Medicine And The Media Medicine and the media

Failed publications: the medical model

BMJ 1998; 317 doi: (Published 08 August 1998) Cite this as: BMJ 1998;317:420

Why are so many medical reports and newsletters written in pseudoscientific gobbledygook? Tim Albert considers these sad creations

  1. Tim Albert
  1. trainer in written communication and visiting fellow in medical writing at the Wessex Institute for Health Research and Development

    Next time you see a newsletter or an annual report from a distinguished medical body, look for the anodyne bureaucratic phrases and the pseudoscientific gobbledygook, the pompous initial capitals, and the photo booth “repertory company” photographs. Then reflect that in all probability a lot of highly paid academics put in a lot of expensive hours making the publication that bad.

    Earlier this year I gave up that part of my business which produced newsletters for medical and academic organisations. While most of my clients were charming, stimulating, and able, they were working within a culture that encouraged a type of behaviour that has serious implications for the relation between medicine and the media.

    The story invariably goes something like this. Someone decides that it is time the organisation had a newsletter or glossy annual report. A middle manager (rarely a doctor or a scientist) is nominated to do the work, and she (almost invariably a she) brings in outside professionals to help. Together they carefully define the purpose of the publication; describe the readers they wish to reach (usually influential lay people); and commission designers, photographers, and professional writers. The first draft is completed within the deadline; it looks handsome and is (for the target audience) reader friendly.

    Now the trouble begins. Instead of the document being shown to one person at the top of the organisation to say whether the organisation can live with it, in the name of democracy and the spirit of scientific inquiry (also known as peer review) it is sent round to all the major players in the institution for their opinions.

    This is invariably disastrous. Paragraphs are removed or (worse) added for reasons of institutional and professional politics. Well produced photographs are replaced by those more flattering to the subjects. Words like department, doctor, and division become Department, Doctor, and Division (although patient always stays as patient). Sentences that were short and simple become converted into the worst kind of medical journal speak: “About two thousand people die each year from asthma” becomes “It has been demonstrated in the literature that 1986 men and women in England and Wales die from asthma and related disease.” Instead of being focused on persuading outsiders of the merits of the institutions, the document becomes a series of compromises, each intended to serve the interests and attitudes of the main political players rather than those of the target readers.

    And, yes, it does matter. One of the most powerful influences on media messages is what organisations and individuals say about themselves. If a large part of a large sector—in this case the scientific medical establishment—is putting out messages that are less effective than those from other organisations then they will be misunderstood or ignored. For evidence, compare the publications of medical organisations with those put out by successful commercial organisations, and then ask yourself which ones are likely to attract, and keep, uncommitted readers.

    There must be a major change of attitude. If scientists and doctors want good documents they must learn to accept plain English (and the strong messages that go with it) and hire and then trust good professional communicators. Those at the top of these institutions must be more explicit as to what they want their documents to achieve, more robust in the way they handle internal critics, and more exacting in the way they evaluate the document's success. Others in these institutions must learn to be less touchy. In particular, doctors and scientists must realise that, although they may be good judges of good science, they are not necessarily good judges of good communication.

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