Writing in medicine - How to Capture an audience: Editorials, letters, blogs and social media Professor Azeem Majeed, Department of Primary Care and Public Health, Imperial College London Social media differentiates itself from more traditional forms of media by its immediacy and its focus on social interaction. Websites and online forums allow users to share information through interactive electronic exchanges. Many businesses now incorporate social media into their marketing strategies to deliver key messages, advertise services or improve communication with clients. The NHS, doctors and health professionals have been slower to take up the use of social media but we are now also now seeing increased use of social media in the health sector. In this interactive workshop, I will discuss how health professionals can use social media to get their messages across to patients, and also the use of social media in education and campaigning. I will also discuss writing for traditional medical journals with a focus on publications such as editorials, commentaries, letters and clinical discussions.

1. 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

2. 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

3. Some social media platforms
• Blogs
• Twitter
• Facebook
• YouTube
• HTML Newsletters
• Many others: Instagram, Storify etc.

4. 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

6. 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

7. Twitter
9000 tweets per
second
230 million active
users monthly
29% of 15-34
years old on Twitter

9. 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

11. 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

12. Facebook
1.23 billion active
users monthly
223 million European
on Facebook
30% of users between 25 – 34 years old
24% of marketers report that Facebook is
critical to their business

14. Facebook in Clinical Practice
Informal, friendly
Confidentiality (monitoring)
Interact with patients
Share information
quickly
Promote activities
Flu vaccination season
New services
Registration of new
patients

16. 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

17. HTML (Email) Newsletter
Regular newsletter
Goal:
Publicise work
Educate patients
Proactive form of marketing
MailChimp
Design: pictures, graphs, charts,
concise, limited medical jargon
Distribution

18. Targeted newsletters
Aimed at specific groups
Flu vaccine programme
QOF reminders
NHS Health Checks
Childhood immunisations
Screening programmes
Impact remains to be evaluated

19. 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

21. NHS Choices
Basic information
 Location
 Contact details
 Opening hours
 Staff
 Services
Managed by designated member of staff
Patient feedback

23. NHS Choices – Patient
feedback
Authoritative and constructive answer
Designated member of staff (practice manager)
Consistent, non-generic answers
No defensive/negative replies
Invite patients to discuss issues confidentially

24. 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

25. 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

26. Examples of what not to post?

27. 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

28. 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)

29. 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

31. 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

33. 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

34. 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

35. 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”

36. 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.

37. Some examples rewritten
1: 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 enable
an 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

38. 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?

39. 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

40. 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

41. Acknowledgements
Thanks to my clinical and academic
colleagues
Thanks also to my patients