Random Tips from ASJA 2014

I just returned from the annual American Society of Journalists and Authors (ASJA) conference and wanted to share some tips I took away from it.

–If you’re interested in getting content marketing gigs, send lots of letters of introduction. 20-30 letters is not a lot. Send hundreds. It’s a numbers game, says Jennifer Goforth Gregory.

–To get some content marketing gigs, you may need a strong social media presence, even a high Klout score, says Land du Pont of Federated Media. For these gigs, you might be sharing your work on your social media channels.

–“Don’t tell me you have 9 specialties – I won’t think you have any,” says Dan Davenport of Meredith Xcelerated Marketing (by the way, he also hates the incorrect spelling of Xcelerated – I have to admit, I was glad he said that!).

–Dust off your resume for content marketing agencies, because many of their clients want to see it before you get hired for a gig.

–Conferences like this are about building community, not just networking.  The community can motivate you and can give you what you want in terms of work, but you have to put yourself out there saying who you are, why what you do matters, and what you want. If people know what you do, they can give you work

–“I don’t think you realize how good I am. No writer should say that,” says Daniel Jones, editor of the Modern Love column at the New York Times.

–Modern Love receives 6,000 submissions  a year for 52 slots. About 1 in 12 of essays run resulted in book deals.

–For science pitches, it’s more important that you have a great pitch, than you have a science background or top notch publication experience. Editors may look at your background and clips, but less than you’d think. Your pitch speaks for itself.

–Persistence in all things. Pitching. Reporting. Investigating. Following up.

–(Some) pitches can be very short. Editors will ask for more information if they’re interested.

–If you don’t want to pay for coaching, find an accountability partner or group, do the foundational work (introspection, develop insights and test them) and then make changes. It’s hard work and you can get there on your own if you’re open to learning from others and digging deep within yourself.

–Observation (not a tip): It’s funny to see someone at the conference who you’ve know from two writer groups and Facebook for a very long time, but every year at the conference, this person sports a blank look when seeing you, clearly with no clue who you are, even after you act friendly and remind the person of your name. And this happens every year.

–Mentoring writers through the ASJA mentoring program is beneficial. You realize you know more than you thought, and your mentee takes home actionable tips to improve their careers. You might even see the AHA! light go off while you talk. It’s inspiring to see the professional strides made by my mentees from past years.

–If you want to go out while at a conference, don’t sit around waiting for an invitation. Plan something yourself, inviting people you want to hang out with or putting a blanket invitation out there. You’ll get more takers than you expect, and people appreciate it.

–I’ve gotten a lot of work from fellow writers I met at the conference, not just the editors/panelists. Walk up to random people or introduce yourself to the person sitting next to you, and stay in touch.

Additional reading:

My live tweeting from the conference

The #ASJA2014 tweet stream

Kelly James-Enger’s best tips from the ASJA conference 

Jennifer Goforth Gregory’s 5 best tips

Vanessa Lewis’ tips

Stephanie de Ruiter’s take on Constance Hale’s Sassy Sentence and Wicked Good Prose panel

Review: Blood Work: a Tale of Medicine and Murder in the Scientific Revolution

I went to the ASJA writing conference last year and met Holly Tucker, a dynamic Vanderbilt professor who has joint appointments in the department of the history of medicine and the department of French and Italian. When she heard I was a medical writer, she eagerly told me about her upcoming book, Blood Work: A Tale of Medicine and Murder in the Scientific Revolution. I couldn’t wait for it to come out!

In the book, the history of blood transfusion is wrapped around a historical murder mystery involving a French physician, Jean-Baptiste Denis, whose experimental transfusions were as much about trying something new, as it was making himself rich and famous. Denis had a fair number of detractors who wanted the transfusions to end. Continue reading

Medical Students Assessed on Personal Skills

When I was a medical malpractice investigator, it was common knowledge that a doctor’s poor communication skills often contributed to patient claims, and that a doctor with a great relationship with a patient could sometimes make a mistake and still have the patient on his/her side. The Closed Claim Project confirms this. They note that with two physicians equal in all other ways, patients who sue their doctors tend to more unhappy with the relationship they have with their doctors, than the actual outcome of the care.

With this in mind, it was gratifying to read a New Jersey Star-Ledger article recently, which showed a new program used for medical students interviewing at Robert Wood Johnson Medical School. Instead of just being assessed on educational background and a personal interview, they’re now assessed partly on their ability to deal with people. They use a structure called a multiple mini interview (MMI). It’s  described as “medical admissions speed dating,” focusing on treating patients as people, not symptoms.

The students go into six to 10 different rooms in short order, pausing first to read a scenario, question or task which may involve a doctor’s personality and possible ethics issues. They then share their insights with the interviewer. The program was developed at McMaster University in Canada, and is used by 17 medical schools there. A handful of schools in the U.S. have adopted it too.

I think that’s a great approach. I recently finished writing a hospital newsletter (volume III) and was impressed writing about an award one physician received from his surgery students. One reason the students liked him so much is that he actually inquired about their personal lives, to see them not just as students, but as people. The resident giving the award said “by the end of our four years…he has somehow learned more information about our personal lives than our parents.”

That’s exactly what patients want as well. To be treated like a person and not a symptom. It’s a good lesson for the medical community.

Second opinion

Drug Firms Paying Doctors

When a doctor prescribes a medication to a patient, most patients don’t question how much the doctor knows about the drugs, or where they got their information.

When I investigated medical malpractice claims, I was usually the only person in the doctor’s waiting room in a suit. Unless there was a drug rep there. We’d smile at each other, and the drug rep would sometimes ask what drug company I was from. I wasn’t allowed to tell them I represented the doctor’s professional liability carrier. I just said I was there on business. I’d hand my card to the receptionist and the rep would look annoyed when I got called back before he or she did.

Drug reps are one way that doctors learn about drugs. These reps, often attractive, young men and women, tote in samples, pamphlets, candy and often lunch (I benefitted from this food too – sometimes the doctor and I would grab sandwiches to eat during our discussion, or they’d give me pastries to take home).

Doctors are in on the goods too. A recent investigation by ProPublica detailed how. For example, over 18 months, seven New Jersey physicians were paid between $100,000-$212,000 to talk up specific pharmaceutical products in medical conventions, conferences, consulting and lunch-and-learns.

This is not news in the industry, but bringing the actual numbers to the public eyes is a good way to question the ethics.

Earlier this year, NPR’s Fresh Air had an interesting interview with Dr. Daniel Carlat. He wrote the book Unhinged: The Trouble with Psychiatry – A Doctor’s Revelation about a Profession in Crisis.

The book topic merits its own blog post (the premise being that many doctors are abandoning talk therapy and just prescribing medications, partly due to time and financial issues). In the Fresh Air interview, Dr. Carlat talks bout his experience getting paid by Wyeth to give other doctors information about depression and its treatment, including the use of Effexor (that part of the interview starts at 25:17). When he started doing these lunch-and-learns, he was getting paid to tell doctors what he already believed about treating depression, and using Effexor as part of that (along with a slide deck supplied by Wyeth). Dr. Carlat’s message coincided with Wyeth’s marketing message.

As time went by, Dr. Carlat realized he was being influenced by the payments, and found himself embellishing Effexor’s positive effects, and diminishing his talk of side effects. He felt the pressure from having the drug rep in the room listening to him, and felt he needed to keep up the positive talk if he wanted to keep earning money from these “educational” seminars. At one talk, Dr. Carlat told the doctors that the studies on Effexor’s benefits were based short term studies, and that if the studies were longer, that Effexor might not be advantageous over other options. That turned out to be his last talk. The drug company expressed concern, and Dr. Carlat realized he wasn’t useful to the company when he gave the unvarnished truth – only when he towed the line.

Listen to the whole interview here and read Dr. Carlat’s account in his New York Times Magazine story here.

To be sure, using doctor to sell to doctors in an educational format is effective. These doctors are seen as peers and thought leaders. When you see someone speak at a conference, you don’t automatically assume they’re being paid to do so (though often there’s a written acknowledgement of a financial relationship in the conference brochure). Doctors may learn something about a topic they’re less familiar with from these paid speakers. But the teaching may be unintentionally (or even intentionally) biased.

How does this affect patients? On the plus side, doctors might be better educated about a specific disease or treatment. But patients might also get prescribed a drug based on learnings from a biased seminar. Or they might be prescribed a drug without knowing that the drug company is monitoring and rewarding doctors for their prescription patterns – whether or not its the best drug for the patient.

It would be nice to think doctors are independent of this, but throw money into the mix, and it just muddies the water.

For more information:

–ProPublica broke the story with detailed analysis and databases on what pharmas paid to what doctors. Read more here:

Profiles of the top-paid doctors

Not all the doctors on pharma payroll have good credentials, according to ProPublica

New Jersey doctors on the take

Why you should check out your doctors

It’s easy to sensationalize something as strange as butt implants. Today’s Star-Ledger has a story about six women who are now hospitalized after getting injections to increase the size of their rear ends.  These women unfortunately went to an allegedly unlicensed practitioner. Instead of receiving medical-grade silicone, they got a diluted version that you’d use to caulk a bathtub. There’s an image I’d like to forget.

When I worked as a medical malpractice claims investigator, one of my (frequent) clients was a cosmetic surgeon (his specialty was otolaryngology). Not a plastic surgeon – there’s a difference (you’ll get an earful if you ever mix them up in front of a plastic surgeon). My client got in trouble after a calf implant procedure didn’t take. He also had claims filed against him from a man who received pec implants, and a woman receiving a chin implant. Had he done many of these procedures before? No. Was it beyond the scope of what an otolaryngologist should be doing? Well, that was up for debate. The doctor wasn’t criticized for going beyond his scope of expertise with the chin implant, but the pec and the calf implants were harder to defend. He received medical training in those areas, but the expert plastic surgeons we (and the plaintiffs) hired, had a field day.

What was the lesson learned? As a patient, make sure your physician has performed MANY of these procedures before, so you’re not in the guinea pig group. And make sure you’re going to the right specialist for the procedure. The other lessons learned? Check out your doctor before you agree to a procedure. A few places to look:

-State Licensing Boards. The American Medical Association has a list of state medical boards on its website. You can look up whether the doctor is licensed, and often whether there’s been any actions against that physician. I looked up the otolaryngologist, and found that he completed his probation, there was a malpractice award against him, and he had a citation resolved. Is this helpful to a potential patient? You bet.

Health Grades – you can look up 750,000 doctors across the country. While the patient reports can be helpful, take them with a large grain of salt. I again looked up the otolaryngologist, and there were 8 positive patient ratings. Based on the ratings, I would go to this physician. But the background check (which I didn’t run) should show his disciplinary actions, confirm whether he’s board-certified, and more. There’s a fee for the background check ($12.95), plus you may get charged more for their ‘watchdog service’ if you don’t cancel in 14 days.

-Ask for references. Of course the ones the physician gives you will probably be glowing. Ask around. Speak to others who have had the same procedure, so you’ll know what to expect in terms of healing and complications. Ask whether the doctor was easily accessible after the procedure, if you had questions or concerns.

-Make sure you know the risks involved with the procedure. Ask about the worst possible things that could happen. The doctor will give you an informed consent form to sign – it’s often generic, and will list complications like death and unforseen consequences. Ask the doctor for specifics. Granted, bad results can always happen, even to the best of physicians. But if you’re aware of the potential complications, and you’re still game for the elective procedure, then it’s buyer beware.

Developments in Medicine – Dr. William Halsted

Years ago, I worked for the publisher who produced The Face of Mercy: A Photographic History of Medicine at War. It was fascinating to read about the medical advances made during wartime.

These days, we tend to take for granted the use of sterilized equipment, anesthesia and life-saving surgical techniques. Sure, the problem of hospital-aquired infections is still a big one. The epidural during labor isn’t always 100% effective. And the surgery that’s supposed to irradicate a disease sometimes misses some of the diseased cells. We do have have advantages, though, that weren’t available 140 years ago, when physician William Stewart Halsted was practicing.

Last month, the NPR program Fresh Air featured a fascinating interview with author Gerald Imber. He wrote the book Genius on the Edge: the Bizarre Double Life of Dr. William Stewart Halsted.  Halsted was quite the medical pioneer, starting the first residency program and developing the radical mastectomy (lowering the cancer recurrence rate from 100% to 50%). Halsted was the first medical practitioner to implement rubber glove use – after a nurse developed dermatitis issues from Halsted’s mandate that staff clean their hands with mercuric bichloride. He was the first documented physician to do a blood transfusion, using several syringes of his own blood, to revive his sister who hemorrhaged after childbirth.

Halsted performed the first gall bladder surgery – on his mother, no less. He saved her life – especially since he steralized his tools with carbonic acid, lowering the risk of infection from the operation. He realized the value in steralization and tried to convince New York City’s Bellevue Hospital, where he practiced, to build him a sterile operating room. They laughed at him, so he raised the money himself, building a antiseptic operating tent outside on hospital grounds.

Of course not all his discoveries were healthful ones. Cocaine was known to be a numbing agent, and he experimented with it, trying it first on himself and then on his students and patients. Halsted became addicted, as did his students. However, he realized that anesthesia could be used to numb a larger area of the body, resulting in general anesthesia. His research into anesthesia won him awards from the American Dental Association.

I’d recommend listening to Terry Gross’ interview with author Imber. You can listen on your computer or download it to your MP3 player. Then get the book. It’s now on my reading list.