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grow page by page and look forward to Dr Ber- The rest of the book is organized to alter-
nard’s future work. nate between a group of traditional chapters
Suzanne Minor, MD on writing tips (Getting Started, The Process,
Florida International University Pointers and Pitfalls, Ethical Issues, Getting
Herbert Wertheim College of Medicine Your Work in Print) and more loosely ar-
Miami, FL ranged chapters (Remarkable Writing, Back-
stories, What Writers Say About Writing, A
Writer’s Attic). In the former group, Dr Tay-
What Every Medical Writer Needs lor uses many historical examples to illustrate
to Know: Questions and Answers points. For example, he tells the breaking-into-
for the Serious Medical Author print stories of writers such as Anton Chek-
Robert B. Taylor hov (who needed money to pay medical school
Springer International Publishing, 2015, 220 pp., $34.99, softcover tuition) and Elisabeth Kubler-Ross (whose On
Death and Dying began as a series of medical
The term “medical school seminars). In emphasizing the impor-
writer” is used to de- tance of “ruthless” revision, he notes that “Er-
scribe many different nest Hemingway rewrote the last page of [A]
types of profession- Farewell to Arms 39 times.” He observes that
als, from journal- a “productive” day for a writer could mean any-
ists who write about thing from 10 pages (Stephen King) to three
health and health sentences (James Joyce).
care, to professional Drawing on his own writing and editorial
writers who author experience, Dr Taylor reviews the pros and
reports for trade cons of outlining and multitasking, provides
publications, to ac- tips on improving readability (use short words
ademic researchers and sentences and first person point of view),
who write for medi- makes suggestions for how to overcome writ-
cal journals and the er’s block, and offers strategies for working
physicians and nonphysicians who edit those with troublesome coauthors. He advises pro-
journals. As an associate deputy editor of spective authors to strictly follow journal in-
American Family Physician, a family medicine structions, and he provides a list of areas to
teacher and researcher, and a health blogger, I reexamine if a manuscript is repeatedly re-
consider myself to be an example of the “seri- jected. Finally, he offers practical guidance on
ous medical author” addressed in the subtitle when to request permission to borrow mate-
of Dr Robert Taylor’s comprehensive yet sur- rial, how to avoid plagiarism, and identifying
prisingly concise treatise on medical writing. and resolving potential conflicts of interest.
Dr Taylor is an emeritus professor of family The other group of chapters serve as catch-
medicine who has authored more than 30 med- all repositories for an impressive array of facts
ical texts, patient self-help books, and medical about writing, a few useful but most just inter-
writing guides since the 1970s. Rather than esting trivia. Is it really necessary for readers
being another “how-to” book on medical writ- to know what is the “Heaviest Medical Refer-
ing, he explains in the Preface, this book is ence Book in Single Volume” (the 1983 edition
about medical writing: “What we do, why and of Dr Taylor’s very own 2,020 page, 12-pound
how we do it, the goals we seek, the perils we family medicine reference text), that Sherlock
face, and what we can learn from others who Holmes creator Sir Arthur Conan Doyle once
have walked the trail before us.” In the first used the pseudonym A.C. Smith, or who first
chapter, “About Writing and Medical Writers,” coined the term “phantom limb” (American
Dr Taylor invites readers to journey through physician-writer Silas Weir Mitchell in 1871)?
the history of this diverse profession, whose Probably not, but these chapters help to make
members included Hippocrates, Galen, Osler, the book even more accessible and personal,
William Carlos Williams, and contemporary as if Dr Taylor himself was sitting with the
physician-authors Jerome Groopman and Atul reader and spinning tale after writing tale.
Gawande. He briefly surveys different types of The text is also richly illustrated with photos
medical writing and changes in the publication of well-known medical writers, noteworthy ar-
process over the centuries. ticles (eg, James Parkinson’s 1897 essay on the



“shaking palsy”), and striking medical images alike. Too seldom in academic medicine is the
(eg, a child infected with smallpox in 1973). subject of uncertainty explicitly recognized,
Although students and novice writers may named, or given a theoretical framework that
want to purchase a more traditional and/or might help discuss and explore the muddiness.
less expensive book on the craft, I recommend This book attempts to rectify this problem.
What Every Medical Writer Needs to Know as a The editors admit to approaching the sub-
valuable resource not only for “serious” medical ject with presuppositions—that uncertainty
authors who write for a living but for family is central to primary care and that achieving
physicians and clinicians who write occasion- competency in its management requires “op-
ally for publication and would enjoy learning portunities for regular, case-based, small-group
more about the inspiring history of the pro- discussion among professionals, preferably …
fession. with a skilled and trained facilitator in the
Kenneth Lin, MD, MPH workplace on set-aside time.”
Georgetown University The first three chapters do a good job setting
Department of Family Medicine the context by describing current concepts of
uncertainty and its management and by push-
ing the vocabulary even further. In Sommers’
Clinical Uncertainty in Primary first chapter, there is a helpful summary of
Care: The Challenge of available literature on the subject. In Chapter
2, Trisha Greenhalgh, using four case exam-
Collaborative Engagement
ples that will resonate with practicing clini-
Lucia Siegel Sommers and John Launer, cians, attempts a taxonomy of uncertainty as
Editors concerning (1) the evidence (voice of medicine),
New York, NY, Springer, 2013, 306 pp., $209 (hardcover), $69.99
(paperback), $26.25 (ebook) (2) the patient story (voice of the lifeworld),
(3) what best to do for a particular patient
“The key to un- in a particular situation (clinical judgment
derstanding medi- informed by “tacit knowledge”), and (4) the
cal judgement is fragmentation of care between team members
knowing that it is and across computer networks (pointing out
fundamentally the that our latest attempt at health care reform,
management of un- through technology-supported multiprofession-
certainty,” Eric Cas- al care, may create more uncertainty than it
sell is quoted early resolves). This framework will help us in our
in this book. I don’t consideration of the various small-group meth-
remember being ods listed in chapters that follow. In Chapter
taught this fact in 3, Colin Coles describes theoretical constructs
medical school, nor concerning development of professional judg-
explicitly in resi- ment in patient care and in teaching. He shows
dency. Our learn- that it helps to frame both health care and
ing took place in a teaching as “praxis” in which the target truly
world of scientific rationality where we were may shift after starting on a journey with a
given universal facts and taught precise mea- specific patient or student.
surement techniques in order to gauge our The next nine chapters, written by pro-
patients while wearing clean white lab coats; ponents, describe six types of collaborative
for every unknown there was one correct groups currently being used in North Ameri-
multiple-choice answer (if one studied hard ca and Northern Europe. These include Balint
enough). Meanwhile, in our preceptor clincs Groups, Practice-Based Small Group Learn-
(aka, the school of hard knocks) we quickly ing (PBSGL) in Canada and Scotland, Nar-
saw that most real patient care takes place in rative-Based Supervision (NBS) in England,
“the swampy lowlands” where correct answers Practice Inquiry (PI) in the United States,
seemed to morph with the territory. Peer-Supervision Groups in Denmark, and the
This disconnect between the received view case-based learning of “FQ Groups” in Swe-
of medicine and what students actually expe- den. Each method is described in theory and
rience in preceptorships, between the popu- practice, and several interesting examples are
lar perception of medicine as an exact science described. More or less robust outcomes and
and the reality of the swampy lowland, creates evidence are reviewed for each.
an emotional burden for student and teacher