These five medical editing tips are a precis of my experience as a medical editor in healthcare advertising agencies. Working in healthcare advertising agencies is an extremely hectic but extremely rewarding experience. The variety of therapy areas and materials is stimulating and intellectually engaging, providing a very enjoyable working environment. Clients include some of the largest pharmaceutical companies in the world and projects will include the launch of potential blockbuster drugs. This is invigorating but comes with tight deadlines and several medical/legal reviews, so the pressure is constant to maintain accuracy and consistency as launch dates loom.
Despite the fact that material is approved at the copy document stage, there will always be revisions at the artwork stage, which includes physical materials as well as tablet apps and websites. It is at this point in proceedings that errors can creep into the finished product, with several members of the client team providing last-minute input to an overworked account manager liaising with the copywriter, art director and studio, while trying to meet a print/launch deadline. With this in mind, these are my top five tips for the medical editor at this critical juncture.
1. Edit the amends before artwork if possible (because clients are not writers)
As I mentioned before, the copy document is supposed to have been approved before entering the artwork stage; however, there is something about seeing the material in the final visuals that leads to revisions (and further approval stages). Generally, this will involve minor amends but sometimes it will include the client rewriting sentences or entire sections, and deleting paragraphs or figures. It is here that problems arise.
The first problem is what is being added. Healthcare agencies are hired because it is their job to do the hard work of communicating the promotional ideas in the best way possible. If they didn’t, clients would do it themselves. This is apparent when the client wants to add something new. The client knows what to say but that doesn’t mean that it has been constructed perfectly. Apart from punctuation and grammar issues and even typos (in my experience, hyphens are the greatest casualty in new text from clients), there is also the rest of the piece to consider – this can range from the brand’s style to consistency with the tone of the rest of the material. The client sees a problem to be fixed, and has provided a solution. In an ideal environment, the editor would see the amends before they are inputted, but with demands on studio artworkers and availability in schedules, the account manager doesn’t have that luxury. Therefore, the medical editor should know what amends have been done so that they can be taken into consideration for the entire project and not just what has changed.
2. ABPI compliance
This is connected to the previous tip about checking new amends but deserves a separate entry – client additions/subtractions that can affect a piece at the language level can also affect compliance with the Association of the British Pharmaceutical Industry’s Code of Practice. Introduction of the word ‘safety’, including a figure that has relative risk reduction but not the absolute risk reduction as well, rearranging the entire piece so that the prescribing information layout has changed to more than 100 characters per line or the x-height is smaller than 1 mm – these are all elements that the medical editor needs to consider when last-minute revisions are compiled.
Typos are embarrassing, but they rarely lead to a case being brought to the Prescription Medicines Code of Practice Authority, which can result in corrective statements or public reprimands against the client’s company. This does not look favourably on a healthcare advertising agency, so be aware.
3. Tables and figures
Ensuring that the numbering of tables and figures is correct in a document is part of the medical editor’s duties, but it is particularly important to pay attention to tables and figures when amends are incorporated. Deleting tables and figures in the middle of the material without renumbering the figures and the mentions of the tables and figures in the text, paying attention to abbreviations and references (see later tips) that occur in deleted or added tables and figures, taking into account ABPI compliance with new tables and figures – these are all elements I have encountered many times when last-minute amends occur. This tends to occur more when the clients feel that there should be more visual elements (too much writing seems scary to them, as can be observed in the increase in infographics in promotional material), so it is an area where close attention must be paid.
Medical promotional material uses a lot of abbreviations, due to the complex nature of the science communicated and the constraint of space. Abbreviations become second nature to those involved in the creation of materials, which means they are easy to forget. Last-minute additions or subtractions rarely take these initialisms into account, so the medical editor should be vigilant because other people in the process won’t be.
There are various approaches to tackling abbreviations – defining at first mention, using them undefined but with a definition as a footnote at the bottom, using them undefined but with a glossary at the end – but each method can be affected by amends, and I have experienced them all. New abbreviations added without defining them, removing sections that had the definition of an abbreviation used subsequently, even adding a definition of an abbreviation that is subtly different from that used in the same document or in previous materials – stay alert for the important yet often neglected abbreviation.
Sometimes, I think that I am the only person in the process who cares about references. Compared with the rest of the document, which has the important points to communicate and the bulk of the writing to check for errors, references are seen as a very minor element. Checking that references are correct and adhere to client style and that URLs are up to date is part of the medical editor’s job (different copywriters have their own style, old materials are updated without checking links or access dates, and a successful healthcare advertising agency should have several clients with differing reference styles that can be easily confused), but it becomes even more important when last-minute revisions occur. I have lost track of the number of times that a client-requested amend has missed the deletion of a reference, leading to a complete renumbering of the entire document – I began to feel that nobody else looked at citations and references apart from me. Incorrect referencing is not an immediately glaring error, but it can cause legal problems if a healthcare professional asks for a specific reference from the client, such as a ‘Data on file’ specific to the company, and it cannot be determined what is the correct reference. If I had to point to one tip that a medical editor should focus on, it would be the references.
Those are my top tips for the medical editor in healthcare advertising agencies. Do you have different tips? Let me know in the comments.