Writing is a big part of medicine, and writing should be the goal of those training for medicine. Now, forgetting for a moment the bitter incongruity of someone like myself writing about good writing, it is worth stressing how important written communication skills are in medicine.
Many aspiring medical students think about the massive amounts of scientific and medical knowledge which needs to be assimilated and then the joys of building rapport and patient interaction. So clearly, scientific knowledge and the skills of verbal (face to face) interaction are important, but I think a lot of people don’t think about the importance of good writing in medicine. Decades of medical shows have shown doctors being incredibly brilliant diagnosticians (Gregory House) and scientists (Dr. Who is a doctor, right?), and certainly the importance of the social interaction aspects of medicine (basically everyone except Gregory House). However, very rarely are medical professionals shown sitting in front of a computer reading and generating prose. Just as legal dramas present attorneys interviewing witnesses or arguing cases instead of writing briefs, modern medicine is like the law, very much about text, which is often unglamorous.
Let’s ignore the importance of scientific writing in this overall discussion, but it is worth mentioning that much of medicine involves scientific research, and a big part of that research is driven by written grant proposals and scientific publications which share the results of that research work with others That’s the whole point of the research, once something is learned the results need to be shared, otherwise, people will keep repeating the same things over and over again. It is important to be able to write at least reasonably well if you want to succeed in science, but science and research are only a smart part of medicine.
There has been a huge amount written about the diminishing amount of patient contact by physicians, but an importantly neglected part of that discussion is just how much time is spent doing things like reviewing text and lab results, looking at imaging, and generating more text. In a relatively informal study done by some hopsitalists I know, they found that internal medicine residents were spending 6-8 hours a day actively working with the EMR system at the hospital. A lot of that time is spent reading material, and some of that time is spent entering information into controlled frameworks (such as clicking on various options for physician orders), but a huge amount of that time is just spent writing text. Writing patient reports and creating new records for patients.
The idea of medical records dates from the time of Hippocrates (likely more than one person). He had the novel idea that physicians should know how to read and write, ideally so that they could record disease progression and keep records of what worked and what didn’t to help their colleagues and those who came after. Nowadays, medical records are often more about billing and legal protection than improving outcomes. However, in addition to their use in data mining for improving outcomes, it is possible that the medical records themselves can help improve patient outcomes.
Now, there may be some problems with this. Medical records are sometimes used to record physician’s impressions of when patients are not being honest (Gregory House referenced once again), which can be valuable in other healthcare interactions. There are shades of impression there about patient behavior or adherence. However, there are also many opportunities for false information to be propagated in the medical record, and having patients be able to verify the information can be invaluable.
So not only is important to write well so that other physicians can understand what has happened with your patients, it may be important to write well so that patients themselves can understand and take better care of themselves.
How do you get better at writing? By reading good writing. By writing a lot. Having people read it and comment, and re-writing. Ben Franklin, one of the great writers of early American practiced his writing by reading famous pieces and then trying to write them again from memory as best as he could. At first he couldn’t express the ideas nearly as well as the famous writers he was emulating, but as time went forward, he began to feel that sometimes he could write things a little more effectively each time and certainly was able to find his own voice.
It does help to learn some of the rules of grammar and writing style, so that if you choose to find your own way of writing you know which rules you are breaking. Everyone has a different style of writing and has different strengths and weaknesses. For example, I have learned that I pretty much write a phonetic representation of what I say to myself in my head. That means I often have trouble with using the incorrect homophone of the word I am intending, as I chug along writing quickly. Also, my natural tendency is to write incredibly long, run-on sentences with multiple dependent clauses, so I have had to practice writing shorter, pithier, statements as I know these have much more impact and read more effectively, but it is hard to do sometimes, particularly as my thoughts wander as I write which leads me to multiple digressions such as thinking about the etymologies of digression and clause, but I digress as I attempt to make this sentence into a poorly formed joke.
It may help to study a foreign language. Often you learn more about generalities of grammar to see how they work in different contexts. You could get a textbook on grammar or a concise book on literary style. You can take a class and get some high quality feedback on your writing.
Don’t take my word for the importance of good writing, Weird Al said is much more effectively, and with a beat: Good writing is important
