Practical wisdom in modern healthcare: A conversation with Raj Rattan

From science to philosophy: formative influences

What inspired your interest in philosophy?

My interest in philosophy really began in school. From the age of 11, my education was almost entirely science‑based – and, truthfully, other subjects didn’t interest me much. My teachers were concerned that my interests were too narrow and encouraged me to keep a balance by taking general studies classes. Those classes included an introduction to philosophy. At the time I regarded these classes as a diversion, but looking back they were very influential during my formative years.

I was drawn back to philosophy, particularly to Stoicism, after I graduated from dental school. Philosophy has offered an insight into different aspects of my professional life from owning and operating a small practice group, to teaching, and my dentolegal and consultancy work.

I was driven to study the subject in more depth under the guidance of Professor Ray Tallis, a physician, philosopher, poet and novelist and who was once described as ‘one of the world’s greatest living polymaths’ (Intelligent Life). I remain in touch with him, and he continues to inspire.

Philosophy in policy, governance and practice

How did it impact on your professional life?

In terms of impact, I recall one conversation from my time as a part‑time policy adviser at the Department of Health. I attended a meeting with the then Chief Dental Officer, Dame Margaret Seward, and David Lammy – now Deputy Prime Minister – who was serving as a junior health minister at the time. During a discussion about clinical governance, we found ourselves talking about Aristotle’s Doctrine of the Mean. It was a thoughtful exchange, and it made me realise that my interest in philosophy gave me an original perspective – if you can call principles that have stood the test of time for 2000 years ‘original’.

The moral core of healthcare

Healthcare is often viewed as a highly technical field. Is that an accurate portrayal?

Healthcare today is informed by evidence‑based practice, clinical research, and increasingly by technological innovation, but we must not forget its moral core. The American physician and bioethicist Edmund Pellegrino reminded us that medicine is a moral enterprise, grounded in the covenant between clinician and patient. Aristotle’s concept of phronesis guides sound judgment and ethical action in a field that is both scientific and moral in nature.

What is phronesis and why does it matter now?

That brings me to my next question. You have written and lectured about phronesis – what do you mean by phronesis and what is its relevance today?

The word phronesis comes from ancient Greece and means “to think” or “to exercise sound judgment.” It was Aristotle who framed it as practical wisdom.

Today, it can be understood as the wisdom that guides clinicians to apply evidence, experience and ethical values to do the right thing in the right way and for the right reasons.

I like the phrase clinical phronesis to describe the specific form of practical wisdom that arises within the clinical setting. It refers to how wisdom is expressed in everyday clinical practice. Phronesis sits alongside theoretical understanding and mastery of practical skill – what Aristotle called episteme and techne.

As an aside, I always remember the journalist and humourist Miles Kington. He famously observed that “knowledge is knowing that a tomato is a fruit; wisdom is not putting it in a fruit salad.” That accords perfectly with Aristotle’s distinction between episteme and phronesis.

Breaking down practical wisdom in practice

Can you break down the components of phronesis for us?

Excuse me for being self‑referential, but I recently wrote a chapter titled What It Is to Be WISE. I use WISE as an acronym to describe the key components of phronesis – Wellbeing, Insight, Sensitivity and Experiential learning.

Wellbeing reminds us that healthcare is ultimately about human flourishing, not just technical success.

Insight is the capacity to see what really matters in complex situations.

Sensitivity speaks to empathy and ethical awareness.

Experiential learning is where theory becomes wisdom through reflection on practice.

You can learn knowledge and skills from textbooks or simulation, but phronesis grows through lived experience and reflection.

Evidence, uncertainty and judgement

What is the relationship between phronesis and evidence‑based practice (EBP)?

The relationship between phronesis and evidence is complex. The pursuit of evidence can sometimes create the illusion that judgment is no longer required.

EBP provides knowledge and technical skill, while phronesis supplies the discernment needed to personalise care in the face of uncertainty. Practical wisdom connects science to real‑world complexity.

Aristotle, algorithms and artificial intelligence

AI is becoming more prevalent in healthcare. What are your views on how AI impacts phronesis and vice versa?

I’m tempted to reframe your question as “Aristotle and the Algorithm.” My interest in philosophy often overlaps with AI. In developing the INFORMED and RECORDS frameworks, I grappled with how Aristotle’s virtue ethics might apply.

AI excels in theory but lacks moral agency. Analysed through a virtue ethics lens, AI systems lack phronesis, which is computationally irreducible. Technology offers perspective, not judgment. Phronesis ensures technology serves clinicians, not the other way around.

Nick Bostrom’s Paperclip Maximizer reminds us that intelligence without wisdom can be destructive. Moral and contextual judgment must guide the code.

Wisdom in an age of information

Is there anything else you would like to share on practical wisdom?

I will conclude with T.S. Eliot’s Choruses from the Rock. His words still resonate today. Information is everywhere, yet wisdom often eludes us. Our medicolegal and dentolegal experience reminds us of this daily.

The algorithm offers precision and speed. Aristotelian philosophy reminds us healthcare must still be guided by phronesis.

One Four Seven: A book yet to be revealed

And finally, can you explain the title of your next book – One Four Seven?

The short answer is no. The slightly longer answer is not yet.

Further reading and resources

Aristotle. Nicomachean Ethics. Translated by W. D. Ross. The Internet Classics Archive.

Chatzopoulos et al. (2025). Clinical Applications of AI in Periodontology. Medicina.

El Khoury (2025). Exploring the ethical landscape of AI in dentistry. Journal of Dental Research.

Liu (2025). AI in Dentistry: Innovations, Ethical Considerations, and Future Directions. MDPI.