MacPhail was the first woman physician sent by the Free Church of Scotland as a medical missionary. At the time she was sent to take the post, there were only 60 women registered as physicians in England and only ten were serving abroad. MacPhail founded a permanent dispensary and clinic in her home in Madras during 1888, primarily focussing on health care for women and children. Christina Rainy, a Scottish educationist (and sister of Robert Rainy), arrived in Madras towards the end of the 19th century, and began raising funds to support the clinic back in Scotland. These additional funds allowed for the clinic to be expanded and a fully fledged mission, Rainy Hospital, was opened in 1914 by Lord Pentland.
