Member Spotlight: John Fankhauser, MD, CEO of ELWA Hospital in Liberia

Driven by his faith, John Fankhauser, MD, quit his family-medicine job in California and moved his family to Africa. Five years later, he talks about physician leadership in a nation ravaged by war and disease.   

John Fankhauser

John Fankhauser

It was an opportunity both daunting and intriguing to any physician leader: Move to an African nation that had been ravaged by civil war and Ebola, and rebuild not only a health care facility but health care itself.

That’s what John Fankhauser, MD, did in November 2013, when he quit his family-medicine job in California and moved his family to Liberia for what was supposed to be a one-year mission with a faith-based organization.

As the five-year mark approaches, Fankhauser, a member of the American Association for Physician Leadership since 2007, talks about physician leadership in a country that has one physician for every 40,000 people.

QWhat made this opportunity appealing to you?

A My wife — she's a nurse by background — and I have both been drawn to global health. We lived in Guatemala, and traveled to Sudan and to Southeast Asia. We had been talking for a long time about doing that with our [three] children. … Over a period of time and a lot of family discussion and a lot of soul searching … the more we read about Liberia, the more we saw the health care need there. It was an opportunity to have significant impact.

Q The civil wars that ended in the early 2000s destroyed some 95 percent of the health care facilities. Were you starting from scratch?

A There had been seven or eight years of really substantial recovery [before he arrived], so much of our health care structure had been rebuilt or was in the process of being rebuilt. Yet the infant mortality and the maternal mortality and the health care outcomes were still among the worst in the world. [The hospital he works at was] in the middle of a building project — we had a 50-year-old facility that had really felt the impact of the war and the economic downturn here. In November [2016], we moved into this new [85-bed] facility — a hospital in which we can function.

Q Why tackle a challenge you might not get your arms around entirely?

A My personal faith has been a large part of what's driven me that way. The Bible demonstrates over and over that the more you give of yourself and the more you look outward, the more you get in return. I found that to be true here. I've seen so many people of so many different backgrounds doing extraordinary things. You develop an admiration for the human spirit.

Q How do the principles of physician leadership help your mission? How do you apply it to make things better?

Liberia map

A Training related to teamwork, quality management and project management, working with teams and looking at individual strengths, and trying to augment people's strengths and build them to add diversity to a team — they do. Not all [principles] translate here, but the major concepts do: what individuals are about and what drives them, and allowing them to grow and use something that they're passionate about as a way to move them. I think those are concepts of “better” in any culture. This experience, with its different culture and different environment with different types of people, has helped me as a leader in looking at any issue or at a problem and [deciding] the kind of team I would want to build, and then strategizing how to reach [a solution] with the people I'm working alongside.

Q Is physician leadership a tangible concept for the resident medical colleagues? Aren’t they happier just to have another doctor helping out?

A In this culture, being a physician is naturally associated with the expectation of leadership. I work with seven other physicians, and all of them are extraordinary leaders. Physician leadership is the force behind extraordinary change in our system and can help improve the quality of care we give. That’s largely true of any leadership position — physician leadership and nursing leadership, working well together. There are really strong physician leaders working together here. It's been my job to help coordinate that team for critical patient care of the highest quality we can provide.

Editor’s note: This is a Member Spotlight feature from the AAPL Newsletter. The newsletter is emailed monthly to all association members. For information, or to suggest members for future profiles, email

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