Tuesday, August 2, 2016

Reflections on my summer publications

When I haven't been blogging, editing, teaching, or seeing patients this summer, I have experienced the satisfaction of having reports of a couple of my longer-term projects appear in medical journals. In contrast to a blog post, which can be conceived, written, and published in a few hours (although the thought process often takes much longer), the timeline from submission to publication in a journal is usually several months at a minimum.

For example, in the spring of 2014, after having helped to develop a search tool for primary care-relevant Choosing Wisely recommendations, I wondered what proportion of these recommendations were based on evidence of patient-oriented outcomes, as opposed to expert consensus. I convinced a collaborator, a family physician at Fort Belvoir Community Hospital, to help me apply the Strength of Recommendation Taxonomy (SORT) to 224 different recommendations that had been generated by various medical specialty societies. It took many hours of working on our own and several conference calls to complete this project, which we presented at the Preventing Overdiagnosis conference at the National Institutes of Health last September. We then wrote the paper and submitted it to what we thought was an appropriate journal, but the editors of the journal (which will remain nameless) disagreed, rejecting it without even sending it for peer review. So we resubmitted it to the Journal of the American Board of Family Medicine, which accepted it after peer review and revision and finally published it in their July/August issue. Here is the bottom line:

We found that a majority of primary care–relevant Choosing Wisely recommendations are based on expert consensus or disease-oriented evidence. In light of other factors that drive unnecessary medical interventions, such as patient satisfaction and fee-for-service reimbursement, this may make it more difficult to convince clinicians to change established practices. Further research is warranted to strengthen the evidence base supporting these recommendations in order to improve their acceptance and implementation into primary care.

Not long afterward, the journal Family Medicine published a book review that I wrote about Dr. Robert Taylor's enjoyable and useful What Every Medical Writer Needs to Know. I love reading good books about the process of writing, medical or otherwise, and recommended it highly:

Although students and novice writers may want to purchase a more traditional and/or less expensive book on the craft, I recommend What Every Medical Writer Needs to Know as a valuable resource not only for “serious” medical authors who write for a living but for family physicians and clinicians who write occasionally for publication and would enjoy learning more about the inspiring history of the profession.

After it was published, a residency mentor, whom I credit for giving me my start in medical writing, e-mailed me to say that he had decided to purchase a copy of the book based on my review!

Although blogging has advantages over traditional medical publications (perhaps my favorite being that I get to be the writer and the editor), I am glad that I invested the time to be published in these family medicine journals.