top of page

Amar Rughani

Provost RCGP South Yorkshire North Trent & retired GP.


Oh, if only WISE was an acronym, but it’s not. The reason I feel uncomfortable in writing about wisdom is that it is something we become aware of through others rather than become conscious of in ourselves. In fact, the ‘wiser’ we are thought to be in making judgements and extrapolating beyond the known, the more pricked we feel by our own limitations. In particular, the blind way we navigate forward through assumptions rather than through taking the trouble to make others feel understood.


Our work as GPs has human relationships at its core. In this context, wisdom has little influence if it walks alone; it must be accompanied by compassion. So, in my career, I’ve used judgement and compassion principally in my clinical work but beyond that, in developing the art of leadership in primary care and it’s the latter way of being a ‘WiseGP’ that I’m going to focus on.



As a GP educator I was concerned when leadership was introduced to the curriculum. I knew it was important, important enough that it shouldn’t be reduced to a series of tick box competencies. However, I wasn’t clear what it was, let alone how it could be taught. This led me to read widely, where I found that much of the guidance was from communities that had different cultures and values from Medicine.

And there lay the problem, because leadership is only effective in relation to the context. I quickly found that leadership can’t be taught, but it can be learned and I developed my abilities through taking lead roles, supporting and mentoring others and using these insights to write a book on the subject.


I don’t see myself as a ‘natural’ leader, whatever that means, but as someone who wants to work with others to improve things and make a difference for their communities. Am I so different to anyone else? I doubt it. So, if most of us have this drive, the ability that distinguishes effective leaders is helping the team make improvements when the way ahead isn’t clear, when risks are involved and people have to be kept on board.


To do the problem-solving, we need people who can see things in different ways. This adaptability and creativity doesn’t come through groupthink, but through diversity. So why does wise leadership matter? It’s because it’s inclusive, gets the best out of people and helps communities to survive, improve and flourish. Are there may things more important than that?



Okay, for what it’s worth in relation to wise leadership:


  • Beware of tips. Thank goodness life is not that straightforward.

  • Forget your preconceptions about leadership. If you’ve helped people to make a difference to their lives, you’ve been doing the work of leadership already, so allow yourself to feel comfortable with the role.

  • The skills you use in the consultation with individuals are just the same as leaders use outside the consulting room with groups of people. You’ve got the skills; you just need to learn to transpose. 

  • Learn to be a more effective leader by doing it, maybe by leading a small team.

  • Every effort you make is an experiment, so don’t expect to get it right but do expect to improve through looking at the outcomes and getting feedback from insightful people that you trust.

  • Learn to be more open: with ideas, by working with people who are different from you and by being prepared to change your behaviour.

  • Take pleasure in the achievements, but learn to recognise that they are ours not mine.


…and if you want to learn more, read the book:

The Leadership Hike: shaping primary care together

Amar Rughani and Joanna Bircher

Pub CRC press Taylor & Francis group 2020

bottom of page