Ep 8: Jumping into the Deep End

with Sandra L. Fenwick

November 18, 2020


Share Episode
Share on email
Share on twitter
Share on linkedin
Share on facebook


Sandra L. Fenwick
Chief Executive Officer, Boston Children's Hospital

Sandra L. Fenwick is the Chief Executive Officer of Boston Children’s Hospital, where she leads a team of 20,000 people dedicated to improving and advancing child health through their life-changing work in clinical care, biomedical research, medical education, and community engagement.

Ms. Fenwick is a leading advocate for a recommitment to investing in children — especially pediatric health care — in the face of growing threats to our children’s health and well-being.

Ms. Fenwick joined Boston Children’s in 1999 as Senior Vice President for Business Development Strategy and was promoted to Chief Operating Officer later that year. She was named President in 2008 and was appointed Chief Executive Officer in 2013. Throughout her tenure, she has led the hospital’s efforts to control costs and adapt to a changing health care environment. Those efforts have resulted in outstanding credit ratings, a robust financial profile, and a proven track record of delivering among the highest value pediatric care in the nation.




One Just has to figure out how you're going to break the challenge up into bite-sized pieces, but also have in the back of your head to do the right thing with integrity, honesty, and trustworthiness.



Sandi Fenwick  0:02

Taking on a new organization, a new team, new board, a new faculty and a huge operating deficit. We were in really desperate shape. I was not only thrown into the deep end, I don’t think there was any water there. 


Lan Nguyen  0:17

That was Sandi Fenwick, CEO of Boston Children’s Hospital, the number one pediatric hospital in the nation. 


Sandi Fenwick 0:24

I remember hiding my pregnancy because I was afraid that it was really going to work against me, although it clearly didn’t. 


Lan Nguyen  0:30

In this conversation hosted by Dr. Julie Gerberding, EVP and Chief Patient Officer at Merck, we celebrate Sandi’s trailblazing, four-decades career in light of her recent retirement announcement, and learn about her path to becoming an exemplar, healthcare administrator, and advocate for children’s health. So let’s jump into Her Story, a program where we explore the intersection of women leadership and health care.


Dr. Julie Gerberding  1:01  

Hello, and welcome to Her Story, an opportunity for us to talk with some incredibly amazing women and understand their journeys to leadership. I’m Dr. Julie Gerberding, and I’m the Chief Patient Officer at Merck. And I’m absolutely delighted to be joined today by Sandi Fenwick, who’s the CEO of Boston Children’s Hospital and a woman who’s had an amazing leadership journey all of her own. So hello, Sandi, and welcome. I’m going to just jump right in and ask you to tell us a little bit about what you’re doing now and then we’ll kind of backtrack and talk about how you got there.


Sandi Fenwick  1:36 

Thank you, Julie. And thank you for this wonderful opportunity. I always have said and have said it, actually, through my whole journey, that I’ve had the best jobs in the entire world. And today, I really think this is the top of the top. I’m the CEO of Boston Children’s Hospital here in Boston. We’ve been named the number one Children’s Hospital by U.S. News and World Report for seven years in a row, and it has been an incredible journey. I’ve been here for 21 years and it is truly a gift to the world.


Dr. Julie Gerberding  2:07 

You and I met in an inauspicious situation. I believe we were trying to crew a sailboat in Rhode Island, with probably very little sailing experience. But it was in that moment that I just got a chance to get to know you as a person, beyond your role as the CEO of the number one Children’s Hospital in America. But you started back in Simmons College, and then you went to Texas to get your master’s degree in health policy. How do you go from Boston to Texas? And how did you go from your undergraduate focus to pursuing that particular pathway? 


Sandi Fenwick   2:46 

Well, Julie, I had another detour that was even more interesting. So I went to Simmons, a wonderful college, now university. And I was studying both biology, double major chemistry and pre-med, so I thought I was on my way to medical school, but I took a job in research at the Harvard School of Public Health as my first job out of college. And one of the interesting things was that they said you could travel because we were doing a lot of public health work around the world. And so a couple months after I got there, they asked me if I would go to Saudi Arabia. And so in 1972, I went to Saudi Arabia to work on a project that they were working on, on an eye disease called trachoma, we were set up in a lab in a hospital in Dhahran, on the eastern shore, and it was an extraordinary experience. 


When I was there, the department chair came and said to me, “We’ve been talking about you back in Boston, and we see some real leadership here. Would you be willing to stay for the next two years, and run the program?” And so, that was my first foray into leadership; into science. So I stayed there for two years – I actually met my husband there – so it was really an extraordinary time. I got to travel, I got to work there, was doing science, and then we actually –  together, after we got married – moved to Texas. So that’s how I got to Texas. I did my master’s there, continued to do research there, but I realized that leadership and getting my master’s in healthcare administration was really the path that I wanted to pursue. So that’s what then took me back to Boston. My husband went back to graduate school and I came to Beth Israel. And the journey there was extremely wonderful in every respect as well.


Dr. Julie Gerberding  4:37 

When you think back to that time in Saudi Arabia, when someone recognized your leadership, what do you think they saw? If you had to guess, what would you say made you stand out from the crowd, so to speak? 


Sandi Fenwick  4:49  

Gosh, that was a long time ago, Julie, I try to look back and think about, I am very organized, extremely organized. Part of what we had to do there was to manage a team that went into the villages, organizing our trips back and forth, out, bringing the materials back that we collected. The second year, we did a clinical trial, organizing everything around how we were going to manage giving the drugs to the patients, believe it or not, it was doxycycline. And I think working with all of the interesting and diverse people; so we had nurses, we had a couple of doctors, we had a secretary, a driver. We had to go into the government to get permission, and I kind of was thrown into the deep end a little bit and just had to try and figure out how to do a little bit of every one of these things and keep the project going and reporting back into Boston.


Dr. Julie Gerberding  5:43  

I like that jumping into the deep end when you trace your trajectory from Beth Israel to Boston Children’s, you just have a set of progressive steps in your ladder, just kind of almost a linear ascension to the role that you have today. And along the way, there must have been other times when you were thrown in the deep end. What was probably one of the biggest challenges in your career progression that you kind of look back and say, “Wow, I can’t believe I did that.”


Sandi Fenwick  6:11 

There were several. At the BI, I was always looking for new opportunities. What was coming around the corner? And as we were moving into HMOs, and into our first round of capitation, and working to build a network, those were all new and challenging opportunities, and no one else was really interested in doing them, and so I said, “Well, there isn’t anybody else, this is the right thing for the organization, it’s a new opportunity to learn and to take on new things.” I was in charge of the merger with the BI deaconess and the two networks and systems. And that, in and of itself, was an interesting challenge, trying to bring the two very different organizations together. And then as I moved up to corporate to be a part of the leadership team that ran the system, but I think the biggest challenge was when I decided I really wanted to get back into hospitals, having been up at corporate for a couple of years. And I went over to Children’s, that’s when I arrived here. 


What I didn’t understand, Julie, was the challenges that I would face here. Five months after I got here, the board decided to make some changes in the top leadership and let go the CEO and the President and COO, and asked me if I would take on the role as the COO permanently and then step in for the CEO until they found a new CEO a year later. So taking on a new organization, a new team, new board, a new faculty, and a huge operating deficit. We were in really desperate shape, financially. We were eating into our endowment, there was no strategy, there was a lot of strife between the leadership and the board. There was no communication. Morale was in the depths of issues. And so I was not only thrown into the deep end, I don’t think there was any water there. And so, was little by little, tackling just one big challenge after another. And people still reference those years that was 1999 to 2001-2, and we did it we turn this place around and obviously are who we are today. 


Dr. Julie Gerberding  8:26

I had the privilege of visiting the hospital in the recent past, and not only seeing just the incredibly beautiful facility and the care that you feel the minute you walk in the door, but also the incredible research enterprise that you’ve built surrounding the Children’s Hospital and what that really means for the quality of care that you can provide. But this courage, the courage of jumping into the deep end, where did that resilience and that confidence come from?


Sandi Fenwick  8:52  

I think it’s my parents, I think it’s my background. My grandparents were immigrants, my parents, they came with nothing, my parents did not go to college, and they obviously believed deeply in not only education, but community and people and hard work, but also self confidence. And my dad and mom said, “You can do anything you ever want to do, you can be anything you want to do. But most importantly, believe in yourself.” And those are the words that have stuck with me ever since. And as I think about the things that drive me, it’s passion. Passion for the work that you do, the purpose of the work that you do, and the courage to take on every step along the way, sort of the next hill. And we have lots of hills, Julie, you and I, many times during our career, in many of your wonderful parts of your journey. There’s always going to be a challenge, there’s always going to be a crisis, and one just has to figure out how you’re going to break it up into bite-sized pieces and and tackle it, but also always in the back of your head is do what is the right thing to do with integrity and honesty and trustworthiness. And so those are sort of characteristics that have always guided me.


Dr. Julie Gerberding  10:09 

So being true to your values, knowing your purpose, and basing yours success on the confidence that you acquire as you go forward. So one of the things I’ve noticed about your bio is that you have a lot of board service, both publicly traded company boards, but also nonprofit and community kind of boards. Why do you do that? And what do you think that serving on the board brings to you and what do you try to bring to a board? And I’m asking the question because a lot of people are striving or interested in board opportunities. They’re not really sure where to get started or why and when. So I think this is a topic that maybe it’s a little bit later in the career trajectory of some people but it’s something that most of us have At some point or another, and you’ve obviously made some really good choices. So I’d be interested in hearing a little bit more about that.


Sandi Fenwick  11:08  

This was something that I actually was interested in, actually 30 years ago was the first board I joined. And it was an opportunity, it was the Greater Boston YMCA. And part of it was beginning to understand how other organizations really worked. I was very interested in board and governance and how organizations are led and governed. I was very interested in how other, both, at that point, other nonprofits were successful. And it was an opportunity to really begin to be connected to the business community, because many of the people on the board were business leaders. And so that was one reason. I believed in the mission of the organization, because it was really, interestingly enough, even though it was the YMCA, they were doing an enormous amount for children and women with opportunities and housing and job training and the like–not just for men, but clearly for women and families. So I believed in the purpose, I then joined both my children’s boards of their schools. That was about ensuring that the organization was healthy and again, made enormous relationships with both community members, as well as business leaders. And they have all been relationships that I have kept as friends and as business colleagues ever since. 


I was asked to join a public company board about 15 years ago from a wonderful colleague that I had met, who was the CEO and looking to expand the board and become more diversified because she was a woman. And she was looking for another woman to join her board. And so luckily, I was able to do that I was on that board for 10 years. Again, I believed in the product that they were working on, I learned so much from the other people because this was a world I wanted to learn more about for my own institution. So it was a biotech company. It was a specialty biopharma company. It had gone public, and so it was a whole new world about being in the commercial and corporate world. And I just kept learning and trying to bring back to my own institution, more rigor around governance, more understanding about how one really could drive some of our own research into the commercial world and get it faster and closer to patients. “What were the hurdles? How did we understand the details around the FDA and approvals and everything else?” So it has always been, what can I learn and bring back? And then over time, as I learned, what could I contribute from my experiences? Obviously, people were very interested in, “How does a hospital work? How do hospitals make decisions? What are the things that you struggle with? What are the HR issues? What are the compliance issues? What are the technology issues?” So there are a lot of opportunities for back and forth contribution, and so that’s the way I have looked at, now, my most recent corporate board, and I think I’m doing okay, because they asked me to stay on, we’re going to merge, hopefully, in the short term with another company. So I guess I’m doing something right.


Dr. Julie Gerberding  14:18  

I’m sure you are doing more than something right. But I think your story is really compelling because a lot of times when I’m mentoring or counseling young women, they’re striving to be on a fortune 500 publicly traded company board, but that starts often at a community level. And as you said, getting on the board of your children’s schools, or serving on a library board or a church board, whatever it is, gives people that initial credibility and credential because once you’re on a board, your network, by definition, expands. And then you have the chance to meet other people, which leads to more board opportunities, and it feeds forward. So I think your story is exactly exemplary of how we can support each other, but also start with what’s within reach and gradually build your resume and your credentials to be able to participate in that kind of service. 


The higher you go in the organization, the more rare it is for women to be in the majority role. So clearly, there probably have been opportunities in your work trajectory, your leadership trajectory, where you’ve had to be the N of one in the room or really recognized that we haven’t really achieved the kind of diversity and inclusion that we’re striving for. Tell us about some of that and how you’ve been able to reshape your own organization to be a more diverse and inclusive culture, because I heard that when I was there, and I’m interested in how you went about that.


Sandi Fenwick  15:11  

I think this is probably one of the most important things we need to think about. And it’s diverse from every perspective. And so when I think about diversity, I think about it broadly: about equity and inclusion. So for me, it’s comprehensive, and it goes through everything from gender to race, ethnicity, language, culture, thought, differences of opinion, differences of backgrounds, and expertise. And so all of those things, whether it is starting at the board level of any organization, “How are we really thinking carefully about all of the contributions that the people?” Especially for small boards, because there you have limited opportunity to say, “How many of these things can we find in an individual?” Characteristics, both human and experience, and expertise. So for me, it starts at the top of an organization and you can’t talk about it in the whole organization, if you’re not demonstrating it at every level. Then it’s true of the management, it has to be absolutely a diverse and a carefully constructed management team. We have really a wonderful management team here. My leaders at Beth Israel believed in that strongly as well, so I come from watching and observing others who believed in it strongly and not only saw the value of it, but also how to make it intentional, and how to make sure that it’s at the board level, it’s at the management level, it filters down as you’re thinking about leaders across the organization, and then it’s everywhere. It’s really thinking about how do you make sure that everyone feels that you have an environment that is welcoming, respectful, open to conversation, people can speak up, whether it is, you know, we had a lot of trainings around the “Me Too” movement, are now doing and we just committed to doing 100% training of close to 20,000 people here of unconscious bias training. And we’re going to do that across the organization and all the way up to the board. So you have to be intentional about it. It has to be at the top of your agenda, you have to have the willingness and the boards I sit on, I talked about it, have to have those difficult conversations when it’s not there. And then make it something not only for the people that are in your organizations, but obviously, as you think about everyone you want to serve, because if they don’t see the faces, the languages, the understanding of their own differences, and the people that they’re being served by, you’re really not completing the full meaning of equity and inclusion.


Dr. Julie Gerberding  18:57  

Is there a circumstance that you’ve encountered throughout your career where you had to deal with this on a personal basis? Where you felt that you were not treated in the appropriate way, either because of your gender, or your education or whatever? These things come up from time to time, even in the best work environments with the most well-intentioned people, but sometimes we’ve all encountered these challenges.


Sandi Fenwick  19:19  

Julie, I think we’ve all had incidents where we have been either belittled; we’ve been tested. I remember hiding my pregnancy, because I was afraid that it was really going to work against me, although it clearly didn’t, you know, when I finally had to declare that I was pregnant. But I think one time really does stand out. And it’s a funny time because it was very hard. My first promotion at Beth Israel was in a difficult circumstance when, again, my predecessor in a role was being asked to step away from the role. And I was asked to take over and I’d only been in the hospital for a year. And this administrator’s partner, physician partner really was angry. And so I had to go have a meeting with him. And he was brutal, absolutely brutal, and I had to defend myself. “Why did I think I should get this role? I really had no experience in the hospital, I had very little experience,” on and on and on. And I just kind of stood my ground and basically said, I thought I had this experience for this reason, that I really was dedicated to learning everything I needed to. And we kind of left not on the happiest terms, but I basically started to work with him. I tried to embrace and engage his own knowledge. And we’ve become really good friends up until today. And in fact, I heard from him last week. He stays in touch with me. He’s still working at the BI and we found a wonderful journey, but it was tough. And I just basically had to put that aside and keep going forward and prove to him that I can do the job.


Dr. Julie Gerberding  20:59

Takes courage, courage and candor. It’s tough. Now the news is full of your retirement plans. You’ve had a really long and incredibly successful run at Boston Children’s, I’m sure many people are mourning the anticipation of that change. How did you decide that it was time to make a move like that? And do you want to share with us what you’re thinking about doing next? Of course, we’d all love to be able to gossip about that. But how do you know when it’s time to make a big move like that?


Sandi Fenwick  21:29  

It’s never an easy decision. And I’ll tell you it’s been agonizing thinking about when to do this. I started having a conversation – I truly believe in very mindful succession planning, at every level within my organization, at the board level. And so several years ago, I realized we also had to think about board succession. We have had the most fabulous board and board chair for many years. And so I thought about “How do we do this here at the hospital and what’s the right order and the right timing of all of this?” And we knew we couldn’t do a lot of change together. And so we basically started to talk about what would be the right timing, in the right order for a succession a couple of years ago, and I sort of picked a date, which sounded like it was way out there – the future – and it was in the 2020-2021 timeframe. The other thing I also felt strongly about was really trying to see if there was ever any way that I could do a smooth and very thoughtful handoff to my successor. And so wanted to see if there was some way that I could bring on board when I first became the CEO, someone that could eventually take over. And that has all taken place. It has been a wonderful partnership and journey that I’ve had with Dr. Kevin Churchwell, who I recruited to be my partner as the COO and CMO at the time, but then promoted him to President a couple years ago. And he was just named the upcoming CEO a couple weeks ago. And so, thinking about how to plan for this in a very mindful and strategic way, was something that I’ve always thought about in terms of the way I do my work. And then I had to do it for myself, and for the organization. And while it feels absolutely right, from the organization’s perspective, I think it’s going to be a wonderful, smooth transition. We have a great plan for the next decade and beyond, and I think there’s always a time when you really want someone to take over for that next big chunk of work, the next changes that we know are coming. And so at some point, it’s right to turn over the execution of those goals and strategies to someone else. So that’s the way I thought about it. 


I now have four grandchildren, one that’s just been born a couple weeks ago, and my husband I met in Saudi Arabia, that I’ve been married to for 46 years, I realized that life is also short. And I am very interested in continuing my work for children, for women, for health care, both science and technology, where it’s going, and I think that there’s another way to not necessarily take on another big CEO role, but to participate in many other community ways and other organizational ways. So it feels right. And I’m hoping it is right.


Dr. Julie Gerberding  24:34  

Yeah, I’m thinking back to that young leader in Saudi Arabia, who was offered the next big opportunity because she was organized. And you have, I think, managed to sustain that theme throughout your career right up through this decision about succession and retirement in a very organized, thoughtful manner. So seeing the balance between your amazing strategic competencies and turning around a hospital system, growing an endowment, building a research enterprise, and at the same time, just the discipline in the organization that you’ve been able to use as your modus operandi throughout that entire spectrum. It’s just it’s a wonderful exemplar of leadership. We’ve come to the end of our time, and I hate to end this conversation, so maybe there’ll be a Her Leadership Story part two coming up when you move into your next chapters. But I do want to ask you one last question, and that really relates to the fact that not everyone gets to write a book about their story, but if you were going to write a book about your story, would you have a theme or a title in mind, how you would claim your story?


Sandi Fenwick 25:43  

Absolutely. I go back to what my dad always said to me and that is, “Love what you do and do what you love and do it with passion and purpose.” And somewhere in there, there’s a title, but that is really what I would talk about. It’s leading with passion and purpose and loving every day. Getting up and learning and being surrounded by the most extraordinary people. People are everything to me, Julie. And I have been so blessed to work with people and getting to know someone like you in my journey is really the blessing that I’ve had the opportunity to have.


Dr. Julie Gerberding  26:17  

But I can’t think of a more lovely way to end the conversation, Sandi. Thank you so much, Sandi Fenwick, for everything you’ve done for the children of the world, but also in sharing your story with our viewers.


Sandi Fenwick  26:30 

Thank you, Julie.


Lan Nguyen  26:32

Her Story is a weekly podcast produced by Think Medium. Please subscribe to Her Story on Apple Podcasts or wherever you’re listening right now. You can access the video version of Her Story on YouTube or on our website thinkmedium.com/herstory. Be sure to rate and review Her Story so we can continue bringing you stories from inspiring women healthcare leaders. We’ve found that podcasts are known through word of mouth, and we appreciate your spreading the word to friends, family, colleagues, and mentors. For questions and suggestions about Her Story, contact us at herstory@thinkmedium.com. Thanks for listening.

Subscribe for Updates​

For exclusive access to Think Medium content and program updates, subscribe here.