Robert B. Taylor - The Clinician's guide to Medical Writing.pdf - Medicine - KynioWolny

Table of Contents

Dedication

Preface

vii

About This Book

xiii

1 Getting Started in Medical Writing

2 Basic Writing Skills

3 From Page One to the End

4 Technical Issues in Medical Writing

5 What’s Special About Medical Writing?

105

6 How to Write a Review Article

127

7 Case Reports, Editorials, Letters to the Editor,

Book Reviews, and Other Publication Models

143

8 Writing Book Chapters and Books

167

9 How to Write a Report of a Clinical Study

195

10 Getting your Writing Published

213

Appendix 1 Glossary of Terms Used in Medical

Writing

247

Appendix 2 Commonly Used Proofreader’s Marks

253

Appendix 3 Commonly Used Medical Abbreviations 255

Appendix 4 Normal Laboratory Values for

Adult Patients

259

Index

263

Getting Started in Medical Writing

Does being a clinician make you or me a capable medical

writer? No, it doesn’t, any more than being a physician qualiﬁes

me to be a good stock picker, business manager, or even vaca-

tion planner. It only means that I have medical knowledge and

skills, and am trained to care for patients. On the other hand,

just because you are a clinician who sees patients daily does not

mean that you cannot become a capable, even great, writer.

Being that great writer requires knowledge, skill, experience,

the capacity to endure rejection, and a strong will to succeed.

The knowledge part includes both medical and “writing”

knowledge. Let us assume that, by virtue of your clinical prac-

tice, you have the medical knowledge. Then what you must

master are the body of information and the technical skills

that can help you become a great writer. You must know how

to assemble and use basic writing resources. You also need to

understand key issues in medical writing such as how to get

started and how to get ﬁnished, the various models of medical

writing, how to prepare a manuscript, and how to get your

work published. Acquiring this knowledge is no small task,

but it can be done.

Writing for the medical literature has its own special con-

siderations. Writing vibrant prose is not usually the key issue,

and at times may appear to be disadvantageous. Rew 1 has

written, “A fog has settled on scientiﬁc English. Well-written

English effortlessly communicates the writer’s intent to the

reader. Unfortunately, far too often, science is written in a form

that renders the content hard to understand, and which makes

unreasonable demands on the reader.” It seems that many

medical articles, notably reports of clinical research studies,

are written to be published and cited, but not to be read. I

hope that you and I can aspire to a higher level of writing skill,

and that editors and readers will appreciate the enhanced

readability of our work.

2 GETTING STARTED IN MEDICAL WRITING

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. Not everything I wrote was published. I also began

writing health books for nonmedical 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 30 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 determi-

nation. Being a writer takes a lot of work and you really need

to want it. But if you develop the itch to write, it can only be

relieved by the scratch of the pen—or today by the click of the

computer keyboard. If you begin to see yourself as a writer

working on a project, as I am working on this book today,

then you will think about the project whenever you have a

spare moment, and as ideas occur, you will jot them on a scrap

of paper, index card, or personal digital assistant. You will

record the concept or phrase when and where you can, just

so it doesn’t get away, because that is what writers do.

WHY WE WRITE

For years I have periodically conducted writing workshops

for clinicians. Conducting writing workshops, of course, guar-

antees an audience that is self-selected to be more interested

in writing than those in competing workshops on how to per-

form a better hemorrhoidectomy or how to manage one’s

ofﬁce practice. Generally, most of the participants are previ-

ously published medical authors, at least to some degree. Each

of these workshops begins with the same question: Why do

we write? The answers, while diverse, tend to be the same

in each workshop, and are listed in Table 1.1. I am going to

discuss a few of these.

First, let’s discuss and dismiss the ﬁnal entry on

the list—earn income. Medical writing is not lucrative.

WHY WE WRITE 3

T ABLE 1.1. Reasons why we write

Gain intellectual stimulation

Share ideas

Report research

Express an opinion

Generate discussion

Advance one’s discipline

Assert “ownership” of a topic

Attain promotion/tenure

Report a case

Enhance one’s personal reputation

Achieve some small measure of immortality by publishing our ideas

Earn income

Advertiser-supported publications (more about them later)

often pay a few hundred dollars for an article. Book royalties

are generally meager; after all, the audience of clinicians who

might buy your book is small. Book chapters, editorial, and

research reports pay nothing and are written for other reasons.

If your goal is wealth, you should add more clinical hours to

your schedule or buy stocks that go up—anything but medical

writing.

What about the other reasons? For those in academic medi-

cine, promotion and tenure are very important, and publica-

tions are the key to success. As medical schools become

increasingly dependent on clinicians seeing patients for eco-

nomic survival, it would seem that this clinical effort would be

rewarded with the carrots of career achievement—promotion

to the next rank and, where applicable, tenured faculty posi-

tions. In 1988, a study at Johns Hopkins Medical School

reported, “Those who were promoted had had about twice as

many articles published in peer-reviewed journals as those

who were not promoted.” 2 I have not seen a recent similar

study, but my academic colleagues do not tell me that anything

has changed, and an academic faculty member who bets his

or her career on advancement without publications is taking

a dangerous path. Yet some seem to be doing so.

I tell young faculty that, as a broad generalization, it takes

at least two publications a year to be considered as “satisfac-

tory” in scholarly activity when it comes time for promotion.

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