Bringing Healthcare Home with John Porter

John Porter never set out to lead one of the nation's largest rural health systems. The 2018 Inductee of the South Dakota Hall of Fame simply wanted to be a lawyer.

But over time, through relationships, trust, and a willingness to follow where opportunity led, his path evolved into something much greater. John became a central figure in shaping modern health care across South Dakota and the region. His legacy is rooted in helping shape Avera Health into a system that serves communities with compassion and excellence."

Looking back, John sees his journey not as something he built alone, but something shaped by many.

“It wasn’t just me,” he reflected. “It was thousands of people behind me, doing it all.”

A Childhood Dream Turned Commitment

John was born and raised in Pierre, South Dakota, where his parents operated a small office supply business. Growing up in the state’s capital, he developed an early interest in government, law, and public service.

He worked road construction jobs in the summers and stayed focused on his goal of becoming a lawyer. That goal never wavered.

“I set my mark on wanting to be a lawyer. It really intrigued me,” he said.

John attended the University of South Dakota, earning his undergraduate degree before continuing to law school. Along the way, he married his high school sweetheart, Penny, who supported the family as a nurse while he completed his education.

After law school, he joined a Yankton firm where he practiced general law. It was there, during a summer internship, that he was first introduced to legal work for the Presentation Sisters of Aberdeen, S.D., and Benedictine Sisters of Yankton, S.D.’s health ministries.

At the time, he had no idea that the introduction would shape the rest of his life.

Following a New Path

John’s transition from law to health care leadership happened gradually. At first, he handled legal work for the Sisters while continuing a general law practice. Over time, he became more involved in governance and administration, eventually stepping fully into leadership roles.

“I had no intent coming out of law school to focus on health law,” he said.

That path led him to help establish the Presentation Health System, bringing together hospitals and care facilities that had previously operated independently.

Years later, he would help guide an even more significant transformation.

In the late 1990s, John played a key role in bringing together two Catholic health systems, the Presentation Sisters and the Benedictine Sisters, into a single, unified organization. The process took years of conversation, trust-building, and a shared vision.

“They just came to the conclusion that we are stronger together than we are apart,” he said.

The result was the establishment of Avera Health, with John serving as its first President and CEO.

Under his leadership, Avera grew into an integrated health system serving communities across multiple states, with hospitals, clinics, long-term care, and innovative virtual care services that allowed patients to receive treatment close to home.

One of his proudest accomplishments was advancing that vision.

“Quality health care close to home,” he said, became a guiding focus.

Powerful Guiding Principles

Throughout his career, John’s leadership was grounded in a few simple but powerful principles. Integrity came first.

“As my mom used to say, you don’t ever do anything you wouldn’t be proud of reading on the front page of the newspaper the following day,” he said.

He also believed deeply in openness and collaboration. Decisions were never made in isolation. Teams were brought together, ideas were shared, and every voice had value.

“None of us is as smart as all of us,” he said, reflecting a philosophy that guided decades of leadership.

John also learned to remain open to change. His own life was proof that a career path can take unexpected turns.

“The lawyer became a health system CEO,” he said. “You never know where it’s going to take you.”

A Strong Mission

By the time John retired in 2018, Avera had grown into the largest employer in South Dakota, serving communities across multiple states and reaching patients through both in-person and virtual care.

Yet for John, the numbers were never the point. What mattered most was the mission.

Even as a lifelong Protestant, he embraced the Sisters’ health ministry as his own, helping create a culture where employees could see their work not just as a job, but as a calling.

“They’re there because of the opportunity to express their own beliefs and ministry,” he said.

Today, his legacy lives on in the communities served, the systems he helped build, and the people who continue that work.

When asked how he hopes to be remembered, his answer reflects the same humility that defined his career.

“For the integrity, the openness, the approachability,” he said.

From a young man set on becoming a lawyer to a leader who helped transform health care across the region, John Porter’s story is a testament to integrity, collaboration, and a willingness to follow purpose wherever it leads.

Learn more about John Porter’s legacy here.

Watch the full interview with John Porter to hear his story in his own words.