Intended for healthcare professionals

Career Focus

Freelance writing

BMJ 1997; 315 doi: (Published 15 November 1997) Cite this as: BMJ 1997;315:S2-7118
  1. Lynne Low, freelance medical journalist
  1. London, SW1V 1NP

    Polished written communication is a useful skill for all doctors. Not all will want to take their journalistic careers as far as Lynne Low has, but there's a start here for those that do

    If you baulk at the thought of producing an audit report but leap at the chance of turning your sabbatical into a travel piece for the local paper, freelance writing as a career, or part of your career, may be for you. It is an attractive and increasingly popular option for doctors who enjoy writing and who wish their working lives were more creative.

    Besides self expression, there are other reasons to write. Freelancing could be a step towards a full time career in the press. It provides a chance to work from home, around other commitments. If you have a deepening political or social ideal, writing allows you to enter the debate. Many doctors write to capitalise on their expertise, to reach a wider audience, and even to influence public policy.

    Doctors who write often do it part time. The brave ones relinquish their clinical careers entirely. It can help to have a regular working pattern and regular money coming in, because pay from writing, especially initially, can be very patchy. You need to know what deadlines you can meet, which can be difficult if you are also obliged to accept locum positions at short notice. Many writers work on a sessional basis in various specialties.

    What shall I write?

    It cannot have escaped your notice that media interest in health issues has never been higher. This is good news for a doctor who wants to write. Ideas that occur to you need not simply relate to the clinical specialty you practise but to a completely different aspect of medicine that fascinates you, such as legal matters or ethics. But why confine yourself to medicine? Your passion for container gardening provides just as good material. There are doctors who never write on medical topics, preferring the distraction of sport, music, accountancy, or art. Finally, “don't write off the more mundane aspects of your life, such as buying a flat overseas, dealing with officialdom or struggling through rush-hour traffic.”1 These are all potential articles, if marketed correctly.

    Many medics write only for their peers, but others have dreams of public renown. Is it possible to be the Oliver Sacks of gastroenterology?

    Books generally don't make much money: modern day bestseller lists are dominated by books on diet, self-improvement, life after death, or the deeds and misdeeds of celeb- rities. Even books that whip up a storm of controversy do not always sell wellÑmany more people read the reviews and watch the debate on TV than actually buy the book.2 Media culture is such that human interest always wins over pure science. The press and the public also have little stomach for medical uncertainty. The path to fame and fortune seems no easier for doctors than for anyone else.

    How to get started

    The next time you pick up a piece of print, consider how it came to be written and whether you could do the same or better. Who commissioned it? Apart from newspaper and magazine articles, public relations companies and drug companies can be lucrative sources. The writing involved may be anything from straight conference reporting, to video scripting, to the production of a leaflet for pharmacies. Publishing houses may need writers to contribute chapters for compilations, like encyclopaedias, or to write “expert” books or booklets. It may be your dream to have a column in the Guardian, but local and regional papers, the traditional stepping-stone for journalists, need good writers too.

    Medical magazines and the weeklies (Pulse, GP, Doctor, etc) have tended the early careers of many writersÑif you can inform and captivate your professional peers, entertaining an audience you know less well (such as readers of consumer magazines) may be less of a challenge. If, however, even your partners in practice cannot understand what you are trying to say in an article, you are likely to have a harder time selling to the mass market.

    Selling your work requires you to predict what editors want and to know what kind of writing you are good at. Every publication has its own identity, which must not only match the idea you have come up with but the style of the piece. Study current and back issues to get a feel for what they have covered, what they do again and again, and what they have missed. Who reads this magazine? Make a few informed guesses at their lifestyleÑwhat else will they want to read about? Study the tone of the publication and ask yourself if you can write the same language.

    Timing is another aspect. Daily newspapers demand rigorous newsworthiness, and even their feature section items are strongly topical. Newspaper editors also want fresh angles on stories that have dominated the headlines for weeks or that seem to have been done a million times before. Look ahead to important anniversariesÑbirths, deaths, and yearly events.

    Weekly and monthly magazines may be less exacting, but they are still interested in current and seasonal concerns. Take things one step further and see if you can give the editor a cover story, or at least a cover line. Can your piece be summed up in five attention-grabbing words?

    How to pitch an idea

    Think of an idea and ask yourself what statement you are making. This gives you the angle. Then consider why this piece should be written, whether it is timely, and whether readers will be interested in who is involved.

    Don't forget how you are going to gather information. An article on breast cancer will be easier to research (and sell) than one on a vanishingly rare condition. An article is instantly more marketable if it includes a good measure of personal quotes from people involved in the story, so knowing who you want to talk to adds greatly to your proposal.

    Remember that an article idea does not have to be complicatedÑsome of the best features are the simplestÑbut it has to be compelling. Pitching your idea correctly is a learned art. John Illman, medical correspondent for the Observer (and editor of the Guardian's health pages for eight years) summarises it thus: “I'm looking for ideas that surprise me. I'm not looking for propagandaÑ80 to 90 per cent of ideas submitted to national newspapers are attempts to reinforce existing propaganda. Topicality can do a lot to get a second rate idea into print. The time to write about colds and flus is not May or June. Case histories can do a lot to bring life to a piece.”

    Pick up the telephone and prepare to tell the editor in three clear sentences why you should be commissioned to write this piece. Often, and sometimes before you have completed your first sentence, you will be asked to put it on paper and fax or post it. Your letter should be short and to the point: explain your idea (why, what, who, when, how, etc), give relevant background information, mention who you will interview, and summarise your writing experience if you have any (this is where medical magazines, many of which encourage doctors to write, come in). Enclose a cutting or two if you can. Finish by saying that you look forward to hearing from them.

    At this stage, as Tim Albert says, “in most cases there will be resounding silence. This is extremely frustrating for writers, whose days and nights will be spent agonizing over the fate of their masterpiece. For the editor, on the other hand, this article will be one of many.”2 If you have not heard, telephone again within two weeks. If the editor doesn't bite, don't be (or sound) surprised. Don't pester eitherÑyou may easily cast yourself as the editorial version of the heartsink patient. Rework your pitch for other publications, come up with several more ideasÑand keep trying.

    What's the pay?

    In general, standards of pay reflect the publication's circulation. Bestselling lifestyle magazines may pay over £100 per 400 words, while limited circulation magazines (including medical publications) may offer the same payment only for the entire 1200 word article. The average rate for doctors' contributions to medical weeklies is about £50. Certain common medical outlets are more lucrativeÑdrug or public relations companies often pay more than magazines, possibly £300-400 per day for short projects.

    Is it possible to live entirely by writing? Clearly, the answer is yes. If you average six articles a month at £250-400 each you are making a living, but until you are well established it will be difficult to maintain this number of commissions. Cash flow is a constant problemÑsome magazines pay within six weeks of accepting your work, while for others you have to wait for publication, which may be in three months' time or longer.

    What's it like?

    “Freelancers suffer chronic anxiety on two counts: about having too much work, and about having too little.”3 It is easy to spend as much time chasing payment and new commissions as actually writing. It can be lonely, isolating work, and for many freelances the telephone is a lifeline.

    “The only drawback to being a professional writer is actually having to write.”4 But meeting deadlines and fulfilling your editor's directions for the articles are essential if you want to get on. Journalism functions on “who you know” more un- ashamedly than medicine does. Of course, editors use and reuse a stable of trusted freelances, who are also quite often people they like. It isn't easy breaking in, and the best time to do so may be when a new editor is taking over. Luck and chance play as big a part as your prowess with the word processor.

    The rewards are that your vanity is boosted each time you see your name in print and you become linked to a world outside medicine, which can work as an antidote to the pressures of practice. The world of medical journalism has been described as “small, varied, and bitchy and … probably not for the faint hearted,”5 but if you have worked in the NHS you should be halfway there.

    Recommended reading

    • Albert T. Medical journalismÑthe writer's guide. Oxford: Radcliffe Medical Press, 1992.

      Essential for the doctor who wants to write on any subject, not just medicine

    • Moore C. Freelance writing. London: Robert Hale, 1996. Comprehensive guide with sections on various marketsÑlocal papers, PR companies, business magazines and lesser known outlets

    • Crofts A. How to make money from freelance writing. London: Piatkus, 1997. Includes information on writing books and for the stage, screen, or radio, and advice on agents

    • Dick J. Writing for magazines. London: A and C Black, 1996.

      In depth look at the magazine trade

    • Hoffman A. Research for writers. 5th ed. A and C Black, 1996.

      Standard guide to getting all the facts, including what the weather was like “on that day”

    • Legat M. An author's guide to publishing. London: Robert Hale, 1994. Useful account of the publishing world, including entries on legal matters such as copyright, libel, and contracts Writers' and artists' yearbook. London: A and C Black, yearly editions. Turner B, ed. The writer's handbook. London: MacMillan, yearly editions. Both are exhaustive guides of all sources of opportunity for writers. Includes information on writing events, societies, services and competitions

    Useful contacts

    • GP Writer's Association. West Carnliath, Strathtay, Perth PH9 0PG. Tel 01887 840 380. Fax 01887 840 380. Contact Professor F M Hull

    • Medical Journalists' Association. Membership secretary Stephen Hedges 0171 257 2475.

    • Association of Broadcasting Doctors. Contact Mr Peter Petts, PO Box 15, Sindalthorpe House, Ely, Cambridge CB7 4SG. Tel 01353 688 456 fax 01353 688 451

    • Society of Authors (medical section). 84 Drayton Gardens, London SW10 9SB. Tel 0171 373 6642 fax 0171 373 5768


    • Try your local college or university. Tim Albert Associates run courses on various aspects of medical writingÑTAA Training, Castlebank House, Oak Street, Leatherhead KT22 7PG

    • For correspondence courses try:

      School of Creative Writing, Clarendon Court, Over Wallop, Stockbridge, Hampshire SO20 8HU. Tel 01454 311 399The Writers Bureau, Sevendale House, 7 Dale Street, Manchester M1 1JB. Tel 0161 228 2362

    • Writing School, Nationwide House, Hyland Business Centre, 72-86 Garlands Road, Redhill,Surrey RH1 6NT. Tel 01737 779 065

    • Websites Freelance Online at


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