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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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My road to medcomms

I would say that, by comparison with most medical writers I know, I took the long way round into medical communications. By comparison with other freelance medical writers I am unusual (although by no means unique) in that I went freelance before I became a medical writer.

After graduating, rather than go on to a PhD, I went to work in the pharmaceutical industry as a process development chemist – taking on likely candidates from the initial safety and efficacy screens and finding and optimising work-arounds to the laboratory synthetic route to make it suitable for full-scale manufacturing.  Having gone on to do similar jobs with Tate & Lyle and then Zeneca Agrochemicals, I came to the realisation that I couldn’t progress my career in the lab without a PhD (which I still didn’t want to do), so I started to look around for a new career.

At about the same time, PJB Publications (whose business was later incorporated into Informa) was looking for an editor for a new competitor intelligence product (AGROProjects) for the agrochemicals industry. It seemed the perfect answer: I’d discovered an aptitude for and enjoyment of writing during my lab career and here was a job that would allow me to develop those skills without completely losing touch with my R&D roots. And I had the challenge and the fun of developing it pretty much from scratch, including making market research visits, working with the design team to come up with a ‘look’ for the product, working with the marketers to develop promotional materials, developing budgets and sales targets and, of course, gathering and validating the content. This was all experience that would prove useful later.

After 4–5 years of growing the AGROProjects portfolio of products I was offered the opportunity to take over the management of the editorial team for the business reports division of PJB. These provided insight into new products and technologies, changes in the regulatory and business environment and company profiles for the pharmaceuticals, medical devices and animal health sectors as well as agrochemicals. (I still find this ‘big picture’ stuff really interesting – and Twitter makes it really easy to stay in touch. I’d definitely encourage other medical writers to take an interest too.) The job came with opportunities to mentor new in-house writers and editors, to provide input into the content of the reports and to commission freelance writers.

At the end of 2002, a reorganisation of the business reports division eliminated the need for an editorial team. My job was made redundant and I took the decision to strike out on my own.  I had work right from the start – primarily editing and proofreading – thanks to the contacts that I’d made whilst Editorial Manager and through former colleagues from PJB who’d moved on to other organisations. Initially though, I couldn’t get work from med comms agencies – they only wanted to use people with agency experience.

I signed with some of the primarily London-based recruitment agencies that handle freelance and interim contracts, and that led to some very interesting work outside of my usual area of expertise. Then in mid-2004 I had a call from a recruiter who was looking for a freelance editor who could also work in-house for a med comms agency not far from where we lived in Berkshire.  I got the job, and MedSense is still a client now – although since our move to Kent I no longer go and work in-house, and I do as much writing as I do editing these days. Over time, working with MedSense allowed me to build up some real experience of agency life beyond writing and editing – liaising with clients and KOLs, helping to run advisory boards, preparing  materials for conferences and symposia, working up designs with the studio and preparing and pitches.

Not long after I started at MedSense I got a call from an ex-PJB colleague who was working with Medical Action Communications (now Innovex) – again they wanted a freelance editor who could work in-house when they needed extra help. I’ve estimated that in the first year that I worked with them I edited and referenced around 1000 Powerpoint slides!

In 2006, my husband took up his dream job in Kent. As a freelancer, I was able to take that pretty much in my stride. Being primarily home-based it was no struggle to combine working and managing childcare in the initial months while he was away in Kent during the week, and then just move my office and client list once we had found a new home and schools for our children.  Since we’ve been in Kent I’ve continued to alternate between short-term and long-term contracts (primarily with med comms agencies) and purely freelance work.

Finally being able to say that I had some agency experience really opened up doors into other agencies, and I’ve gradually been able to add to my client list. Once or twice I’ve become aware that my (twice made) decision not to do a PhD has meant that I’ve been passed over for a job, but overall it doesn’t seem to be an issue. (Although I can point to 7 years in commercial R&D and a couple of peer-reviewed papers to strengthen my credentials as a scientist. )

In terms of sourcing new work, recruiters are still an important source of introductions for me, but just as important are my EMWA listing (http://www.emwa.org/Freelancer-listing.html), my listing on the MedComms Networking site (http://www.medcommsnetworking.co.uk/independents.html), LinkedIn (http://uk.linkedin.com/in/jytricker) and my own website (www.freelancemedicalwriting.co.uk). Just occasionally I think about a permanent position, but not usually too hard and not usually for too long. Freelancing has its downsides of course, but overall I relish the variety of work it brings me and the opportunities to ring the changes in how and where I work.

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

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My freelance medical writing and editing work in 2011

Another year, another retrospective. I said at the start of last year’s retrospective that I tend to have a lot of variety in my work, and, as if to prove a point, 2011 was completely different from 2010!

The year started at a frantic pace. In the space of 9 weeks I did some consultancy work for an established client preparing for a big pitch, some more regulatory writing (patient narratives), assembled a core slide deck on photodynamic therapy, complete a position paper on the treatment of non-melanoma skin cancer with authors drawn from an advisory board, proofread an issue of Human Genomics, and edited an issue of a cardiovascular journal, a manuscript for my Italian clients, some web copy and a drug monograph (for a new client).

The major difference between 2011 and 2010 was that I spent 8 months working under contract for a local agency here in Kent. I was covering for an editorial team leader while she was on maternity leave – giving me the opportunity to manage a team for the first time since I went freelance. This was my first experience of working in a big agency with a formal structure, which was very different from the very small agencies that I usually work with.  It also provided an opportunity to help mentor some junior writers just starting on their careers, their enthusiasm was invigorating. The team had a wide portfolio of clients and products to support, providing a range of materials for publication and presentation in different media. There was some travel to attend advisory boards, conferences and client meetings and even some filming with a key opinion leader talking about a clinical trial he’d taken part in.  I wrote copy for three websites (two on acute lymphoblastic lymphoma [ALL] and one on haemophilia) and I also wrote a few apps – my first foray into that medium.  It was a very busy 8 months, and I had a great time and made lots of new friends and contacts.

Since finishing the contract I’ve been just as busy with an equally broad range of writing and editing work in urology, neurology, haematology and gastrointestinal cancers, adding two more clients to my roster in the process. This work will take me through to February, and after that – well I’m looking forward to finding out!

Social media

I’ve been very pleased with the performance of my website – www.freelancemedicalwriting.co.uk – it has generated a number of leads – from pharmaceutical companies to publishing companies to academics, mainly in the UK but also from across Europe. I’ve been particularly pleased with how it is performing for search engines, but a target for 2012 will be to find ways to improve its page ranking.

I have links in to and out of www.freelancemedicalwriting.co.uk to my Twitter account (@jytricker), to my LinkedIn profile (http://uk.linkedin.com/in/jytricker) and to my blog site, Trickerish Allsorts (https://trickerishallsorts.wordpress.com). I’ve significantly expanded my contacts/followers on LinkedIn and Twitter this year, but have not published as many blogs as I’d wanted to – although the reason for that was my workload, so I don’t feel too bad. More frequent blogging is another target for 2012, then.

Old-fashioned networking

I do enjoy getting together with fellow medcomms professionals and I went to a number of excellent events in 2010. These included several organised by Network Pharma (www.networkpharma.com) – a training session on the revised ABPI guidelines (since revised again!), a symposium on open access publishing and an evening with Guardian columnist  Ben Goldacre MD (see my Access all areas blog: http://wp.me/p15PpZ-1t and www.badscience.net) at which we discussed transparency in biomedical publishing. I went to my first European Medical Writers Association (EMWA) meeting in November and enjoyed getting together with fellow freelance writers from across Europe as well as catching up with some friends and acquaintances from the UK industry and undertaking some training in regulatory writing. December saw me at the European meeting of the International Society for Medical Publication Planning (ISMPP) – another great opportunity for training, catching up with old friends and meeting new contacts. One of the things I most like about ISMPP meetings is the high attendance from the pharmaceutical industry and publishers – it was good to talk to them directly.

CMPP

On the subject of ISMPP, a personal highlight for me was gaining that organisation’s accreditation as a certified medical publications professional – meeting an important standard for ethical publishing in the biomedical sector and achieving one of my goals for 2011 in the process.

2012

It’s going to be an extraordinary year in many ways – particularly here in SouthEast England – but in terms of work I will be happy to have more of the same in 2012. I am due to be attending the European Association of Urology meeting in Paris at the end of February – and I’m very much looking forward to that. Thereafter the year is a blank page. Fingers crossed for another good year though.

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Access all areas

I’ve been to two meetings recently on the general theme of access in biomedical publishing. One was an in-house meeting to share some thoughts and learning points on open access (OA) publishing and the other a Medcomms Networking meeting to hear Guardian columnist Ben Goldacre’s views on how clinical trials results are published. That meeting has prompted a discussion thread on The Publication Plan’s LinkedIn page that has been running ever since and which seems to have pulled those two ideas together.

Open access publishing, particularly in the biomedical sector, is undergoing steady growth.1 Beyond the laudable concept of allowing everyone (including patients) to read and study the research, the ‘online only’ nature of OA publishing has other benefits, not least the facility to publish (sometimes extensive) data tables for which there would never be room in a print journal and the potential for more rapid publication. The editorial boards of OA journals also seem to be more open in their approach to content, needing primarily to satisfy themselves that studies are scientifically robust rather than making an additional judgement call on whether the work would be of interest to their subscribers.

The expansion in OA publishing has pretty much coincided with increasing requirements for the pharmaceutical industry to be more open and transparent about its funding and reporting of clinical trials including its relationships with trial investigators who author papers and the medical communications and medical education agencies who provide medical writing and other support for the preparation of manuscripts in which trial results are reported. This followed the disclosure in a number of class actions involving patients who had suffered drug-related adverse events that data about the drug’s safety and efficacy had not been fully reported in papers that had not been written by the study investigators but by un-named and unacknowledged medical writers (ghost writers) working for med comms agencies and paid for by pharma companies.

These requirements, which largely have been driven by the International Committee of Medical Journal Editors (ICMJE) in its Uniform Requirements for Manuscripts Submitted to Biomedical Journals, and the International Society for Medical Publication Professionals (ISMPP) – authors of Good Publication Practice, aim to make it possible for editorial staff, reviewers and readers to know when trials have been funded by pharmaceutical companies and to scrutinise the reporting of trial results against the study protocol to make it easier to see if data are being withheld or misused. They also require the involvement of medical writers to be disclosed along with the source of funding for this involvement. Authors must declare how much involvement they have had in preparing the manuscript, any financial arrangements with pharmaceutical companies, and their willingness to take responsibility for the content of the paper.

Dr Goldacre, whose passion is evidence-based medicine, charges that, even now, too many clinical trial reports distort the evidence-base for drug safety and efficacy and that medical communications companies and the medical writers that work for them are complicit in this distortion. See his website for some specific examples. You might imagine that this was not easy for a group of medical writers to hear – perhaps particularly so because Dr Goldacre is not a typical pharma industry ‘basher’. He readily acknowledges the role of drugs in healthcare (‘no medicine without medicines’) but wants doctors and healthcare funders to have access to all the trial data.  He singled out the dearth of reports of negative findings (ie where the test drug fails to demonstrate superiority over other drugs or placebo) as a particular source of bias. I think that this point was generally accepted by people at the meeting – certainly from the point of view of transparency. Where opinions diverged was on whether it could be achieved.

Going forward, pharmaceutical companies will be posting all raw clinical trials data on the clinical trials.gov and EudraCT websites. But in terms of providing useful information to physicians, if this is the only way that negative data get published, is that either sufficient or appropriate?

The usual answer to the question ‘Why don’t negative results get published?’ is that journals won’t accept papers that don’t advance the understanding of medicine. But I don’t know how many people are trying to ‘push the envelope’ and convince journals that understanding might be advanced by publishing negative results in some circumstances. A published study report would allow some context to be added to the results and some reasoned speculation about why the study hypothesis wasn’t proved, which might open up avenues to further research (I, of course, as a medical writer, should declare a vested interest at this point).

Going back to where we came in, in OA journals we have a broader forum for publication. If even a negative study meets the requirement for robustness, there is perhaps a greater chance of it being accepted. Moreover, where allowed by the journal, readers may have the opportunity to comment on and ‘discuss’ the paper online, and in real time, adding to the scientific interest in the paper. In theory at least though, OA journals should not be the only option open to teams wishing to publish negative results. The ICMJE’s position statement on publishing negative studies says that: ‘Editors should seriously consider for publication any carefully done study of an important question, relevant to their readers, whether the results for the primary or any additional outcome are statistically significant. Failure to submit or publish findings because of lack of statistical significance is an important cause of publication bias’.2

At the current time, the pharmaceutical industry has much to do regain the confidence of the people who use its products. Granting access to data for all studies, in tandem with complete disclosure of the nature of its relationships with the study investigators and the people who write up the study, may go some way to achieving this aim.

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

References

1. Laakso M et al. PLoS One 2011;6:e20961.

2. www.icmje.org.publishing_1negative.html

Useful websites

International Society of Medical Publication Professionals www.ismpp.org

International Committee of Medical Journal Editors www.icmje.org

European Medical Writers Association www.emwa.org

MedComms Networking www.medcommsnetworking.co.uk (for links to the LinkedIn page of The Publications Plan)

Ben Goldacre www.badscience.net

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