Maggie Mahoney Improved Health by Supporting Innovative Thinkers in Health and Medicine
By Desmond K. Runyan, MD, DrPH, national program director, Robert Wood Johnson Foundation Clinical Scholars program
I was deeply saddened to learn that Margaret E. “Maggie” Mahoney, a pioneer in health care and philanthropy, passed away recently. As head of the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program, an influential and acclaimed physician training program that Mahoney helped create, I have the great honor of carrying out one aspect of her great legacy in health and philanthropy: improving health and health care by supporting innovative thinkers in health and medicine.
Mahoney herself was one of those innovative thinkers—and I am so grateful she had the courage to stand by her unconventional convictions.
I never met Maggie Mahoney, but I attended a talk she gave to the RWJF Clinical Scholars program annual meeting Scottsdale, Ariz., back in 1980, if I am not mistaken. Then the head of the Carnegie Foundation, Mahoney described the origin and original purpose of the program and sent a clear message that the program would continue into the future. If the Robert Wood Johnson Foundation ever ceased supporting it, she said, the Carnegie Foundation would adopt it as its own.
This is but one story illustrating the great and lasting influence Maggie had on health and health care. She certainly influenced my career, and she also improved the lives of some 1,200 Clinical Scholar alums, and countless patients and other medical providers all over the country.
As a new Clinical Scholar in the late 70s, I had little understanding of the seminal role she had played in the program and at the Foundation seven years earlier. For me, David Rodgers, Dick Reynolds and Annie Lea Shuster were the faces of RWJF on site visits and at national meetings. I knew that the Clinical Scholars program had started with the Carnegie and Commonwealth Foundations and involved faculty luminaries at Yale, the University of California San Francisco, Duke, McGill and Stanford. I now know that it was Maggie's vision to create a program to train academic physicians in a completely different mold. The idea was to support physicians who would see medicine in a different and, at the time, nontraditional light. She wanted to support physicians who turned to the social sciences for data and who took a population-based perspective when asking research questions.
What I didn't know is that this vision was hatched in a discussion with Maggie Mahoney and five eminent medicine department chairs. Don Madison, MD, a faculty member in the Department of Social Medicine at the University of North Carolina, was national program director of the Rural Practice Project for the Foundation in the 1970s. He frequently traveled to Princeton University in the Foundation's early days to attend meetings about his program and to meet with the small group of leaders who had the task of elevating the Robert Wood Johnson Foundation from a local to a national foundation.
Don related early stories of the Foundation and attributed the adoption of the Clinical Scholars program by the Foundation directly to Maggie's leadership and advocacy; she had come from Carnegie to the Foundation, and the Clinical Scholars program came with her. Maggie then left the Robert Wood Johnson Foundation and returned to Carnegie as its leader.
The original vision for the Clinical Scholars program included mastery of social science and clinical epidemiology research and the expectation that scholars would publish in the social sciences.
There have been some small changes to the program over the last four decades. It is perhaps somewhat less reliant on scholarly self-direction and on relationships with program faculty. The mentoring has been more formalized and expanded, and courses are perhaps more formal.
But the core design of the Clinical Scholars program has remained remarkably steady since its inception. It remains a two-year fellowship for physicians and is designed to address the shortcomings and limitations of American medicine. It remains attentive to the social sciences, clinical epidemiology, health services research, and preparation for leadership.
Maggie is no longer with us. But her legacy continues on at the RWJF Clinical Scholars program, which fosters the same kind of excitement among scholars and the same level of commitment to improving health care organization and delivery today as it did when she first helped bring it in to being.