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Mary Ann Kirkconnell Hall:
Hospitalists face numerous demands, and those in academic medicine are also expected to write and publish their work in peer-reviewed journals, present at conferences, and give lectures and talks. We’re all familiar with the “publish or perish” cliché, but almost no one goes into hospital medicine intending primarily to be a researcher. Hospitalists are smart people, and they’ve dedicated their careers to a specialty that isn’t superficially glamorous or notably high-paying, but that virtually all of us will someday need. Hospitalists’ awareness of the needs and experiences of our sickest people in real time is unmatched by any other specialty.
Strategic use of support staff can be a catalyst for the dissemination of this knowledge. People who’ve completed medical school and residency or preparation as advanced practice practitioners (APPs) have the intellectual ability to do scholarship; the limitations are time, supplemental skills (like navigating citation databases and references), and confidence. At the Emory Division of Hospital Medicine (EDHM), we’ve found that a medical writer can complete tasks unrelated to clinical content, teach those extra skills, cheer on hospitalists’ efforts, and increase scholarly productivity.
Help wanted: medical writer
In early 2021, EDHM identified a significant strategic goal: providing scientific and grant writing support in the form of a dedicated medical writer. With more than 270 faculty physicians, non-faculty physicians, and APPs at the time—now more than 300—caring for patients at 10 hospitals, EDHM is believed to be the nation’s largest academic hospital medicine program. In the previous years, EDHM leadership observed increased interest and engagement in scholarship among our hospitalists. However, due to heavy clinical demands, it was very clear that our clinicians needed assistance and coaching in scientific writing and other forms of written scholarship.
In alignment with our division’s goals, we believed that the medical writer role was critical to move our group from excellence to eminence academically and pivotal to increasing our research and funding portfolios, attracting talent, and helping retain our academically oriented clinicians. Also, we believed a medical writer would increase our capacity to mentor trainees academically. We envisioned this role would include writing, editing, conducting literature searches, and preparing manuscripts, grant applications, promotion packages, and award nominations. We also expected that the selected candidate would mentor less experienced faculty and promote writing services within the division. We started our quest to identify the best candidate and, with excitement, we welcomed Mary Ann Kirkconnell Hall to EDHM in November 2021.
Mary Ann Kirkconnell Hall:
What does a medical writer do, exactly? My primary tasks center on traditional scholarly productivity. In academic medicine—as in all of academia, really—manuscripts are started or even drafted and then hit delays in the publication process: collating feedback from multiple authors, responding to reviewer comments, difficulties in choosing a journal or formatting papers correctly, or just falling off the radar due to competing priorities. For teams at this stage of writing, I meet with the author(s) to determine what’s holding the process up, coach them on responses (or refer them to someone else who can guide them), and then plan the next steps. As a team, we break these steps into as many easily completed, discrete tasks as we can, and make a delegation plan. I frequently serve more as a project manager than a writer/editor. Some tasks require authors’ content, but a medical writer can complete many (e.g., compiling a citation manager database and using it for references so they don’t have to be reordered with every revision).
Many hospitalists would like to do more scholarship but are uncertain how to start. We offer several institutional programs (like a Clinical Vignette Competition and our EDHM Research Day) where first-time scholars can present and get feedback from peers in a supportive but rigorous environment. In my position, I meet with hospitalists who have expressed interest in writing an abstract, either for a research or quality-improvement project, or regarding an interesting case, and guide them in getting started, refining their drafts, and navigating submissions.
I developed several templates to help our authors out, mostly based on existing resources, so no one ever has to begin writing by staring down a blank document page. For example, I used the CARE Guidelines for writing case reports (https://www.care-statement.org/) to create templates for clinical vignette writers to “fill in the blanks,” and a separate, formatted, case report Word template for submission to journals that includes typical case report sections along with writing prompts for each.
The early success of several division faculty in using these templates to publish for the first time with case reports got others excited, and I started (and continue to offer) two-hour, in-person Clinical Vignette Boot Camps where hospitalists share their cases for discussion, learn what makes an effective vignette, and draft bullets with the main points of each section. Participants leave the workshop with a robust draft for a vignette (sometimes a completed vignette), improved confidence, and often new co-writing relationships with colleagues. Many go on later to present their work at conferences (like the SHM’s annual Converge conference) and publish their work as case reports in peer-reviewed journals. I work closely with boot campers through this process, guiding them to conduct literature reviews, refine their text, and move through submission processes.
For original research and quality improvement, I play a similar supportive role. Authors and I meet for “brain download” sessions where they tell me about their project/paper/writing task. I am naturally very curious and so I ask lots of questions, and I take copious notes. After the chat, I draft bullets from the notes, organize them into a narrative to the extent possible, and format them as a manuscript. In terms of authorship, I follow the International Council of Medical Journal Editors’ criteria (https://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html) to determine whether my contributions rise to the level of authorship on a case-by-case basis.
Brain downloads are also useful for promotional materials, letters of support, nominations for awards, and other tasks that require less clinical knowledge or writing skill and more organizational narrative shaping (and the time to do it). I help our faculty format their CVs and proofread their personal statements and portfolios, and sometimes I even get to do fun things like helping people draft biosketches.
As EDHM’s scholarship footprint grows, we are exploring new internal and external funding opportunities; this is an area where a medical writer with experience in proposal writing and evaluation can really help. Grant writing is like most other writing projects in terms of timing and logistics, but I help our EDHM authors focus on organization, research design, and creating a compelling narrative that demonstrates a causal pathway from intervention to intended outcomes. I also provide an eagle eye for compliance with grant or proposal requirements.
No position in hospital medicine is exempt from a little scut work, even a medical writer’s. I assist with copyediting and proofreading, reference formatting, drafting correspondence with journal editors, and crosswalking drafts with journals’ submission requirements. While these tasks are important and necessary, they are not a good time investment for a hospitalist to spend hours on when a medical writer can do them quickly, thoroughly, and with little opportunity cost.
Given EDHM’s size and complexity, I could not do my job without support from my supervisor, Jasmah Hanna, EDHM’s associate director of research projects. Even before I was hired, EDHM’s scholarly productivity had begun to grow. While this is due in the near term to Ms. Hanna’s strategic efforts, in the longer term, it is also due to our division director Dr. Dan Hunt’s belief in investing in the professional development of the hospitalists in our division, and support from Emory University School of Medicine’s administration and leadership.
Tips for hiring a medical writer
For a medical writer, training in scientific writing is not negotiable. Understanding academic writing conventions is necessary, as is knowledge of review processes, abstracts, and manuscript structure, and the importance of framing the novelty and utility of your work to persuade readers to invest their time in it.
Medical writers often function as writing project managers, so organization and “soft” people skills are paramount. Previous experience in applying for funding, either through grants or contracts, helps—not just in compliance and technical writing skills, but also in thinking about what the funder is seeking and how to showcase the organization’s capacity to deliver. Teaching and coaching skills are essential too: you must give people the skills to do this work themselves, lest you simply serve as a glorified stenographer.
Content knowledge is useful but not imperative. Medical writers don’t have to be MDs, DOs, PhDs, PAs, or NPs, as long as they have the skills to help those who are tell their research stories. Since most publication, literature researching, and funding processes are analogous across fields related to biomedicine, consider seeking candidates outside of medicine, from fields like public health, allied health, and other biosciences.
Ms. Kirkconnell Hall is the senior medical writer at Emory University’s Division of Hospital Medicine in Atlanta.
Ms. Hanna is the associate director of research projects at Emory University’s Division of Hospital Medicine in Atlanta.
This article was originally published by The Hospitalist