John P. Gonzalez, PhD, ISMPP CMPP, Solanum Medical Communications Ltd.; Paul A. Petruzzi, DLitt, ISMPP CMPP, The Lockwood Group

A famous quote often attributed to Margaret Thatcher, former Prime Minister of the United Kingdom, and others should provide caution: “Watch your thoughts for they become words. Watch your words for they become actions. Watch your actions for they become habits…” (1)

In medical publications, development of a lexicon or vocabulary document is generally considered an essential requirement for publication planning activities. Rigorous research is undertaken to develop scientific and technical terminology that is consistent and clear, and that can be applied through the lifecycle of the product. However, beyond the product lexicon, the language used by medical publication professionals also deserves serious consideration because language gives insight into intent, which can easily be misinterpreted.

Medical publication professionals work in a highly-visible, highly-regulated environment and must adhere to government regulations, industry guidelines, society or journal requirements, and good publication practices (eg, GPP3). Although these sources do not provide specific guidance on the “do’s and don’ts” of appropriate language, it is useful to develop a lexicon that supports the tenets and principles that they contain. It is also important to note that, in general, marketing terminology and commercial jargon (eg, KOL) should not be part of the language used in conjunction with medical publications. For example, the objective of a review article is to summarize recent peer-reviewed publications and not to “set the stage” for the introduction of a new product. Similarly, publication plans are designed to ensure timely data dissemination and that a body of evidence is accurately reflected in the literature rather than to “increase share of voice.” Terms used in publication planning and publication development are best when they are accurate, avoid possibly negative connotations, and precisely describe the objective of the publication.

Colloquialisms may creep into the lexicon and, for example, prompt references to authors as “key opinion leaders” or “KOLs.” Jargon used in casual conversation or internal briefings may inadvertently become default language, which may spill into more formal conversations with authors, editors, and other colleagues. It is particularly important to be mindful of the language used in email. Anecdotal reports note that >100 billion business emails are sent and received every day. The sheer volume and immediacy of email may invite a prompt and casual response, rather than invoke time for thoughtful and selective choices. As email is permanent, forwarded, and discoverable, it is beneficial to ensure that the language used is accurate, cordial, and appropriate to the task at hand. Email and its content, when released into the public domain, can result in consequences ranging from simple embarrassment to Corporate Integrity Agreement or other (eg, lawsuit) punitive fines and requirements. Email is also subject to interpretation depending on the perspective of the reader. For example, the use of phrases, such as “influencing or changing physician behavior,” could be interpreted as anything from getting physicians to improve clinical practice and patient care, to potentially influencing prescribing decisions.

The following are some examples of terms that may be best avoided, suggestions for preferred terms, and a brief rationale.

Terms to Be Avoided Preferred Terms Rationale
Key opinion leader, KOL External medical expert, subject matter expert, specialty expert KOL suggests influence vs an acknowledged expert in the field
KOL mapping Desk research conducted to identify medical experts While “mapping” is a term used in medicine (eg, gene mapping), in the context of publications and author selection, it can suggest selection based on influence
Key messages Scientific communication points


“Messaging” is a commercial term that is often associated with promotion vs publications


Compensation or fee for service Honoraria is associated with a payment made to acknowledge academic or scientific status vs a fair market value payment for a service provided
Increasing share of voice in the literature


A complete literature base that accurately represents the totality of the research conducted Publication plans are developed to disseminate data from a research program and should not be “inflated” by “slicing” data sets to generate additional publications
Publish data in order to influence prescribing habits and change physician behaviors Publish data to enable clinicians to keep up-to-date with advances in their field Medical publications are developed to educate, inform, and provide a rationale for clinical decision-making vs influence
Up-and-comers, rising stars Emerging investigators or researchers Up-and-comer and “Rising Star” (possibly a term borrowed from Hollywood) do not accurately represent the position of scientists who are early in their career and can imply that these individuals may be readily influenced
Relationship building Expert medical engagement “Relationship building” implies that there is an effort to influence the researcher to participate in certain activities; while this may be fine for online dating, it does not have a place in medical publications

Awareness of the impact of verbal and written language should become culturally embedded in an organization. At a practical level, the language used to describe services on websites and printed materials should be reviewed on an ongoing basis to ensure alignment with compliance and similar guidelines. In addition, emails and templated correspondence can be regularly audited, and rogue language routed out. Otherwise, a “swear box” in the meeting room is a useful and humorous tool to remind everyone to “mind their language.”

Disclaimer: The opinions expressed within are the authors’ own and do not necessarily reflect the views of the authors’ employer.



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