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THE CHALLENGE OF MEDICAL WRITING IN AMERICA THEODORE BERLAND* Medical communications accelerated from a crawl tojet speed in two generations. Fifty years ago doctors did not talk much, except to order, "Turn your head and cough," or "Step up on the scale, please," or "Open wide and say, 'Aaaah,' " or "Let me worry about that, dear." A far cry from Our Bodies, Ourselves [1] and Malepractice [2], two recent books which instruct women on asserting themselves in matters of how doctors care for their bodies. In those dark days, patients received more mumbo jumbo than scientific information from their doctors. They were handed medicines, or sugar pills, and told, "Take this, three times a day. You'll feel better tomorrow." Prescriptions were written in Latin specifically so patients would not learn their secret ingredients. Fees and prices were flexible; they depended on how the doctor, pharmacist, or other health professional felt. Medical books, especially textbooks, were not available to the public. There was scant medical information in newspapers, with news stories overshadowed by quacks' ads for cures for impotence, baldness, female problems, and so forth. The World Almanac of 1929 [3] contained ads for Absorbine, Jr., for tired, sore muscles; the Philo Burt Method for treating spinal deformities; the Trados Model No. 25, a device for "a perfect looking nose"; Dent-Zel-Ite, for toothaches and cavities; Bromo Seltzer for headaches; a natural body brace to overcome weakness and organic ailments; a Brooks appliance for rupture; Clear-Tone for skin troubles; Brown's remedies for asthma, bronchitis, lung troubles, and worms; and the violet ray for quickly conquering pain and disease. And if all these failed, there was an ad for Springfield metallic caskets! This is all a far cry from "General Hospital" on TV every afternoon, and medical advice columns and news stories by medical writers. * Immediate past president, American Medical Writers Association; science editor, Department of Public Affairs, Michael Reese Hospital and Medical Center, Chicago; faculty, Grand Valley State College, Allendale, Michigan. Address: 2729 West Lunt Avenue, Chicago, Illinois 60645.© 1983 by The University of Chicago. AU rights reserved. 003 1-5982/83/2604-0356$01 .00 Perspectives in Biology and Medicine, 26, 4 · Summer 1983 | 587 The nature and quantity of medical information in the mass media of communication have changed dramatically in the short time span ofhalf a century. However, medical writing and editing, the substance and the process, have not changed enough, have not caught up with the available technology. Technology has caught up with, and passed, many other professions as well. Electronics enhance and accelerate every task which a human can perform. But it is not enough to learn to use a computer to help prepare text, edit it, and convert it to type for printing. Those who write about the latest advances in medicine and science too often ignore the impact which technology has on the communication of medical information to the public. The old ways are not good enough in our electronics-quick society. Virtually the entire United States and Canada have instantaccess to the rest of the world through the electronic media of radio and television. The channels of access are quickly multiplying as cable and coded broadcasting enter our living rooms. There are no longer four channels, or even eight, but 20 or more. And beyond cable are the earth stations—those dish antennae, pointed to communications satellites, which are sprouting at homes and motels. And health and medicine claim a larger-than-proportional share of this flood of information. But we medical communicators are not keeping up. The patient who enters the doctor's office is already armed with facts and opinion from "60 Minutes," "Quincy," and the Reader's Digest. She is getting her information, distilled and digested, well in advance of the doctor who is waiting to examine her. The doctor probably does not use the mass media as a source of medical information. Instead, she would rather get that from meetings and from the journals. Examine this tableau a little closer. The doctor's information is pretty much what she learned back in medical school and during her internship and residency some years ago. The patient...


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