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Q
What are the pros and cons of different types of 
medical writing (ie, pharmaceutical/biotech, 
regulatory, managed-care industry, the 

publishing industry, public relations, lay press, public 
health, nonprofits, and hospital/university)?

A
My 20 years as a full-time writer/editor at a research 

facility attached to a hospital included the prepara-

tion of texts for journal publication, talks for meet-

ings, editing of books, and management of 13 annual 

reports. This wide range of experiences led to not only sub-

sequent employment at a pharmaceutical company but also 

access to contacts as a freelancer for clients in 6 countries. 

Obvious advantages of the full-time situation, of course, are 

steady salary, benefits (insurance, etc.), and retirement plan, 

all based on that of a university medical school. Less obvious 

is the personal growth in skills and opportunities, for exam-

ple, company-paid membership in the American Medical 

Writers Association (AMWA)! The only real disadvantage was 

time constraints, such as limits on vacation time.

 Afterward, when a new Director of the institution 

replaced me and much of the former staff, my subsequent 

job was as freelance writer for a commercial pharmaceu-

tical company. Advantageously, the hourly pay was about 

1½ times higher than before. Sometimes I could work from 

home, and because the company freelancers were a team, 

I could choose amounts of time off. The disadvantage that 

surprised me was resentment from my full-time colleagues 

that I could come and go at will.

 Finally, I became a roving freelancer. I am still amazed 

that post docs from early in my full-time research-institution 

career had advanced to become department heads, particu-

larly in China and Japan, and requested editorial services at 

my choice of cost/hour. However, that situation included the 

disadvantage of a lag in time of payment, sometimes weeks 

or months after completion of a project, because the clients 

preferred to lump costs together.

 This saga would not be complete without citing the 

advantageous gift of AMWA membership, which provided 

professional contacts and teaching opportunities that did 

and still do underlie my career. 

— Phyllis Minick

 Although I have worked for all of the above industries, I 

will focus here on the area of my most extensive experience: 

pharmaceutical/biotech companies. All of these companies 

need medical communication professionals. Many people 

think that the industry is all about regulatory affairs; it is not. 

Regulatory affairs work is its own thing, often quite apart 

from other areas of the industry. For example, departments 

aside from regulatory affairs that generate work for writers 

and editors in a pharma/biotech company may include the 

following

• Advertising

• Animal sciences

• Biological sciences

• Clinical research

• Corporate communication (public relations)

• Corporate or product development

• Human resources

• Marketing communication

• Medical affairs/medical services

• Medical communication

• Pharmacology

• Professional training and education (for non-MD health 

care professionals)

• Sales training and communication

• Website management

 Thus, one could say that medical communication in 

pharma/biotech includes virtually every aspect of commu-

nication, a wide variety of target audiences, and all media. 

As an employee and later a freelancer, I have worked for all 

of these departments.

 For years, I contracted directly with the companies, 

but today, most companies (the larger ones, at least) prefer 

to hire outside agencies to handle their writing/editing/

communication needs. For regulatory affairs and clini-

cal research projects and reports, a contract research orga-

nization is used; for most other communication projects, 

agencies for MedCom, continuing medical education, adver-

tising, or sales training are hired. 

 As a freelancer, some advantages of contracting directly 

with a company include more intimate contact with the 

players; the ability to call an expert in the company any time 

you need to, generally a higher rate, and a feeling of being 

FREELANCE FOCUS

Brian Bass Lori De Milto Phyllis Minick



      AMWA Journal / V36 N2 / 2021 / amwa.org    83

more immediately connected with the entire process, whether 

it be medical affairs, marketing, or regulatory affairs. When 

contracting with an outside agency, you are one step removed; 

you generally are paid a bit less because one must consider 

the agency’s need for profit/markup, and you sometimes get 

paid late (some agencies even ask the freelancer to wait until 

they have been paid before paying the freelancer). Moreover, 

depending on the agency, they may be rather paranoid about 

allowing you to speak directly with the pharma/biotech client, 

ie, worried that the company might want to hire you directly. 

So, usually you must sign a “noncompete” agreement in addi-

tion to the nondisclosure agreement, and sometimes negotia-

tions over the reasonableness of such contracts can become 

complicated.

 Regardless of whether you contract with a pharma/biotech 

company directly or through one of their agencies, there are 

many advantages to working in this industry, a few of which 

include

• A chance to work on a wide range of projects and/or thera-

peutic areas 

• A plethora of work because of the vast number of such  

companies and agencies 

• The opportunity to work with intelligent people and teams 

• The joy of being able to work on projects that are genuinely 

interesting and fun (usually when working in MedCom, 

Marketing, Sales Training)

• Interesting travel opportunities paid by the company

• Helpful education and training

• Generally a higher hourly rate than paid by other industries

 There are, of course, also some disadvantages as well. 

Below are some that are mostly related to regulatory affairs 

(although some of these can been seen as advantages if you 

enjoy studying and learning): 

• You must study and understand well the industry as a whole, 

including the process of proving new drugs, devices, or bio-

logicals.

• You need to be comfortably familiar with Food and Drug 

Administration regulations and guidelines in general as 

well as those relating to the production of specific types of 

reports and clinical summaries. 

• You should understand thoroughly the structure and con-

tents of an NDA submission (ie, the Common Technical 

Document), even if you are writing only a specific segment 

or section of such submission. 

• You may end up with a team (in-house or in-agency) filled 

with tension and fear because their bonuses and raises 

depend on achieving milestones and deadlines demand-

ing enough to increase your stress level, to say nothing of 

the horrendous stress level of the associates with whom 

you end up working. (In this regard, the agencies do have 

more burden, because they contract with the companies for 

extremely high dollars and are liable for errors and omis-

sions for which a freelance writer in pharma/biotech should 

never accept liability.)

• You could be working with an inept Project Manager and 

thus find yourself receiving a “data dump” that takes hours 

to dissect and organize, leading to “scope creep” that 

requires you to fill the role of Project Manager, which func-

tion should pay more; thus, you may have to renegotiate 

your fees (I charge ≥30% more for project management and 

organization than for writing.)

• You could find yourself in the uncomfortable position of 

having to tell the company or agency employees that their 

“ask” would violate ethics as well as regulations. This could 

be about a particular “spin” the client wants you to create 

from clinical study results (eg, in a Clinical Study Report or a 

journal article), claims a marketing group wishes to make in 

collateral materials for sales representatives and/or health 

care professionals, hiding or omitting data that are unflatter-

ing to the company, and other questionable practices.

 Overall, the pluses outweigh the minuses; otherwise, I might 

have dedicated most of my career to working for nonprofits. 

— Cathryn D. Evans

 All types of medical writing have pros and cons. Although 

you should choose the type of medical writing you do, your 

background, experience, and writing skill are usually more 

important than your preferences. For example, regulatory writ-

ing pays more than other types of medical writing and is in 

high demand. But with my journalism degrees and my free-

lance experience in health care content marketing and health 

journalism, I’m not qualified to do regulatory writing.

 Likewise, many freelancers with clinical or scientific 

degrees and experience wouldn’t do well at what’s usually con-

sidered the more glamorous side of medical writing: public 

relations, content marketing, most work for patients and the 

public, and marketing-oriented work for health care profes-

sionals. You need very strong writing skills for this type of work.

 If you work with the right clients like I do, the pay for this 

type of work is very good but not usually as high as most other 

types of medical writing. The deadlines are usually much more 

reasonable than in other types of medical writing, and there 

are very few meetings or team-based work, which I like.  

 There’s a lot more freelance work in what I call clinical and 

scientific medical writing (pharmaceutical/biotech, regulatory, 

etc.) than the type of work I do. That’s good news because most 

medical writers have clinical or scientific backgrounds. 

 Learn more about different types of medical writing before 

deciding what might be right for you. Talk to other freelancers 

FREELANCE FOCUS



84    AMWA Journal / V36 N2 / 2021 / amwa.org        

about what they like and don’t like about their work. Look for 

courses, tutorials, and other opportunities to try types of medi-

cal writing that seem interesting to you.

— Lori De Milto

Q
Have you offered daily rates to your clients? If so, 
what are the situations in which daily rates have 
worked best for you?

A
I have never offered daily rates to my clients and 

would never do this. As freelancers, we need to have 

time for the inevitable revisions that come in when we 

aren’t expecting them and rush projects for good clients. If we 

agree to spend a full day doing work for one client, then we 

either can’t serve our other clients or we have to work too much 

to be productive.

 Also, under the Internal Revenue Service standard for inde-

pendent contractors, “the payer has the right to control or 

direct only the result of the work, not what will be done and 

how it will be done.” A daily rate could violate this standard. It 

is also very likely to be a problem in any legislation that might 

be passed, such as the PRO Act.

 In my freelance business, most days, I do work for 2 or 3 

clients. Although I occasionally spend all or most of one day or 

a few days on work for one client, I would never commit myself 

to doing this by offering a daily rate. A project rate is a much 

better way to bill clients. It gives clients the cost of the job for 

budgeting purposes and gives us the flexibility to do the job 

when it works best for us as long as we meet the deadline. 

— Lori De Milto

I have offered daily rates for projects requiring travel, eg, my 

hourly rate times 8.0 hours per day, including flying/travel time, 

regardless of how many hours are actually “worked” that day. If 

the client wants more than 8-10 hours of work in a single day, I 

charge my hourly rate for the hours above that. (I do not charge 

the time for going out to dinner with the group, unless it is a 

working dinner.) Otherwise, for most projects I simply charge 

hourly, although for some clients I will produce something for 

a fixed fee.

— Cathryn D. Evans

I don’t think it’s good idea to offer clients daily rates because 

it ties your value to your time, and there’s a finite amount of 

money any client will pay for an hour of your time. Worse yet, 

the thinking behind a daily rate is that the client’s giving you 

a full day of work, so your day rate should be discounted from 

your accumulated hourly rate for a day of work.

 First of all, the client isn’t doing you any favors because 

tying you up for a day keeps you from being able to juggle the 

other clients and assignments you have. Second, suggesting 

you give a client a break for a full day of work implies you don’t 

otherwise have a full day of work on your plate, because if you 

did, you’d make more money doing that work instead. Whether 

you really have a full day of work on your plate or not, your 

client should believe you do and pay you accordingly.

 That said, I do use a “daily rate” in my estimates for attend-

ing in-person advisory board meetings. Remember when they 

used to be a thing? My “daily rate” in those circumstances is 

actually a bit higher than what the client might pay as a cumu-

lative hourly rate. They’re taking me away from juggling every-

thing else on my plate, and sometimes, those days can be pretty 

long. The client is paying for my undivided attention, whether 

I’m actually in the meeting or traveling across the country to 

get to the meeting and get home. This also helps ensure that cli-

ents only take me out of the office when they really need me. 

— Brian Bass

FREELANCE FOCUS

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