Is Medical Writing Really a Profession in Practice?

I’ve been reading a book by Donald Schön, The Reflective Practitioner: How Professionals Think in Action, that has got me thinking about the working definition of the term “profession” and whether this term is appropriately applied to the field of medical writing. I am not sure it is for the following reasons.

When considering medical writing as a profession then one must ask whether the knowledge base of medical writing has the requisite properties and whether it is regularly applied to everyday problems of practice. Many who work to define professions state that the systematic knowledge base of any profession is thought to have 4 essential properties:

1. Specialized
2. Firmly bounded
3. Scientific
4. Standardized

Some would suggest the above parameters make Medical Writing a good fit under the moniker of profession. However, I call into question how many medical writers really look closely at the disciplines of writing or knowledge management. Much output I see and many conversations I have with medical writers suggest many write to standards bounded by myths and personal preference and not driven by the evidence of science.
Edgar Schein suggests there are three well-defined components to professional knowledge:

1. Underlying discipline or basic science
2. Skills and attitudinal component
3. Applied science component (yields diagnostic problem-solving techniques to the actual delivery of the services)

I would find that Medical Writing fails to be a true profession as suggested by Schein’s criteria. I see the central gap being the failure to develop a general body of scientific knowledge bearing precisely on the problem of effective and efficient medical writing practices. I say this because of my McCulley/Cuppan work where I have many observations of how medical writing is considered and applied in the pharmaceutical and medical device industries.

For Schein, basic and applied sciences are convergent whereas practice is divergent. This suggests that the hallmark of the true practitioner is the ability to take the convergent knowledge base and convert it into skills and services that are tailored to the unique requirements of the client system—a process that demands divergent thinking skills. My observations suggest that many who operate under the aegis of medical writing are poorly placed to engage in effective, meaningful divergent thinking. The preferred thought pattern is at best the convergent model of “what did I/we do last time?” and at worst “just let me populate the tables and make sure this document is compliant with the template and ICH E3 guidance."

I think I am largely in the camp of those who would call Medical Writing something besides a profession. But I am certainly not with those who would suggest it is but an avocation. Frankly, such a description is quite derisive.

I find myself considering applicable to medical writing the Grady McGonagill position that those who rely on intuition and reflect on their work only episodically risk accumulating unintegrated clusters of habitual practice. They may develop to a level of competence but not beyond. I’d say this is a reasonable description that fits the largest cohort of those who work under the mantel of medical writing.

So what do you think—is Medical Writing truly a profession in practice?


Originally published on our Knowledge Management blog