Category Archives: Medical Writing

Blogs about my medical writing work and medical writing in general

My freelance medical writing and editing work in 2017

A combination of work and domestic pressures has meant that it’s been several years since I last able to sit down in a timely fashion to write a review of my working year. I find that it is a useful thing to do, though: it helps me to take stock of what went well, what could have been done better, and what I might choose to concentrate on (or avoid doing) in the future. For anyone interested in freelancing in medcomms, it also provides a snapshot of a freelancer’s lot, and I hope that it will be useful in that respect.

At the beginning of 2017, I was in the position of having quite substantially expanded my business – in terms of the number of clients that I was working with, the types of work I was taking on, and the size and scope of the projects that I was working on – over the previous 2 years. Realistically, without changing the nature of my business (ie by subcontracting or taking on staff) that expansion could not continue, and 2017 has been a year of consolidation.

For many years now, medical writing has been the cornerstone of my business, with editing and proof reading making up an increasingly smaller part of my workload. I have always enjoyed these area of work, however, and I was delighted to be asked to proof read the annual report and updated resource materials for an international not-for-profit organisation that I have been working with now for 3 years. I also edited a good number of slides – primarily for symposia – during the year. Almost always, these projects also included fact checking the slides against cited references or finding references to back up claims made in the slides. This can be very challenging when the slide concerns the finer points of clinical practice that owe much to the expertise and experience of the faculty member, but which perhaps have never been completely captured in a peer-reviewed publication.

As in previous years, an important aspect of my medical writing work in 2017 was the creation of training materials for members of the pharma sales force. This work is interesting to do because it usually involves assembling multiple modules covering basic information about the disease in question, how it is diagnosed and treated, a competitor analysis and information about the new drug/class of drugs, including a review of the available clinical data. In the past, I have done a number of projects with different medcomms agencies in type 2 diabetes, multiple myeloma, and leukaemia; in 2017, I added chronic kidney disease and mucopolysaccharidosis Type I to this list.

One of my favourite medical writing activities is attending and writing up advisory board meetings, and I had several opportunities to do this in 2017. Each was different in terms of the therapy area (breast cancer, allergy and diabetes), the make-up of the board (one or more of consultants, academics, specialist nurses and pharmacists), and their purpose (two being reviews of the therapy landscape and one a discussion about the positioning of a new drug). While two of the meeting reports were simply for the attention of the board members and sponsors, one resulted in a paper which is currently making its way through peer review.

In a similar vein, I was asked to write summary reports of two symposia, one in haematology and one in psoriasis/psoriatic arthritis. Apart from the obvious difference, these were notable for the fact that in one case I received a very poor audio recording and a correspondingly poor transcript, and in the other case I received very high-quality video recordings of the meeting, along with the slides, which was almost as good as actually being there. Recording meetings is often fraught with difficulty, and bitter experience has taught me to make my own audio recording (with the permission of the participants, of course), also to accept a copy of the agency’s/sponsor’s recording (if there is one), and always to take handwritten notes just in case the belt and braces fail. Copies of the slides (or photographs) also help to ensure that the report is as accurate as possible.

My writing work in 2017 also included a few papers: in addition to the review paper based on an advisory board mentioned above, I was commissioned by a start-up medical device company to work with its lead investigators to publish data from trials of its new fertility device and towards the end of the year I worked up an outline for a paper on developments in aesthetic medicine that is currently back with the authors.

The medical device company was one of three brand new clients for me in 2017. That company and one other (a PR agency) found me through my website (www.freelancemedicalwriting.co.uk), while I found the other client through the MedComms Workbook (http://www.medcommsworkbook.com/) – a freelancer listing service that I thoroughly recommend to freelancers in medcomms. It was also good to work for existing contacts who have moved to new agencies. During the summer, I took a 3-month in-house contract with a medcomms agency in West London. Unhappily, that period coincided with the refurbishment of Waterloo station, which made my commute more difficult than I had expected. Clearly, I didn’t do enough background research there. Generally, I enjoy in-house contracts as opportunities to get out of my home office and interact with real, present, people. They also serve as reminders of the pressures that writers and account managers are under when they place work with freelancers.

So that was 2017, what of 2018? Well, as far as work is concerned, I am off to a busy start. I am looking forward to two days at the European ISMPP meeting (http://www.ismpp.org/european-meeting) later this month and to a Medcomms Workbook networking meeting in March. Having missed both meetings last year, I’d also like to get to at least one of the EMWA meetings this year (https://www.emwa.org/conferences/future-conferences/). I am keen to understand how/if Brexit is going to affect medcomms – one of the topics for the ISMPP meeting – and I hope that this might become clearer during the year. I am trying very hard to keep open-minded about this, and I think that it is important to get out and listen and talk to people from agencies and pharma and device companies about their views and expectations. A particular regret about 2017 for me is that, having suggested them in the first place, I didn’t organise many local meetings for Kent freelancers last year. Hopefully, life in general will be a bit more settled this year and more of these events will happen.

To find out more about me and my medical writing work, please visit my website at www.freelancemedicalwriting.co.uk . You can also follow me on Twitter (@jytricker).

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Book review

You can read my review of the third edition of Liz Wager’s book Getting Research Published. An A to Z of Publication Strategy here.

The review was originally published in Volume 25, issue 2 of EMWA’s Medical Writing journal in June 2016.

To find out more about me and my medical writing work, please visit my website at http://www.freelancemedicalwriting.co.uk . You can also follow me on Twitter (@jytricker).

 

 

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My freelance medical writing and editing work in 2013

When I first went freelance, there were two things that used to cause me great anxiety – not having an IT department to turn to if something went wrong with my pc, printer, broadband connection, etc, and not having enough work.

As I became more established and started to build a client list, I occasionally had the opposite problem – too much work (or rather not enough time to do all the jobs that I had been offered). And if not having enough work was worrying, turning down work for the first time went to another level of scariness!

In the 11 years that I’ve been working as a freelancer, I have learned that the next job will come along, and that it is better to turn work down than to take on a job that I can’t finish to the standard expected by the client (and myself) and in the time required. Feast and famine go with the freelance territory.

Last year was one of those years: feast from January to August followed by famine through the autumn – partly because two contracts were severely pared back, and partly (sadly) because one of my clients went bust. Happily, not only was the failed company bought by a former competitor, but my work also picked up again towards Christmas!

Here are my highlights.

Medical writing

My biggest area of work in 2013 was on training materials. These included modules on new drug classes, procedures or therapy areas for pharma company internal use or for company reps to use with healthcare professionals in the field, as well as a really interesting project that allowed regional sales teams to share their most successful promotional campaigns with similar teams in other countries. While most of the training materials that I wrote were interactive elearning courses, others will only appear in hard copy and one was in the form of a video.

I did a lot of PowerPoint work in 2013. Interestingly, these decks were split between those designed to support drugs at the point of launch, and those that supported products off- or coming off patent. I was also happy to do more work in an area that was new to me in 2012 – payer brochures. Not all of the intended audience for these will have a pharma/medical background, and so it is important to strike a balance with the tone and language used, in order to provide accessible information without patronising the reader.

I have a long-term relationship with a dermatology team in Germany via one of the agencies that I work with, and just at the end of 2013 two reviews that we have been working on for about 18 months – one narrative and one systematic – were submitted. Sadly one was rejected very quickly, but I believe that the other one is progressing to publication.  I also helped a couple of teams to turn the results of surveys of adherence to medication for diabetes and of attitudes to fungal nail disease into manuscripts during the year.

My biggest therapy areas in 2013 were diabetes, eczema and B-cell lymphomas. Diabetes and eczema are areas that I have written about for many years, but B-cell lymphomas were fairly new to me. I also wrote about schizophrenia and multiple sclerosis for the first time.

Editing and proofreading

I continue to proofread the London School of Hygiene and Tropical Medicine’s Community Eye Health Journal, which comes out quarterly. I was also acting editor for three issues of a business-to-business journal for the customers of a medical device company. The latter involved working in-house with the design team at the end of each publication cycle, which was very enjoyable. My slew of PowerPoint work extended to editing and proofreading slides – and I found myself wondering (not for the first time) why you can’t track changes in PowerPoint.

Miscellaneous

This is a new section for this year – inserted because there were two areas of work that accounted for quite a lot of my time in 2013, but which don’t really fall into the medical writing and editing categories.

A few years ago, I was very fortunate to receive formal Zinc training (see http://www.zinc-ahead.com/ for information about Zinc) while I was doing a long-term contract for one of my clients, and I subsequently added it to my freelance offering. This year saw a major spike in Zinc activity, though, and I logged hundreds of hours marking up references for Zinc and creating linked reference packs within Zinc for two existing clients and three new clients.

Two clients asked me to track the posters and plenaries that their clients’ competitors were presenting at international meetings. A lot of the work in this type of project is in deciding how best to display the information gathered.

Away from the keyboard

I was very pleased to be asked by Peter Llewellyn (of MedComms Networking) and Ryan Woodrow (Aspire Scientific) to take part in a series of workshops aimed at current and aspiring freelancers. These were incredibly informative and useful for making new contacts and sharing hints and tips, and I’m looking forward to the follow-up session this year.

I attended the International Society of Medical Publications Professionals (ISMPP)  European meeting in London in January 2012. I was only able to attend for one day, but, as always, it was time well spent for getting up to speed on issues affecting the medcomms industry and meeting new and existing contacts. One of things that I particularly like about ISMPP meetings is that they are well attended by pharma companies, and it is interesting to hear the industry viewpoint.

The European Medical Writers Association (EMWA) held its 2012 annual meeting in Manchester. I spent a very useful two days attending a symposium on writing for payers, various workshops and the freelance business forum. I also had a meeting with the editors of the ‘Out On Our Own’ section of EMWA’s journal (Medical Writing) to discuss a series of three articles that they had asked me to write on how I use social media in my business. The first two are already published (see http://wp.me/p15PpZ-2G and http://wp.me/p15PpZ-2S) and the third will be available soon.

The annual publication planning meeting in London in the autumn as always included a review of changes to the various codes that govern our business, including, of course the US Sunshine Act which had only recently been enacted then. We also had some lively presentations and discussions on changes to the academic publishing model. It was good to see more freelancers attending this (free) meeting – and other meetings organised by Medcomms Networking during the year.

Looking forward

Some of my new clients from last year have already re-commissioned me for this year, which is very heartening, and I have been talking to some potential new clients – some via the Freelance Workbook service and others who’ve found me via my website – about potential new projects. I’ve also been very pleased to do more work with some of my long-established clients.

A very exciting development for me this year is that I have agreed to mentor a student who is interested in making a career in medical writing when she graduates. That will start in the spring and in addition to providing advice on writing style and practice, we will be looking into employment opportunities for new first degree graduates – if you have any thoughts, do get in touch.

5th March, 2014

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SoMe and Me: Self-Promotion and Business Development

The second of my three articles describing how I use social media in my freelance business was published in the December 2013 issue of Medical Writing (©Maney Publishing; http://www.maneypublishing.com) – the quarterly journal of the European Medical Writers Association (EMWA). You can read it here:

Self promotion and business development

I was asked to write the articles by the joint editors of the ‘Out On Our Own’ section of the journal, which is aimed at freelancers, to encourage more freelance medical writers to participate in EMWA’s LinkedIn group and on Facebook and Twitter. These articles are not intended as ‘how to’ guides – I am no expert – I just describe my level of engagement with social media.

The final article in the series will be published in Medical Writing in Spring 2014, and I will post that on Trickerish Allsorts in due course.
To find out more about me and my medical writing work, please visit my website at http://www.freelancemedicalwriting.co.uk . You can also follow me on Twitter (@jytricker).

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SoMe and Me

Earlier this year, the editors of the freelancers’ pages in EMWA‘s journal, Medical Writing, asked me to write a series of articles about how I use social media in my business. These articles are not intended as ‘how to’ guides – I am no expert – but hopefully will help to convince a few more freelance medical writers that using social media doesn’t have to be scary.

The first article was published in the September 2013 issue of Medical Writing (©Maney Publishing; www.maneypublishing.com), and you can read it here.

SoMe and Me_Networking

The second article will be published in December 2013, and I will post that on Trickerish Allsorts in due course.

To find out more about me and my medical writing work, please visit my website at www.freelancemedicalwriting.co.uk . You can also follow me on Twitter (@jytricker)

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My freelance medical writing and editing work in 2012

2012 was a good year! I signed with more new clients than in any year since I went freelance. These included individuals, small medcomms agencies, large multinational agencies, a publisher and, for the first time, an advertising agency. I also continued to work with existing clients – some that I have worked with for a number of years. This also brought a huge variety of work, which I always appreciate.

In contrast to 2011, most of the work that I did in 2012 was on a freelance basis, interspersed with three short contracts. My contacts with new clients were made through a variety of channels: recruitment agencies, LinkedIn, EMWA, my website and a new initiative, the Freelance Workbook. Most of these were in the UK, but I worked with new clients in France and Germany too.

Medical writing

By comparison with previous years, very little of the writing that I did in 2012 was on primary research papers.  Instead, from a writing viewpoint, 2012 was about PR and training. I wrote a number of articles (on biologics and HIV care) for business-to-business magazines, which felt a bit like coming home for me, and which I was particularly pleased to do. Among the training programmes I was involved with were three interactive courses for iPad and/or the web for healthcare professionals , two slide-based courses, and two more traditional booklets aimed at sales and marketing teams. HCPs were also the target for some web copy, a couple of drug monographs and a short series of adverts.

A new target audience for me in 2012 was payers. Demonstrating cost-effectiveness is an important part of bringing drugs to market and the challenge for me was to provide an engaging summary of the therapy area and technology concerned for readers who may not have a medical background, before going on to summarise the health economics data in a fairly short brochure. It’s been challenging, but it’s been absolutely fascinating too.

In terms of therapy areas, 2012 was primarily about diabetes (types 1 and 2), cardiovascular disease, eczema and rheumatoid arthritis. I wrote about Alzheimer’s disease for the first time, did a little bit more work on rare diseases – this time patient leaflets for the parents of babies with rare skin diseases – and revisited vaccines for the first time in a while.

Editing and proofreading

I did more editing and proofreading work in 2012 than I’ve done in recent years. As usual I’ve had a steady throughput of papers requiring editing for English – either from doctors that I work with directly or via med comms agencies – but I did a lot of slide deck edits too. Most excitingly, I have been taken on as a freelance copy editor for a quarterly magazine sponsored by one of the big medical device companies and as a freelance proofreader for a quarterly ophthalmology newsletter produced by the London School of Tropical Hygiene for HCPs and patients in emerging markets. In terms of editing and proofreading, medical devices in their various guises provided quite a lot of my work in 2012.

Away from the keyboard

As in other years, I made sure to get out of my office and attend a few workshops and conferences. This helps to ensure that I keep abreast of changes in the pharma and medcomms industries, and enables me to find out about other things that are going on in the world that might prove useful  in my work. This year these included conferences on changes in the way that pharma delivers continuing medical education to doctors (InPharm), the growing influence of patients in healthcare management and treatment strategies (MedComms Networking), how to use Twitter in business (Digital Surrey) and the use of mobile technology to improve policing in the community (Digital Surrey). The Publication Plan’s annual publication planning workshop proved a great opportunity to learn about how open access publishing is evolving, what it can offer our clients and its customers and to get up to speed on how the requirements of the US Sunshine Act might affect the provision of medical writing/editing assistance to American doctors.

What about 2013?

Well it has started at a frenetic pace! I have been solidly booked since the beginning of the year and each project has been very different from the last – hopefully that is a trend that will continue throughout the year.

I’ve already attended the European ISMPP meeting as well as a workshop on social media for the pharma industry. I am looking forward to the annual EMWA meeting in the Spring, and am hoping to get to other events later in the year. I’m also looking forward to being a panellist at two workshops for new and would-be freelancers that are being held in March.

On the social media front, I feel that it is time to freshen up my website – it’s been up for a little over 2 years now, so a good time, I think, to have another look at the copy and the artwork. I’m still enjoying participating with Twitter and LinkedIn and, as I say every year, I will try to write more blogs!

To find out more about me and my medical writing work, please visit my website at www.freelancemedicalwriting.co.uk .

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Health service or sickness service?

I don’t often manage to make the time to watch the daily Ted Talks, but I inevitably enjoy them when I do and they have always left me with something to think about.

In June, I watched a talk by Rebecca Onie, co-founder and CEO of an American organisation called Health Leads, which really got me thinking – so much so that I’ve been back and watched the video several times since.

Ms Onie talked about how and why Health Leads was established and the work that it does among disadvantaged citizens of the USA. This is inspiring stuff and I encourage you to watch her Ted Talk, but it was one line that really got to me. Rebecca described the frustration of physicians writing prescriptions for medications whose root cause was the conditions in which the patients were living: in essence doctors were dealing with their patients’ sickness without really focussing on their health – was this a health service or a sickness service, she wondered.

The UK Department of Health seems to have been asking itself similar questions. In 2009, it introduced the NHS Health Check – a voluntary screening programme for people aged ≥40 not being treated for cardiovascular disease, diabetes and kidney disease, which is just completing its roll-out phase. The health check uses simple screening tests (blood tests, blood pressure, BMI and patient histories) to identify extant disease or to assess risk factors for developing disease. Follow-up screening visits will occur at 5-yearly intervals.

In the fight against non-communicable diseases (NCDs) I think that this is a worthy programme – I’ve had a health check: it was over in ~15 minutes, the nurse who conducted the test was friendly and reassuring and offered me advice and encouragement when discussing the results of the tests.

It was rather a shame then, to see a review from the Nordic Cochrane Centre in Denmark published this week, which concluded that such programmes do not result in reductions in overall or disease-specific mortality and which recommended that ‘systematically offering general health checks should be resisted’. I was surprised at both the finding and the recommendation. When I had a look at the paper though, I noticed that many of the studies were initiated in the 1960s and 1970s and included subjects who had been born before 1940 – in fact in two studies the subjects had been born before 1920.

Although I’m no statistician and I’m conscious that this is a Cochrane Centre analysis, I’m not sure how helpful it is to make recommendations for today’s patients based on a population whose lifestyle will have been so very different to that of people born after 1960. And although the measurements taken at the screening visits are essentially the same, their accuracy and their meaning in the context of a much wider understanding of NCDs also must be very different. Moreover, the range and efficacy of available therapeutic interventions has changed beyond recognition, which will likely have a greater effect on morbidity and mortality rates in present-day subjects who undergo screening and are found to have disease.

One of the explanations that the Cochrane authors gave for their findings is that the people most likely to volunteer for screening are generally healthier than those who do not. They also voiced concerns that routine testing may lead to over-diagnosis and unnecessary treatment and they quote convincing (and more recent) examples of this.

If the DoH is to continue to offer health checks – and its response to a BBC article on the Cochrane findings implies that it has no plans to even consider stopping – these last two points deserve some attention. It is inconceivable that the NHS would mandate screening checks, so other ways to encourage people to attend need to be sought.

The NHS Future Forum has recommended that every healthcare professional (HCP) should: ‘… use every contact with an individual to maintain or improve their mental and physical health and wellbeing where possible, in particular targeting the four main lifestyle risk factors: diet, physical activity, alcohol and tobacco – whatever their specialty or the purpose of the contact [my emphasis].’ The Forum’s report, The NHS’s Role in the Public’s Health, gives as an example a dental surgery in Manchester which offers smoking cessation studies, BMI and blood pressure checks and even screening for STIs to its mainly young patients, who otherwise have little contact with the rest of the NHS. Also, GPs see women at regular intervals to prescribe contraception, and those consultations could, once every 5 years, be extended to include screening for NCDs.

And with regard to over-diagnosis and unnecessary treatment – well, to my mind, a disease prevention strategy should start with a presumption of no diagnosis and no necessary treatment. However, if you only start to screen at age 40, then this is perhaps a forlorn hope.

In order to prevent NCDs (ie to promote healthiness), I would suggest initiating screening in a much younger population, (perhaps even starting just as people leave school at 18) who can (probably rightly) assume that they are reasonably healthy and who should have fewer anxieties about volunteering to be tested. Over time, such a scheme would allow trends in indicators of healthiness to be monitored and changes addressed before disease sets in and the person has to begin a possibly life-long course of treatment, with all that means for his or her quality of life and for the NHS.

To find out more about me and my medical writing work, please visit my website at www.freelancemedicalwriting.co.uk .

17 October 2012

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