems have a very unique position of being a hub of many, if not all of the different, societal cross currents and how do you take that and, utilize that and show. Connectivity to all the different spokes. If you’re the hub there, there are a lot of spokes. And how do how do you take that role as a hub and be a real contributor.

Kevin Mahoney: Yeah I, I think a big part, Nathan, is intentional leadership versus check the box. And, we saw a lot of pledges after George Floyd’s murder a lot of people, but. Two, two plus years later. Are you intentional every day in trying to close those health equity issues that we’re facing? Working with payers, working with community, working with each other, working with our collaborate, so in Philadelphia, together with Blue Cross and the major health systems, we put together accelerate health equity. Because, no, no one of us should own it. No one, nobody should take out a billboard saying I’m doing more to eliminate health equity than temple. Something a as regional leaders, we should be doing together. And I, I think the framework we have in Philadelphia is helping us get there.

Nathan Bays: Final question I want to ask you final topic is is just about, the importance of. The next generation of leaders, and you’re a teaching institution. Core to your mission is training, new physician clinic and more broadly than physicians, clinical leaders, more, more broadly. So would love to hear your thoughts on that and how you think about that part of your mission.

Kevin Mahoney: Yeah. The first thing I would say is we need to learn. The hospital’s not the center of the healthcare delivery system. And we need to learn as an industry, how to meet the patient where they are. And increasingly that’s virtual. And if we’re not working towards those tools, forget about it. So I, I think some of the competencies that we need I talk about cyborg operations, which is, some things will always be physical, but a lot is gonna be, Handled, virtually handled in a different way, handled at home, handled in the clinic and how do we meld those together so it’s not siloed, but one longitudinal system. Cyborg operations, ai. One of my favorite topics is reverse logistics and again, we’re used to patients driving to us finding a parking spot, sitting in the waiting room, and. And how do we be more like Amazon, where we have to get product in a person is somebody’s house. And how do we do that? How do we get the next generation of physician leaders comfortable with monitoring seven patients remotely for diabetes as opposed to one in their in their waiting room? The other two things that are really critical is a teaching organization. Particularly around physicians and our employees in the future is we always taught be tough, be resilient, muscle through it, that was the hallmark of a physician, when I was an intern, I think go home for a year. I saw patients and I never slept. We have to park that mindset is that’s an ideal to. You shouldn’t have to be a tough guy to be in healthcare. You shouldn’t have to. Resilience is a great trait, but it shouldn’t be something we have to teach you so you can survive. We should change the system.

Nathan Bays: Well, Kevin, first of all, thanks for being, a guest here on the Gary Bikie show. More importantly, thanks for all the work that you do, in, in your community, in, in the Philadelphia area but beyond with the physicians you’re teaching and the innovations that that you’re fostering. We appreciate you taking time out of your schedule to to speak with us today.

Kevin Mahoney: Thank you, Nathan.

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