Beyond the Text: Medical Writers as the New Vanguard in Health Care Content Strategy

This article is a summary of a presentation by Alex Howson, PhD, CHCP, FACEHP at the 2024 Pacific Coast Conference.

Alex Howson, a long-time Continuing Medical Education (CME) writer, laid out a set of practices for overcoming self-doubt and maintaining strong client relationships in her talk, entitled "Beyond the Text: Medical Writers as the New Vanguard in Health Care Content Strategy.” Using CME as a case study, she argued that medical writers can often see themselves as “writers-for-hire” rather than partners in developing client strategy, and that this, in combination with factors internal to us as writers or our clients’ organizations, can drive frustration on both sides of the writer-client relationship. By embracing not only our writing experience but also our clinical and scientific expertise, we can confidently step into a more active role.

Dr. Howson began by putting her academic training on display, providing a comprehensive background of the problem in question: writers’ self-doubt about their role in the development of CME materials. The majority of AMWA members were clinicians or academics before they transitioned to medical writing, careers which involve a long process of socialization to the professional culture and can be a central part of a person’s identity. Despite this inertia, many clinicians and researchers are leaving their field, searching for a more positive work environment, more control over their work, and a better work-life balance. Many AMWA members left their clinical or academic pursuits for medical writing due to these or similar reasons. However, as we leave these stressful work environments, we are also leaving our identities as experts in our field. This, in addition to the unhealthy habits learned to survive in these environments and our trauma from our time in the academic or clinical trenches, results in a high prevalence of self-doubt or imposter syndrome among medical writers.

Exacerbating our internal doubts about our positions as medical writers, many CME organizations are suffering from significant reorganization as private equity firms buy and “streamline” medical education companies. Increased staff turnover results in a loss of institutional knowledge and makes clients less able to provide information about their goals. They may state that they are looking for a “writer for hire,” but they expect a strategic partner. This results in a mismatch in client and writer expectations, and often clients are not able to provide sufficient information but expect writers to fill in the gaps. Since writers cannot succeed in this context, clients are unhappy with the final product, and writers have their self-doubts validated. In the meeting we discussed this problem, and several people spoke up about the feelings of dread, frustration, and impotence that this situation can generate. Again, the problem of a loss of professional identity was raised, which is often compounded by the invisibility of the profession – often, medical writers do not get public credit for their work, which as former academics and medical professionals, we are trained to expect.

Given this suite of obstacles, how do we overcome self-doubt? Mark Hagerty suggested that we all raise our rates! While this was warmly received, Alex had suggestions for more holistic solutions, which she categorized under three main sections: Connection, Care, and Curiosity.

Connection with ourselves, by recognizing the emotions that can arise in stressful situations and by identifying our threat responses, can both help calm us when we feel attacked or confused in client interactions and help us communicate our strategic ideas more confidently to prevent those stressful interactions. Connection with our clients as people, recognizing that they are also likely to be understaffed, underinformed, and overburdened, can also help prevent miscommunications and promote collegial relationships with clients. Connection with our fellow medical writers in meetings, collaborations, and periodic check-ins can bolster our confidence and sense of belonging, and thus make stressful client interactions more tolerable.

Care for ourselves and our emotions needs to be an intentional practice. Dr. Howson mentioned that she uses meditation as part of her practice. Several other attendees mentioned their meditation practices, such as taking 10 minutes just before bed to light a candle and meditate with calm music to detach from the professional puzzles of the day. We also discussed how a mindset of non-attachment to outcomes or the reactions of others can help us weather difficult situations. Alex emphasized that boundary setting is an important facet of this self-care, mentioning that a recent Upwork survey found that most freelancers work 8-10 hours a day, perhaps a holdover from our previous overworked professional lives. Getting care from others, both in informal friend and family relationships and in more formal counselling or psychotherapy relationships, is also a powerful tool to maintain our mental health and professional effectiveness.

We had such a good discussion that we ran out of time, but Dr. Howson also briefly outlined her thoughts on how curiosity can help support medical writers in times of stress. Curiosity about trends in the wider medical world can help us anticipate changes in our area of focus. Curiosity about our own reactions to challenge can help us be less controlled by these reactions. Curiosity with our clients, bringing a beginner’s mind to each new project, helps us deliver the best product possible. By asking every question we think of without worrying about looking stupid or uninformed, we maximize our understanding of the client’s goals and expectations.

Dr. Howson left us with a few relevant quotes and a question:

Ranier Maria Rilke, “Live the questions now. Perhaps… you will live your way into the answer.”

Roger Martin, “Strategy is the choices you make to shape the product.”

Resmaa Menakem, “A calm settled body is a foundation for health, for healing, for helping others, and for changing the world.”

What can you do today to practice connection, care or curiosity? Write it down and refer to it periodically this week.

About the author: Aly Rogers, PhD, is a freelance scientific writer. She earned her PhD in neuroscience from UC Irvine and BS in neurobiology and behavior from UC Davis.