After 22 years at Boston Children’s Hospital — including eight at the helm — Sandra L. Fenwick looks back upon a proud legacy of improving children’s health around the world, and speaks of a future that promises both opportunity and challenges. 

CEO Sandra L. Fenwick greets Boston Children’s Hospital staff

As chief executive officer, Fenwick oversaw the growth of a 150-year-old institution whose influence on global pediatric health is nothing short of legendary. 

A few notable statistics: During every year of her tenure as CEO, Boston Children’s was ranked by U.S. News & World Report as the top pediatric hospital in the nation. Boston Children’s also ranks as the largest pediatric research entity in the world. 

Boston Children’s cares for more pediatric patients with rare diseases and complex conditions than any other hospital in the world, treating patients from all 50 states and more than 100 countries every year. Its popular tagline, “Where the world comes for answers,” reflects the reliance of families who often have nowhere else to turn for life-saving care. 

But do not mistake this nearly unparalleled position for an empire. Boston Children’s, Fenwick says, is a deeply interwoven team of caring people who believe as fervently as she does that pediatric research is essential to the health of children everywhere.  

“For me, success is not singular, I have always seen my role as supporting and serving the people who provide care,” Fenwick says. “It has been an extraordinary honor to lead this exceptional team of talented, devoted, and accomplished people and see what we have accomplished over these 22 years to advance the health and well-being of children, not just in Boston but around the globe.”

The mission that she — and the Boston Children’s team— have devoted themselves to is paramount. “When children thrive, societies thrive,” she says. 

Fenwick began her career as a bright, science-minded young woman who expected to train as a medical doctor or research scientist. But she found her calling in health administration while on assignment in Saudi Arabia with the Harvard T.H. Chan School of Public Health. 

In 1977, she became the first woman appointed to a leadership position at the Beth Israel Hospital. Alongside then-president Dr. Mitchell T. Rabkin, whom she credits as an important mentor, she learned to navigate the changing health care landscape, ultimately leading the 1996 merger between the Beth Israel and Deaconess hospital systems. 

The corporate challenges were interesting, Fenwick says, but she missed the hospital setting and being close to patients.  

In 1999, Boston Children’s asked her to join as a senior vice president and five months later asked her to step into the COO role. This was a challenging time for the hospital, but Fenwick’s natural interest in forming partnerships and relationship-building, along with her naturally optimistic nature, turned out to be a potent combination for accelerating Boston Children’s stability and growth.  

“We wanted to find every mechanism we could to support the work here, and extend the work outside, to accelerate the care and cures,” she says. 

She oversaw an expansion plan that created five satellite campuses, dramatically expanded primary care and network affiliations, and nurtured 14 regional hospital affiliations.

Making the right choices, without overextending, was possible by selective expansion and investments in people and care systems that fostered the change and growth that Boston Children’s needed, Fenwick says. Most important, she adds, was creating “a culture of courage” to drive change and respond to pressing problems. 

She became Boston Children’s president in 2008, and then CEO in 2013.

“We still continue to ask, ‘How can we deliver value? How can we do what we do well? How can we align around a shared vision and lead through change?’” says Fenwick. 

Fenwick believes the legacy of Boston Children’s is a rich story that will continue to evolve and inspire, as she prepares to pass the reins to Dr. Kevin B. Churchill at the end of March. 

“The future is not just about the cures and breakthroughs, but convening and leading and figuring out, how do we include and collaborate with others who work with children? Not just other children’s hospitals, but with biotech and universities, and institutions with long-term implications for children. There is so much on the horizon, and so much to learn and contribute,” she says. 

Fenwick leaves an institution well-positioned to maintain leadership, advance children’s health worldwide – and, she hopes, ready to meet the future and the uncertainties lying ahead. 

“I am concerned about children; the state of the nation’s children is in jeopardy,” she says plainly. “Half of the nation’s children have a chronic health issue and one-in-five lives in poverty.”

An estimated 20% or more of the nation’s children have behavioral health needs and growing disparities due to race, geography, and social access are preventing them from getting needed treatment, Fenwick says. The COVID-19 pandemic has further exacerbated this predicament, the ramifications of which pediatric care providers are now facing head-on.

“This was a growing crisis well before COVID and I am truly concerned about the next five years,” Fenwick says. “We cannot lose sight that children’s health and well-being is not a single component — we must think about children holistically.”

As for her personal legacy, Fenwick is characteristically modest. She wants to be remembered as someone who made a difference, both for the hospital and for people working to improve children’s health. “It has been an incredible journey and the leadership at every level here is grounded in the purpose of making a difference in the lives of children,” she says. 

“My hope is that we never forget children are 25 percent of our population but 100 percent of our future. We must invest in them.”