Writing in medicine - How to

Capture an audience: Social

media, editorials, letters

and clinical commentaries

Professor Azeem Majeed MD FRCP FRCGP FFPH

Professor of Primary Care & Head of Department

Department of Primary Care & Public Health

What is social media?

Sharing information through interactive online exchanges

Used in marketing Deliver key messages

Advertise services

Improve communication

Slower uptake by the NHS

Can be included in General Practices’ communication strategies

Some social media platforms

• Blogs

• Twitter

• Facebook

• YouTube

• HTML Newsletters

• Many others: Instagram, Storify etc.

Blogs

• A blog is a frequently updated online personal journal or diary

• Free blogs: Blogger, WordPress

• Paid Blogs: WordPress

• Medical Blogs: BMJ, Pulse, King’s Fund, PHE

• General Media: Guardian, Huffington Post

Twitter

• Twitter is a service that allows the exchange of quick, frequent messages (tweets).

• Tweets which may contain photos, videos, links and up to 140 characters of text.

• These messages are posted to your profile, sent to your followers, and are searchable on Twitter search

• Twitter ‘lists’ are useful for following specific users of Twitter

Twitter

9000 tweets per

second

230 million active

users monthly

29% of 15-34

years old on Twitter

Twitter in Clinical Practice

Share views and expertise on health news

Respond to emerging health issues Disease outbreaks

Changes to local health services

Informal,

straightforward 140 characters

Promotional tool

Facebook

• A social networking website that allows users to create profiles, upload photos and video and send messages

• Now the world’s largest social networking site with over one billion users

• Allows the creation of groups and the publicising of events

• You can also use your Facebook ID to sign into other sites

Facebook

1.23 billion active

users monthly

223 million Europeans

on Facebook

30% of users between 25 – 34 years old

24% of marketers report that Facebook is critical to their business

Facebook in Clinical Practice

Informal, friendly Confidentiality (monitoring)

Interact with patients

Share information

quickly

Promote activitiesFlu vaccination season

New services

Registration of new

patients

YouTube

• A free video sharing website (owned by Google)

• You can create and upload your own videos

• If you've ever watched a video online, there's a good chance it was a YouTube video

• The ubiquity of smartphones now makes it easy to record & upload videos

• More professional-looking videos require more effort to produce

HTML (Email) Newsletter

Regular newsletter

Goal:

Publicise work

Educate patients

Proactive form of marketing

MailChimp

Design: pictures, graphs, charts,

concise, limited medical jargon

Distribution

Targeted newslettersAimed at specific groups

Flu vaccine programme

QOF reminders

NHS Health Checks

Childhood immunisations

Screening programmes

Impact remains to be evaluated

Practice / Personal Website

Regularly updated

Comprehensive

Location and contact details

Opening hours

Services

Registration packs

News section

Guidelines: emergencies, self-help, online services

Link to other social media platforms

NHS Choices

Basic information Location

Contact details

Opening hours

Staff

Services

Managed by designated member of staff

Patient feedback

NHS Choices – Patient

feedback

Authoritative and constructive answerDesignated member of staff (practice manager)

Consistent, non-generic answers

No defensive/negative replies

Invite patients to discuss issues confidentially

Patient welcome pack

Emailed to all new patients

Welcome letter with embedded links

Patient Access (Emis Web)

Electronic Prescription Service

Patient Participation Group

Most recent electronic newsletter

Capture email addresses from current practice patients

Professional Guidelines

Published by GMC, BMA & others

Remember social media is a public forum

Maintain confidentiality

Respect colleagues

Be aware of conflicts of interest

Even if you delete a post, someone may

retain a copy

Examples of what not to post?

Don’t forget ‘old-fashioned’ media

• Boundaries between traditional medical media and social media blurring

• Almost all medical journals now have an online presence

• Increasing number of ‘open access’ online only journals where the author pays

• Still a large audience for more traditional articles

• Develop a thick skin and be prepared for rejection

What kind of articles can you write?

• Rapid online responses (e.g. BMJ)

• Letters to the Editor

• Clinical commentaries

• Health policy articles

• Editorials

• “How to” articles (e.g. 10-minute consultations)

How do you measure the social media impact of your academic article?

• Altmetric Score: A system that tracks the attention that academic articles receive online.

• It does this by pulling in data from three main sources:– Social media like Twitter, Facebook, Google+, Pinterest

and blogs– Traditional media - both mainstream (The Guardian,

New York Times) and science specific (New Scientist, Scientific American).

– Online reference managers like Mendeley and CiteULike

How do you measure the academic impact of your article?

• Google Scholar Citations

• Provides a simple way for authors to keep track of citations to their articles

• You can check who is citing your publications, graph citations over time, and compute several citation metrics.

• You can make your profile public

Advice on good writing style

• Many style guides are available

• Pick one that you like

• I generally recommend “Medical Writing: A Prescription for Clarity”

• “From Creation To Chaos: Classic Writings in Science” Edited by Bernard Dixon

Some basic points about writing style

• Spend time acquiring a good, readable style of writing

• Be clear and concise

• Avoid using too many long sentences

• When you have the choice of two words, use the simpler one

• Use active rather than passive verbs

• Avoid using colloquial language & cliches

What did Winston Churchill say?

• He said “I have nothing to offer but blood, toil, tears and sweat”

• He did not say “I have nothing to offer but the red liquid that circulates in blood vessels, exertion, lacrimation and perspiration”

Great writers can break the rules

It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us, we were all going direct to Heaven, we were all going direct the other way – in short, the period was so far like the present period, that some of its noisiest authorities insisted on its being received, for good or for evil, in the superlative degree of comparison only.

Some examples rewritten1: In the case of this particular elderly patient hypertensive population, reduction of blood pressure by 18/11 mm Hg was achieved for a mean duration of follow up period of 4.4 years. However, with regard to overall mortality, there was no effect nor was there any effect on the incidence of occurrence of myocardial infarction, whether of fatal or non-fatal nature. With respect to cardiovascular accidents, a reduction in incidence of 42% was encountered, and this was mainly associated with strokes leading to fatality or serious neurological sequelae. Although it was not significant, cardiovascular mortality was shown to be reduced by 22%.

In these elderly patients with hypertension, blood pressure decreased by 18/11 mm Hg for a mean follow up of 4.4 years. There was no effect on overall death rates or on the incidence of fatal or non-fatal heart attacks, but there were 42% fewer strokes, mainly apparent in fatal and major strokes. Deaths from cardiovascular disease decreased by 22%, but this was not statistically significant.

2: It is possible to speculate that operative intervention would have saved this man’s life. The policy of management was conservative because of uncertainty as to the cause of deterioration.

An operation might have saved this man’s life, but we did not operate because we did not know why he had deteriorated.

3: Each case has to be managed individually after a full history has been taken, and examination and, where necessary, special investigations have been undertaken, so that an accurate diagnosis can be made and appropriate treatment selected.

Each case has to be managed individually. A full history and examination and any necessary special investigations will enablean accurate diagnosis and appropriate treatment.

4: Baby walkers are devices that provide preambulatory infants with postural support in addition to offering them the opportunity to experience bipedal locomotion. They are intended to simulate independent walking and by so doing, it is argued, encourage and even accelerate the early acquisition of this skill.

Baby walkers are devices that allow babies who are still at the crawling stage to stand and to practise walking. Some authorities believe that they speed up the ability of babies to walk independently.

Source: Medical Writing. A Prescription for Clarity

The social media strategy

SETTING GOALS

• What does the practice wish to achieve by making use of the social

social media?

• Is the emphasis educating and informing patients, collecting feedback,

feedback, advocating points of views, promoting the general practice,

practice, and/or improving social networking?

THE DETAILS

• How much time can be invested to keep accounts up-to-date?

• Is there a need for extra members of staff?

• What types of message should be diffused (professional, personal,

personal, etc.)?

EXPLORING AND SELECTING APPROPRIATE

CHANNELS

• Which websites and applications are needed to achieve the set

goals?

• What is the best platform to reach the selected audience and to

to deliver the chosen messages?

• What are the rules and codes of each channel?

Can social media benefit

patients?Patient engagement and empowerment

Patient health education

Productive consultations

Communication with key

patient groups

Responsiveness to feedback

Health outcomes

Health promotion tool

Self-management tool

Conclusions

• Be willing to communicate your ideas

• Use ‘new’ and ‘conventional’ media

• Social media – be prepared for criticism

• Conventional media – be prepared for rejection

• Ultimately, you will benefit

Acknowledgements

Thanks to my clinical and academic

colleagues

Thanks also to my patients