What Funders and Surgeons Have in Common

It’s rare that a single piece of writing can profoundly alter your mindset.

It happened to us in 2013 when the Harvard surgeon Atul Gawande’s New Yorker article “Slow Ideas,” gave us a novel way of thinking about the unsexy cause we had been struggling to advance for decades: encouraging grantmakers to dispense with conventional practices that undermine their own grantees.

Gawande describes the uptake curve for two critical innovations in surgery: anesthesia and sterile surgical fields. Anesthesia proved to be a “fast idea”; surgeons around the world adopted it within months. In contrast, sterilizing hands and surgical equipment was a “slow idea”; even in the most sophisticated teaching hospitals it took decades to adopt. Why? Because anesthesia conferred big, clear, immediate benefits for surgeons, and antiseptic techniques didn’t. “Anesthesia changed surgery from a brutal, time-pressured assault on a shrieking patient to a quiet, considered procedure,” Gawande wrote. Antiseptic techniques didn’t improve the surgeon’s experience in the operating room at all, even though they sharply improved outcomes for patients.

These insights are the driving force behind Funding Performance: How Great Donors Invest in Grantee Success, a quick-read book released earlier this month by the Leap Ambassadors Community in collaboration with the Ford Foundation, Hewlett Foundation, Tipping Point Community, Bridgespan, and FMA. In the book, the essayists lay out this call to action for funders:

  • If you want to empower grantees rather than hamstring them, provide more of what nonprofit leader Vu Le cleverly calls “MYGOD” support—multiyear, general operating dollars.
  • If you’ve made the decision to give your precious resources to an organization, then give that organization the benefit of your trust and respect as well.
  • If your website trumpets your concern about inequality, then don’t perpetuate it with funding decisions that always favor pedigrees over lived experiences.
  • If you’re moved by the suffering in your community, then show the courage to give more money when the supply of funding from governments is down and the demand for nonprofit services is skyrocketing.

The essayists see these ideas as quintessentially slow. They have big, clear, immediate benefits for grantees and the communities they serve, but the benefits for grantmakers themselves are harder to see and slower to materialize.

That’s why the Funding Performance essays emphasize what’s in it for foundations to change their practices, not just for their grantees. For example, we share the story of Rose Letwin, one of the first dozen Microsoft employees and the quiet donor behind the Wilburforce Foundation. A passionate wilderness conservationist, Letwin has invested deeply in learning from and with her grantees. Her through-thick-and-thin approach to helping her grantees build their organizational strength and performance has given her significant influence in her field, a string of world-changing environmental wins, and her life purpose. “As a child, I never believed I’d ever be doing these things…. It just seems impossible for a poor kid from southern Indiana.”

The essayists also emphasize what’s in it for foundation staff. In her essay “If Not Now, When?: From Virtue Signaling to Hard Self-Examination,” Ford’s Hilary Pennington says that Ford program officers “are benefiting from more candid and authentic relationships with the leaders and organizations they fund.”

featured quote That’s because Pennington has helped Ford’s grantees—and its program officers—step off the “treadmill of short-term thinking.” Starting in 2015, Ford shifted to offering more grants in the form of general support, paying a minimum of 20 percent overhead on all project grants and launching a five-year, $1B effort to strengthen key institutions that focus on ending inequality in all its forms. Today, Ford’s program officers have more time and encouragement to use their talents to help grantees navigate complex challenges rather than making them jump through hoops.

Even more important, Gawande’s “Slow Ideas” article influenced the way the Leap Ambassadors Community and its collaborators are sharing the book. They’re not wasting a single minute trying to sway funders who have never shown any interest in learning and improvement. And they’re using a “Fabergé shampoo strategy” for reaching receptive leaders—enlisting hundreds of ahead-of-the-curve leaders to share these ideas with those who look up to them as models and mentors.

We hope you’ll join in this campaign. We’re not just looking for leaders who work full time in philanthropy. If you’re a business leader who serves on a foundation board, a public servant, or other civic leader, we hope you’ll encourage foundations in your orbit to provide more flexible, equitable, trust-based support—not just for their grantees and those they serve but also for the good of the foundations themselves.

Yours in advancing important-but-slow ideas,

Signatures: Mario and Lowell
Mario and Lowell



Mario Morino is chairman of the Morino Institute, co-founder and founding chair of Venture Philanthropy Partners, and author of the lead essay in Leap of Reason. Lowell Weiss is president of Cascade Philanthropy Advisors, co-editor of Leap of Reason, and advisor to the Leap Ambassadors Community.


Updates From Around the Leap Community

Speaking of sharing stories to accelerate change, we encourage you to check out the Ford Foundation’s exemplary “Just Matters: Stories of change about issues that matter” series. These beautifully written profiles describe the work of bold community leaders working to bend the arc of justice in America. For example, in the lead profile, Ford introduces us to Sekou Siby, a former prep cook and taxi driver who is now the executive director of the Restaurant Opportunities Center of New York, which is fighting to make the restaurant industry work for everyone. “As an immigrant in the industry, Siby understood what it was like to feel invisible, to feel voiceless…. He knew first hand what it was like to fear a knock on the door. A fear that kept workers from speaking up for what’s right or fair.”

Once again, Phil Buchanan, the president of the Center for Effective Philanthropy, has hit the nail on the head. In his latest blog post, “Beyond the Usual Suspects: Supporting Community-Based Nonprofits in a Time of Crisis,” he pushes funders to expand their grant pipelines in ways that will promote not just equity but also effectiveness. Drawing upon hard evidence, he argues that funders often underappreciate “the value of organizations that are closest to the regular people who make up communities and are trying to make ends meet.” He suggests that individual donors should reach out to their local community foundations to learn about these “unsung heroes.” And he calls on private foundations to consider supporting “intermediaries and pooled funds that may be more closely connected to certain communities than they are.”

Regular readers of this update know that we often stress that leadership, people, and culture—more than any other factors—are what drive organizations, for better or worse. As a result, we took keen interest in the article “CareerBuilder: 74% of employers admit hiring the wrong candidate.” That’s a staggering figure! Think of what all this mis-hiring means in terms of angst, disappointment, and money across our sector and economy as a whole. One of Mario’s mentors, a great CEO, used to say to executives, “If you hire a person and that person leaves in the first year, it’s your fault. You either didn’t do enough up front to be sure of the candidate and fit, or you didn’t put the person in the right role with the clarity to have the chance to be effective.” That’s a tough judgment, but one Mario has found to be justified.

We’re excited to share the Leap Ambassadors Community’s latest “Ambassador Insight” compilation, “Strength in Numbers: Building the Case for Full-Cost Funding from State and Local Government.” This piece is based on nonprofit CEOs Lori Kaplan and Jeremy Kohomban’s successful efforts to advocate for fairer reimbursement of indirect costs from local governments. If Kaplan and Kohomban’s advocacy is relevant for your work and you want to reach out to them, please reach out to us. We’ll put you in touch with them.


Events/Webinars for Raising Performance

Feb 25–Online
Scaling Up: What’s It Worth?” webinar; Alliance magazine

Mar 24–Online
Foster an Inclusive Culture for your LGBTQ+ Staff and Partners” live training session; Candid

Mar 30–Online
The Ethos of Being Trust-Based: Confronting and Correcting Historical Power Imbalances” webinar; GEO

Mar 31–Online
Sustain Your Fundraising and Impact With Leadership Buy-in” live training session; Candid

Apr 29–Online
Are We Better Off Divided? Philanthropy’s Role in Moving America Forward” virtual learning session; Center for Effective Philanthropy

Apr 27-29–Online
Collective Impact Action Summit” virtual event; Collective Impact Forum