Dr Smith is chair of the UK Health Alliance on Climate Change, the Point of Care Foundation, which promotes compassionate, dignified care, Patients Know Best (a company that gives patients access to and control over all their health and social care data, including all records and test results), and of the Lancet Commission on the Value of Death.
Until November 2018 he was chair of the board of trustees of icddr,b (formerly the International Centre for Diarrhoeal Disease Research, Bangladesh) and until 2015 he was the director of the UnitedHealth Chronic Disease Initiative, a programme with the National Heart, Lung, and Blood Institute that created 11 centres in low and middle income countries that conduct research and build capacity to counter non-communicable disease.
From 1979 to 2004 he worked at the BMJ and was the editor of the journal and chief executive of the BMJ Publishing Group from 1991 until he left. A member of the board of the Public Library of Science from 2004 to 2011, he continues to blog for the BMJ and to publish regularly.
He is a visiting professor at Imperial College Institute of Global Health Innovation. Having qualified in medicine in Edinburgh, Dr Smith worked in hospitals in Scotland and New Zealand before joining the BMJ. He also worked for six years as a television doctor with the BBC and TV-AM and has a degree in management science from the Stanford Business School.