Running Head: WRITING AND ITS ROLE IN PRIMARY CARE

Writing and its Role in Primary Care

Andy Tan – Northeastern University

ENGW3306 – Laurie Edwards

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The practice of medicine in the United States is too often focused on treatment.

Physicians are taught to battle chronic diseases, such as cancer and diabetes, yet it still accounts

for 7 out of 10 deaths among Americans each year (Cdc.gov, 2017). These chronic diseases,

however, can be largely preventable through close partnership with one’s primary care. Primary

care physicians serve as the forefront of preventive health because they are commonly the first to

see signs of depression, cancer, and other health concerns. Preventive health is an important

component in primary care. Working as a medical assistant in Healthcare Associates (HCA),

Beth Israel Deaconess Medical Center’s primary care department, I’m required to ask patients

whether they had a colonoscopy, mammogram, and/or pap smear done recently, and if not, when

their last one was; it is recommended for men and women to get screened for colorectal cancer

once they reach the age of 50, for women to get screened for breast cancer every 2 years once

they reach 40, and for women to get screened for cervical cancer every year (Pacificsoure.com,

2018). I value this part of my job because it ensures that each patient gets the right care in the

right setting in an effort to ultimately predict the start of a disease and stall its progression.

Communication and different genres of writing, especially in a primary care setting, are

essential for delivering high quality care. Lab reports, whether it is from a colonoscopy,

mammogram, or pap smear, are all genres of writing used to communicate results to the ordering

physician in which they can then reciprocate to their patients in simpler terms through means of

letters and/or telephone contact. At HCA, patients get sent a letter if their lab results are normal

whereas patients get a phone call if their lab results are abnormal to schedule a follow-up visit

with their primary care physician to discuss their next step. As an aspiring physician, I will be

using these tools and genres of writing to give accurate diagnosis, provide appropriate
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consultations, and establish caring relationships with patients all in the hopes of achieving the

best outcome and patient satisfaction.

Communication and collaboration in the primary care setting exist beyond that of a

physician and their patients. It encompasses other healthcare professionals as well as experts in

other fields such as engineering and technology. Many of the lab reports are stored in the

practice’s online medical records (OMR), another form of genre in this setting. Medical

assistants can access it to input a patient’s vital signs. Triage nurses can access it to refill a

patient’s educations or send prescription pre-authorizations. Physicians can access it to view a

patient’s vital signs and add progress notes. All in all, OMR is a form of collaboration among

different healthcare professionals to create a continuous flow of care for one specific patient.

In a world that is constantly evolving, primary care physicians often find themselves

participating in monthly lectures and conferences to discuss new research and innovation that

can help improve care to their patient. These conferences are often given by healthcare

professionals but experts from other fields are also welcomed to share their idea, such as in

Gabriel Otte’s TEDMED talk: What If We Can Detect Diseases So Early That We Can Avoid

Them Altogether. Otte is the CEO and co-founder of Freenome, a “health technology company

reinventing disease management through systematized early detection and intervention”

(TEDMED, 2017). As a software engineer and entrepreneur, Otte gives a two-minute speech

about Freenome and its ability to be the next innovation in bringing “accurate, accessible, and

non-invasive disease screening” (TEDMED, 2017) through a tube of blood.

Otte began his speech by comparing our health to a rubber band. He used a simile, “our

health is like a rubber band, resilient and capable… until its stretched and at some point cannot

ever be restored” (TEDMED, 2017). By doing such, he established a problem that is current and
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evident in our healthcare system – we are focusing too much on tertiary care and providing

treatment. Otte’s use of simile also served as an attention grabber not so much for the healthcare

professionals in the room but rather for the general public; using a mundane object to describe

something so complex allowed the audience to personally visualize the bigger problem.

Otte’s two-minute speech is reminiscent of a business pitch, when most of the time what

was said is less important than how it was said. Qualities of effective business pitches include

getting to the point fast, establishing the need, and having a multilevel tone when speaking

(OPEN Forum, 2013), all of which was evident in Otte’s TEDMED talk. Otte spoke in a

colloquial yet persuasive tone: “we’ll do this with the combined advances in life sciences and

technology so that one simple tube of blood can give us affordable early detection of age

associated diseases… giving them the highest quality of being cured” (TEDMED, 2017). He

used no medical jargons so that both health professionals and the general public will understand

his solution to the problem he addressed earlier. Otte was also effective in using a multilevel tone

when speaking. He emphasized on words such as “technology”, “simple”, “affordable”, and

“highest quality” which highlighted the mission of Freenome and ultimately the core value of

primary care – using simple and affordable technological advances to provide the highest quality

of care. Otte’s talk was short and concise, however, it still left many, including myself, to

question how this new technology actually works. Otte might have strategically left this out as it

would deviate from the effectiveness of his “pitch” and cause more confusion for the audience

with varying levels of knowledge. He did, however, leave his website to allow those who are

interested to dive deeper into Freenome.

Otte’s TEDMED speech and website are two forms of genre that addressed the same

message to the same audience with varying similarities and differences in style and form. Upon
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entering the Freenome’s website, one can notice the immediate difference it had with Otte’s

TEDMED speech. While Otte’s speech was more colloquial and persuasive, the website

appeared to be informative and used more medical jargons: “using artificial intelligence (AI) and

biomarkers to map out cell-free (cf) genomes” (Freenome, 2018). The website, however, did

define a lot of the medical jargons in simpler terms: “cfDNA – provides insights into immune

response; cfRNA – records which genes were actively expressed” (Freenome, 2018). Healthcare

professionals obviously understand these medical jargons but defining them also helped the

general public comprehend it more easily. The layout of the website was simple and easy on the

eye with important words such as “lifesaving”, “early detection”, “optimizing treatment”

enlarged and bolded on the homepage. Similar to how Otte emphasized certain words in his

speech, enlarging and bolding the words on the website also highlighted and educated the

general public of Freenome’s mission. It is important for this website to exist in conjunction with

Otte’s TEDMED speech since it served as a bridge that connected interest with information.

Communication in primary care exist through many genres of writing, fostering

collaboration between patients, physicians, healthcare professionals, and other experts of varying

fields. Specifically, Otte’s TEDMED speech created a relationship between physicians and

experts in the engineering and technology field. This alliance would facilitate better

conversations between primary care physician and their patients. Communication, and ultimately

collaboration, among all these members in the primary care setting can shift healthcare from a

disease-oriented system to a primary care system where chronic diseases can be detected early

and prevented.
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REFERENCES

Cdc.gov. (2017). Preventive Health Care | Gateway to Health Communication | CDC. Retrieved

from: https://www.cdc.gov/healthcommunication/toolstemplates/entertainmentd

/tips/PreventiveHealth.html

Freenome. (2018). Detecting Cancer Early with Cancer Screening Blood Tests. Retrieved from:

https://www.freenome.com/our-work

OPEN Forum. (2013). 12 Easy Steps to a Perfect Pitch. Retrieved from:

https://www.americanexpress.com/us/small-business/openforum/articles/12-easy-steps-

to-a-perfect-pitch

Pacificsource.com. (2018). The Importance of Preventive Care. Retrieved from:

https://www.pacificsource.com/preventivecare

TEDMED. (2017). The Hive Program. Retrieved from: https://tedmed.com/event/the-

hive#startup-item-692630