Obama, Lincoln, Elizabeth I, Merkel, Sarkozy, Streep/Thatcher, Papandreou, Berlusconi, Gadaffi, Henry VIII. Leadership is in the news and leadership influences outcomes. Primary care sports and exercise medicine has benefitted from transformational leadership in certain countries. Building a national primary care sports and exercise medicine body with 1500 or more members requires a guiding coalition1 to focus on the common, compelling goal.2 It takes a community and it takes a professional lifetime. If quasi-leaders cannot subvert their personal ambition to genuinely support each other to benefit, the collective things go awry.3 Underperformance has many faces.

The American Medical Society for Sports Medicine (AMSSM) has benefitted from 21 years of transformational leadership. The result is a brilliantly supportive milieu for American primary care physicians and fellows which means better outcomes for patients. Lives saved. AMSSM is a jewel in the global primary care sports and exercise medicine crown. In a free, very competitive, market, US primary care physicians vote with their feet for AMSSM. Membership is accelerating, conference attendance climbs year over year and balance sheets point to sustainability. The organisation may serve as a role model, a ‘success story’ for some, and as a result AMSSM is now able to offer terrific value for international physicians who wish to join. More on that over the page.