Some years a go a young friend who had worked with me became the head of a big organisation and asked for my tips on leadership. I’ve had some interest in leadership ever since I did a year at the Stanford Business School, and I enjoyed thinking of what to write to my friend. Perhaps my tips might interest you.

1. “Unto thine own self be true.”
2. “Walk the talk.”
3. Recognise that everybody has different styles of leadership.
4. Be fair and ethical and recognise that almost all decisions have an ethical component.
5. The primary jobs of leadership are to set a vision and then to motivate people to want to achieve the vision. (You don’t, however, have to do these things on your own—simply make sure that they get done.)
6. Try to concentrate on the big picture, the long term, and the outside world.
7. Recognise that leading (“doing the right thing”) and managing (“doing the thing right”) are different and that you don’t have to be the leader and the main manager. Indeed, you will be unusual if you are good at both, and it makes sense to divide the role—as with chief executive officers and chief operating officers.
8. Remember that “any institution that can’t be better than its leader is doomed.” Surround yourself with good people. Give them lots of freedom space, and power to do great things; and feel comfortable that the people to whom you delegate will do things differently from you.
9. Start from the premise that people want to do good things and can be trusted.
Believe that “there are no bad people only bad systems,” but recognise that sometimes it is necessary to get rid of people
10. Cherish those who are willing to disagree with you. Be wary of those who agree with you all the time.
11. Don’t let the urgent crowd out the important.
12. Ask yourself all the time “Am I adding value with what I’m doing?” Often you won’t be.
13. Remember to manage upwards as well as downwards (I did badly here).
14. Find one or two people whom you can trust absolutely. Avoid becoming isolated
15. Consider finding a mentor to whom you can talk regularly (I’ve done this recently but should have done it a long time ago).
16. Remember the extraordinary power of praise, but make sure that it is specific.
17. If you are unhappy with how somebody has done something, say so, but be certain to give them specific advice on how it might have been done better.
18. Acknowledge and use the power you have as a leader, even though it may feel uncomfortable.
19. Appreciate the maxim that “Great leaders have the strength to abandon themselves to the wild ideas of others.”
20. Remember the words of Nelson Mandela “a leader is a servant.”

Richard Smith was the editor of the BMJ until 2004 and is director of the United Health Group’s chronic disease initiative.