How to Choose a Missions Agency: 12 Questions to Ask

NOTE: This article was originally written by Greg Seager, Founder and CEO, Christian Health Service Corps. Some updates have been made since. 

A missions agency is a sending organization that helps prepare, place, and care for missionaries so they can serve faithfully and effectively over time.

Choosing among missionary agencies is not a paperwork decision; it shapes your training, your support, your team life, and the care you will receive when the work gets heavy.

I am writing because most healthcare professionals wanting to serve in long-term missions are asking the wrong questions. Experience has shown that asking the wrong questions can lead to unnecessary failure on the mission field. The questions below are meant to be asked before selecting among missionary agencies through which to serve as a long-term medical missionary.

I posed a list of questions in my book, When Healthcare Hurts that seemed a bit sacrilegious at the time. Those questions helped shift the medical missions culture toward patient safety and showed greater respect for human dignity. The questions shared here may also stretch some serving in, and leading, long-term mission organizations. It is my prayer that this series of posts, and the book to follow, will have the same effect in long-term healthcare missions.

The list is broken down into a few categories of questions. First, what questions should a healthcare professional planning to serve in missions ask potential missionary agencies? Second, what questions should a healthcare professional planning to serve in missions ask about being matched with a facility or health program? Third, what questions should a healthcare professional planning to serve in missions ask themselves to help them be successful on the field? This focuses on the first category. Subsequent posts will focus on categories two and three.

Key Takeaways

• Medical missions place unique emotional, clinical, and spiritual burdens on healthcare professionals that differ significantly from other forms of missionary service.

• Attrition among medical missionaries is often driven by unaddressed realities such as isolation, overwhelming workloads, and repeated exposure to death and trauma.

• Medical missionaries carry an internal weight shaped by constant life-and-death decisions, resource scarcity, and questions of clinical preparedness.

• Effective care for medical missionaries must resemble disaster-response support rather than traditional missionary member care models.

• Choosing among missions agencies requires asking hard questions about preparation, accountability, mentorship, and long-term support to protect both patients and missionaries.

Medical Missions Is Different

One thing was always clear: sending a doctor, nurse, or other healthcare professional to serve in a mission hospital, or even a community health program, looks very different than sending a pastor. Many mission organizations miss this point, and it has contributed to significant attrition in medical missions. When medical missionaries are lumped in with church planters, Bible college teachers, and Bible translators, it becomes harder to see the distinct pressures that drive healthcare professionals to leave the field.

I spend a great deal of time traveling to see medical missionaries serving across many cultures. I have interviewed hundreds of medical missionaries over the years, and some of these conversations are shared on MedicalMissionsTV. These stories carry a consistent theme: long-term medical missions expose people to a weight that cannot be managed by good intentions alone.

Not long ago, I interviewed a single female physician who left the field after two years. Because she was the lone single person on the mission station, she carried a much greater load. Since she did not have a family to go home to and set boundaries around, she was expected to do more calls and work longer hours. That eventually led to her departure from the field.

I also spoke with a pediatrician who left after one year because he could not cope with the vast amount of child death he saw while serving in a rural African bush hospital. He lost 150 children in his first year. That is not a typical missionary set of problems, and it changes how to choose a missions agency.

Medical professionals share many challenges with other missionaries: language acquisition, moving your family to another culture, working within an intercultural team, and educating children, to name a few. Yet they also face daily life-and-death decisions. The classic reason missionaries leave the field—not getting along with other missionaries—still exists in medical missions, but it is far less traumatic than many reasons medical missionaries come home. Many medical missionary challenges cause post-traumatic stress and lifelong wounds.

The Challenge of the Internal Voice

Medical missionaries must manage an internal voice that asks questions most non-healthcare professionals have never heard. It is the voice that asks questions many have been forced to ask in their careers.

• If I would have done something different, would that child have survived? Did I make a mistake?

• Is there something I should have learned before I came to the field that could have saved this child?

• How can I practice here? I never cared for a young mom with postpartum hemorrhage and no blood available.

• I never treated a child so malnourished they cannot stand, walk, or eat. Where do I start?

Experience has taught me that caring for a medical missionary should look more like caring for an aid worker in a disaster zone than caring for a typical missionary. Mission organizations must understand this both conceptually and in member care practice. 

These daily questions are inevitable in the first few years on the field, and they add immense stress to already stressful life circumstances. Combine that with the volume of child and maternal death, being forced to work without needed medications, supplies, blood, and equipment, and walking families through the death of a child or loved one, often daily. These are unique challenges for medical missionaries.

How to Choose a Missions Agency for Healthcare Missions

With that reality in view, the questions below were created. They are not meant to be cynical. They are meant to protect patients, strengthen missionaries, and help missionary agencies build healthier pathways for long-term service.

For some, the best place to start is clarifying the shape of a call and the practical next step. Discerning direction matters, and signs that God is calling you to ministry can help frame discernment without reducing it to a feeling. For others, it helps to zoom out and understand the pathway of preparation that often sits behind successful long-term service, including how to become a missionary.

Questions to Ask Missionary Agencies

Does the organization recognize and understand the unique challenges of healthcare missions?

Does the organization’s pre-field preparation include sections that are specific to healthcare missions?

If so how much preparation is dedicated specifically to healthcare missions?

Does the organization view healthcare as a ministry itself, or do they view it as a platform for evangelism?

Does the organization view healthcare and healing ministries as part of the mission of the church?

Is there spiritual and clinical mentorship available, promoted and or required?

Does the organization have a missionary/member care program that focuses on and addresses the unique needs of healthcare professionals and their families?

Does the organization ascribe to the International Global Connections in Member Care?

What is the work schedule expected, and what are the leave and furlough policies? Are they structured to support healthcare professionals? Are visitors permitted in the first term of service?

Is the organization familiar with World Health Organization (WHO) guidelines for clinical practice in resource-poor communities?

Does the organization know about, and promote their missionaries' learning, programs such as Integrated Management of Childhood Illness (IMCI), Integrated Management of Childhood Malnutrition (IMCM), Integrated Management of Pregnancy and Childbirth (IMCPC)?

Will the organization provide logistical support for healthcare ministry work? I.E. Medical equipment, supplies, volunteer staff relief, grant requests made to support medical work etc.?

These questions do more than screen for competence. They reveal whether a missions agency can shoulder the responsibility of sending clinicians into environments where the margin for error is thin and the emotional cost is high. That is the heart of evaluating missionary agencies with honesty.

Exploring Next Steps in Long-Term Service

When you are ready to move from exploration to action, a helpful step is to compare long-term opportunities that align with your training, convictions, and season of life. Explore options for long-term service and use the questions above as your filter while engaging missionary agencies.

Related Questions

What is a mission agency?

A mission agency is an organization that trains, sends, and supports missionaries for ongoing cross-cultural ministry.

How do I choose a reputable mission org?

Choose reputable missionary agencies by looking for clear governance, strong preparation, transparent policies, and proven member care.

What is the average salary of a missionary?

Missionary compensation varies widely, but many missionaries rely on support-based funding rather than a fixed salary.

How much does a mission trip typically cost?

Costs vary by location, length, and logistics, but travel, lodging, insurance, and in-country expenses often make the total significant.