The top 5 medical writing mistakes

In my role of reviewing the work of multiple medical writers on a daily basis, I see the complete variety of what’s possible in medical writing. Here are 5 mistakes in medical writing to avoid. I could probably include more than 5, but these are the most common.


  1. Being nebulous.

As medical writers we don’t have to be an expert in a medical subject–medical writers can and do write about many different medical topics. In fact, I worry more about the medical writer who feels that they “know” an area and therefore rests on the laurels of their prior knowledge than the medical writer who is motivated to understand a new topic carefully.


Medical writers must maintain the highest level of accuracy in their writing. A copy editor can fix writing errors, but as medical writers, we are the ones responsible for getting our heads around the science and conveying the meaning accurately. The expert whose name is on the piece may have final responsibility for the information, but what we give to them to review should be, to the best of our knowledge, completely accurate. It’s our job.


Maintaining the highest level of accuracy has to do with the way we analyze the meaning of our writing as we go. We need to question the accuracy of everything we write, and we need to be careful not to leave the reader with the wrong impression.


Take this sentence for example: “Sarcoma is an extremely rare form of cancer.” First off, it’s just as easy to write “sarcoma afflicts only 20,000 people worldwide each year”. This tells us exactly how rare sarcoma is in about the same number of words. The first sentence also implies that sarcoma is a (single) form of cancer, when in fact it’s a set of diseases originating from many different cell types, including bone, cartilage, fat and muscle. It’s not exactly wrong to call sarcoma “a form of cancer”, but it’s not the most illuminating way to describe it either. It would be better to write “sarcoma, a cancer that develops from various cell types of mesenchymal origin, afflicts about 20,000 people per year worldwide.” This sentence is a bit longer but is more informative (although it may now be suitable only for a clinician audience).


This level of thinking about the best way to write something is necessary for every sentence that we write. Medical writing, when done right, is cognitively depleting. A day of medical writing will render most of us incapable of deciding what to eat for dinner, for example.


  1. Not considering your readers’ needs

Another pitfall to avoid is not directing a piece to the intended audience or writing at an inappropriate level. Most of us get used to writing in a certain style, whether it is for a clinical or consumer audience. When writing outside of our typical style, it takes a lot of cognitive energy to consider whether we have hit the right mark for each and every sentence. We must be prepared to expend this energy if necessary.


Of course, none of us reading this wants to think that they don’t fully consider their readers’ needs, but based on the various writing styles I read every day, it happens. A lot. Every writer should be able to answer the question “who is the audience for this piece I am writing?” Keeping the audience in mind throughout the writing process is essential.


Sometimes a piece of writing can be too dense, even for a clinician audience. A writer may have rewritten the abstract, but it still reads, in style, a lot like the abstract. In that case, the clinician would be better off reading the abstract. It’s also our job to make writing palatable, even when describing a complicated topic to a clinician.


How to avoid this pitfall? Pay close attention to any client feedback you get. Do you routinely hear the same comments about your writing, for example “this writing is too dense,” or “please define”? Adjust accordingly.


Another thing that clinicians (actual clinicians not writers) tend to do when they write is to use words that they would never say. For example, “armamentarium”, “heretofore” and “notwithstanding”. This is probably because they see their colleagues do it. I would stay away from any word that clamors for attention the way that these words do. They don’t add to the clarity; if anything, they detract from the message.


It’s all about getting your message across in a way your reader will appreciate.


  1. Failure to macroorganize

The type of piece we are writing will affect the order of the information presented. Manuscripts, for example, typically start with background information and rationale in the introduction section, and then the methods, results, and discussion. You are “saving the best for last.”


By contrast, a medical news piece should start with the most important information (the main result) then present progressively less important information.


A feature article should start with a longer lead paragraph designed to draw the reader in and should progress from one topic to another, carrying the reader along in a logical order and dropping them off elegantly at the end.


Some writers reject the idea of using an outline, but I think for longer pieces, they are extremely useful, if not essential, and can only make a writer’s job easier.


When writing a feature article, I first conduct all the interviews with my sources and then go through and read all the transcripts, assigning a number for each new topic that is addressed. When writing the outline I decide in which order I will present the numbered topics. It then becomes a relatively simple task to refer to the numbers within each transcript to pull out relevant quotes and information.


A 2500-word feature article will typically need about 6-8 interviews, and possibly will address about 5-6 aspects of a larger topic. As far as ordering the topics, I try to place the most riveting aspects of a topic near the top of a piece, then, I try to put related topics one after the other. It can be jarring for the reader to jump around among unrelated topics.


The first sentence of each paragraph is extremely important in helping to navigate the reader through your piece. Ideally, this sentence should refer back to the previous paragraph’s topic and also introduce the new topic. For example, if you move from describing the epidemiology of disease x to discussing its cause, you might say “despite its high prevalence, the etiology of disease x is largely unknown.” And then go on to discuss what little is known about the cause of disease x.


Again, there’s a lot of cognitive work that goes on with all these endless decisions we make in the best interests of our reader. If it doesn’t feel that way, we are not doing it right!


  1. Failure to microorganize

As careful as we must be to organize the paragraphs within a piece, we must also pay close attention to word placement within each sentence. Basic rules and mechanics of writing can be read about elsewhere, but failure to adhere to these is a common pitfall in medical writing just like any other form of writing.


There’s a principle in organic chemistry where each atom within a molecule occupies a certain amount of space and therefore causes “steric effects”, influencing the angles between the atoms and, collectively, the structure of the entire molecule. I always think of this principle when I see the same words repeated too close to each other. Steric effect violation! Must be eliminated.


Modifying words and phrases should be carefully placed near the words they are intended to modify.


Again, lots of thought must go into constructing each and every sentence.


  1. Errors

In a piece about common pitfalls in medical writing and how to avoid them, it’s a bit inane to say that “errors” should be avoided. It’s a bit like saying you shouldn’t speed in a school zone, but many of us have received a ticket for that.


One thing I quickly learned to do as a novice medical writer was to look at my screen each and every time after I type in a number. If it’s a table of numbers, then it warrants a separate double check against the original after completion. I cannot imagine skipping this step, because more often than I’d like, I do see a number that needs to be changed. If you haven’t tried this, please do.


Spelling errors in medical words are common but can be mostly eliminated with the installation of Stedman’s medical spellchecker for PC or Spellex for Mac. I can always tell when a writer doesn’t have this program installed on their computer. It’s not enough to simply add medical words to the default Word dictionary. You can detect when that has been done by the same medical word being spelled wrong throughout. Hey at least it’s consistent.


Mathematical units should be double checked, especially not confusing micrograms with milligrams.


Last names and affiliations and degrees must also be scrutinized. Cut and paste these from a reliable source rather than typing them in.


As medical writers, we have to adhere to a high standard. It’s part of our job. In fact, it’s part of AMWAs code of ethics (principle number 3) “Medical communicators should write, edit, or participate in the development of information that meets the highest professional standards, whether or not such materials come under the purview of any regulatory agency. They should attempt to prevent the perpetuation of incorrect information.”


If it were easy, everyone would be doing it. Please do excuse any flaws in this rather hastily written blog post though!