Why physicians need to write

Why physicians need to write

Should doctors be able to write?

At first glance, this might seem like a question with an easy answer.

Yes, you might say, doctors receive a doctorate and are trusted with communicating to and about people at critical moments in their lives. Or you could reply, No, they are scientists and so need to be functional communicators able to write basic notes and prescriptions, and anything more than that is professional frosting.

As with all questions, sorting out which answer is (more) correct is easier if we define our terms.

The key words in this question are ‘doctor’ and ‘write’. Both have literal bare-bones definitions, and both play out in the real world in myriad and widely varied ways. For the purposes of this post, doctor means a licensed physician who engages in clinical care, research, education, or health care leadership and writing means the ability to use narrative to effectively communicate ideas, thoughts, feelings and opinions to others.

Of course, as a doctor-writer who teaches other doctors how to write, I should admit that I’m biased.

But I recognize that I am a doctor who enjoys writing and wants it as part of her career. From that perspective, writing might be one of my hobbies, comparable to the activities of colleagues who invent creative cocktails, build musical instruments from raw materials, or breed lamas (…yup, I know at least one doctor who does each of these things…)

The difference between these activities and writing is that one can be a very fine physician without ever having mixed a drink, carved the fine curves of a violin, or inspired romance between lamas.

On the other hand, I would argue that one cannot be a good doctor without being able to communicate one’s thoughts, knowledge, opinions, and analyses in writing. Sure, a person might be a remarkably skilled surgeon or an uncannily perceptive leader of family meetings, but if that information isn’t relayed accurately and effectively in the chart or in written materials for families, the well-being of patients and families are in jeopardy. These faulty hand-offs, transitions, and instructions have been shown, repeatedly, to be the cause of medical errors, readmissions to hospitals, unnecessary tests, and death.

And that’s just one aspect of the doctor’s role. Another fundamental set of professional responsibilities, cited in the Physician Charter, adopted by leading medical societies in the US, Canada, UK and Europe in 2002 included “providing expert advice to society on matters of health.”

Note, it doesn’t say “to patients” but “to society” – and what are the most effective ways to reach large numbers of people? There are really just three modalities: text, audio, and video. And the latter two, to be effective, often have scripts. Moreover, they always require the clarity of language and expression, mastery of storytelling, and judicious use of data that can best be taught and practiced through writing.

So my vote on should doctors be able to write?

A resounding yes.

We don’t – won’t, can’t – all be Chekhov or Gawande, but we should all have some basic ability to discuss matters of health and health care in ways that are accessible, interesting, and informative to people with no medical background.

Lucky for me, it seems increasing numbers of other doctors agree: In the last few months, I have taught public medical writing at the University of California San Diego, Oregon Health Sciences University, the Society of General Internal Medicine meetings (with Lisa Saunders of the New York Times and Anna Reisman of Slate), and the American Geriatrics Society annual meeting, to name a just a few.

At each place, I encountered health professionals eager to tell stories of their patients, colleagues, research and practice, and at each place I was thrilled to find that alchemy of passion, advocacy, expertise, and talent necessary to produce good work and improve the world.

My hat’s off to them.

Louise Aronson is a geriatrician and the author of A History of the Present Illness. She blogs at her self-titled site, Louse Aronson, and can be found on Twitter @LouiseAronson.

Image credit: Shutterstock.com

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  • http://www.facebook.com/shirie.leng Shirie Leng

    When I was a medicine intern I generated a page-long progress note on every patient every day. My surgical counterparts wrote 3 lines. These days both medicine and surgery spend so much time entering their patients into their computerized database in shorthand that real writing is non-existent. Required premed courses are certainly not conducive to development of writing skills, nor is medical school.On the other hand not everyone can write and sometimes those who can’t still communicate beautifully verbally. I think we need both types.

  • buzzkillerjsmith

    Louse Aronson is the site?

  • http://briarcroft.wordpress.com/ Emily Gibson

    Louise, I agree, and devote at least an hour of every day to writing for the joy of it, telling stories that beg to be told. A good physician sees each patient as an unopened book, ready to be perused page by page, every plot line and character carefully studied, the mystery of the ending yet to be solved. This is not fiction; this is real life.

    Thank you for encouraging the storyteller in us all.

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