Medical writing

"Nearly a quarter of a century ago I left the security of a well-paid and well-pensioned position to go on a mission to show doctors how much they — and their patients — would benefit from knowing the simple techniques of effective writing. As an editor on medical magazines for a decade, I had been surprised by much of what I had seen: winding texts of long and pompous words brought together in rambling sentences that obscured any sensible meaning. Here was a great opportunity, I thought, to pass on what I had learnt as a professional writer: that the best way to express clear and well-ordered thoughts was through clear and simple language. I was confident that within a year or two the culture would start to change, and instead of glibly trotting out phrases like Long-term medication is predicated, doctors would start writing: You may have to take these pills for a long time. To my surprise I met fierce resistance. 'You can't use simple words, they are for children'; ' Approximately is a proper scientific word; it would be wrong to write about '; 'Don't put We examined the patient; instead write, The patient was examined '. One exasperated public health doctor went so far as to say: 'We're doctors. We don't necessarily want people to understand what we are writing'."

"Words matter in science that matters. Far too often, however, the words in medical literature are chosen and arranged without enough care. This leads to confusing, jargon-filled writing that is difficult to read, even for medical researchers. Not only is careless writing a barrier to publication, it makes it more difficult for peers to understand and build on other researchers’ work. Poor communication limits the impact of medical research, so clinicians and patients ultimately suffer as well. Vague and ambiguous clinical practice guidelines, for example, have been linked to medical errors and inconsistent interpretation. … Writing about complex medical research in plain language is challenging. Technical terms, acronyms and jargon, although used too frequently, cannot be avoided entirely. But the benefits — improved knowledge translation, less research waste — are too great for needlessly complicated writing to be accepted as inevitable. Medical educators, academic institutions and health care researchers have a duty to improve the quality of written communication to extend the reach of useful medical knowledge."

"Medical editors, however much they may disagree on scientific, social, or economic problems, will agree on one point: papers submitted for publication are, with few exceptions, badly written. The need for better medical writing is a perennial complaint: but what to do about it? One remedy is a book designed for self-study. Almost every year, publishers will bring out one or more volumes of this type, often helpful if used earnestly and critically. ... A second resource for improvement is the workshop or short course in writing. ..."

"There is probably more bad writing in medical journals than in any other kind of periodicals. For this there is a variety of reasons. Medical men are without leisure, and there is so much in medicine about which something may be written, that they lose their way. Besides, it is a common delusion that the mere fact of attendance for four or five years upon lectures in a faculty of a university confers upon a man those qualitiies of aptitude, precision, and harmony, which are commonly called style. On the contrary, the pursuit of a single, dominating interest, as told the students of , limits a man's breadth of outlook and the range of his intellectual curiosity; it dulls his zest and diminishes his eagerness to know and integrate into himself the best that has been thought and written for the enrichment of his mind. In short, it is a bar to the perception of what is good and what is evil in the art of writing."

"Presenting and communicating information effectively in any medical document is of paramount importance. The facts must be presented in such a way that they can be understood as intended. Many medical manuscripts are used for the diagnosis and treatment of patients: if they are misinterpreted, the consequences could be harm to the patient. Far too many errors that occur in medical practice are the result of poorly written documents, which in turn can result in miscommunication of information."

"The ability to endure rejection is a must. I began medical writing in the early 1970s while in small-town private practice. I had some early success in conducting clinical studies and seeing the results in print in respected journals. I also wrote some articles for controlled circulation, advertiser-supported journals, such as Medical Economics. Not everything I wrote was published. I also began writing health books for non-medical people, what the editors call the "lay audience." Here I collected so many rejection letters that I could have wallpapered a room with them. Only when I began writing and editing medical books did my acceptance rate become favorable. However, after 40 years of medical writing experience, I still receive rejections for clinical papers, editorials, and book proposals. And, yes, it still hurts. If you aspire to be a medical writer you will need determination. Being a writer takes a lot of effort and you really need to want to see your work in print."

"Medical writing, like the treatments it describes, can be used to improve health but also has the potential to harm. Rudyard Kipling (Kipling, 1923) wrote that ‘words are, of course, the most powerful drug used by mankind’, reminding us that writing has the power to change behaviours and attitudes. Medical writing therefore carries a heavy burden of responsibility. However, working with a powerful, or potentially dangerous, substance can be exhilarating. Another factor that makes medical writing such an interesting area is that it inhabits a strange boundary zone between science and art. Medical writing, especially reporting clinical trial results must be factual and objective. Certain aspects can undoubtedly be improved by following checklists and guidelines (Plint et al, 2006). Yet formulaic papers that report results dispassionately tend to be dry and uninteresting, while good papers should be inspiring and persuasive. But if the persuasive elements are taken too far or the arguments are not properly grounded in the findings, the report becomes biased and potentially misleading. Writers therefore walk a tightrope along what has been termed ‘the rhetoric of research’ (Horton, 1995; Schriger, 2005). They need to understand both the underlying science and the expressive art and to know where one should stop and the other begin."