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©2023 American Medical Writers Association. All rights reserved.  
ISSN 2163-5315

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Q1:  What are the potential benefits and limitations of 
using ChatGPT in medical writing, and how can these be 
mitigated?

Many writers in the continuing medical education (CME) 
field who have been exploring ChatGPT as a tool to gener-
ate ideas see at least 3 possible use cases. First, if you are 
unfamiliar with a disease state or therapeutic area at the 
beginning of a project, ChatGPT can be a valuable research 
assistant that rapidly finds information to help organize 
your thinking, generate feedback on your work, and sum-
marize research literature. You can ask ChatGPT to pro-
vide a targeted overview and an “at-a-glance” perspective 
on the basics. But that’s what you’ll get. You’ll still need 
to do a much deeper dive into the peer-reviewed and evi-
dence-based clinical practice literature. Second, some 
writers are using ChatGPT for efficiency gains. They create 
detailed prompts for ChatGPT to generate outlines for 
needs assessments and ideas for practice gaps. Writers I’ve 
spoken to who are experimenting in this way then vali-
date and build out practice gaps using the literature. Third, 
ChatGPT is being explored to support adaptive learning by 
generating patient cases, providing responses to learner 
questions about those cases, and prescribing relevant 
resources for additional feedback and remediation.
 In all these potential use cases, the key to any degree of 
success is prompt engineering that shares sufficient detail 
and clear parameters with ChatGPT at the outset. The 
downside is that there is absolutely no guarantee that the 
information ChatGPT returns will be in any way accurate, 
and it certainly won’t be supported by evidence. Several 
journalists and scientists have now drawn attention to inac-
curacies and false citations that ChatGPT generates because 
no one is fact-checking. If we cannot attribute claims to 
published sources, then we cannot use the content. So, if 
you are exploring ChatGPT, you’ll need to find and corrob-
orate the sources and rigorously fact-check the integrity of 
information it returns. In my mind, the time to check facts 
will swallow any efficiency savings. Using ChatGPT and 
other artificial intelligence (AI) tools to generate ideas and 

content could also nudge writers into sloppy habits. It’ll be 
easier to lose track of your source material if that material 
is not anchored to specific references. Another limitation 
is that ChatGPT does not have the capacity to notice and 
process context and cannot provide nuance or perspective. 
These are human characteristics. As a result, medical writers 
will and must remain the primary drivers of content integrity 
in CME and continuing education for health professionals. 

—Alex Howson

ChatGPT is a program focused on language-related tasks 
that “understands” natural language and can answer ques-
tions and requests. GPT stands for “generative pretrained 
transformer.” ChatGPT was developed by OpenAI and 
released to the public in November 2022. The public inter-
face was trained on information taken from the internet up 
through September 2021; thus, the information is slightly out 
of date, unless you input more recent information during a 
conversation. 
 The public interface is free and requires no setup. Once 
you provide your email address and a password, you can 
type in a question or a request. The best answers come from 
questions that are as specific as possible.

Benefits of ChatGPT
ChatGPT has several potential benefits for medical writing. 
In a webinar I attended, attendees from a medical commu-
nication (med comm) company noted that ChatGPT can be 
used as an initial research tool, for example, to ask for back-
ground or an overview of a therapeutic area. Here are some 
examples:

• “Provide peer-reviewed references for US colonoscopy 
guidelines within the last 10 years”

• “Explain current treatments for acute myeloid leuke-
mia to an oncologist in fewer than 500 words”

ChatGPT can help overcome writer’s block by providing 
a starting point, summarizing a group of paragraphs you 
upload, or suggesting ideas for slide titles. Here are some 
examples:

FREELANCE FOCUS

Melissa L. Bogen Alex HowsonBrian Bass Cathryn D. Evans Ruwaida Vakil

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• “Summarize the introduction and conclusions of the 
following publication as bullet points <insert content>”

• “Rephrase the following sentence to be more concise 
<insert content>”

ChatGPT can help repurpose material for different audi-
ences. It can rewrite scientific material in lay language; 
adapt training modules for physicians to ultrasound techni-
cians; or write a key opinion leader’s bio for a medical meet-
ing from a resume that you upload.

• “Write a 200-word biography of this professor of 
radiology to be shared with peers <insert complete 
resume>”

• “Rewrite this text to be language-appropriate for chil-
dren ages 9-12 <insert abstract>”

• “Turn this journal abstract into a slide presentation 
<insert abstract>”

ChatGPT helps spark the creative process by providing an 
initial summary of information but not final draft material. 
Humans are needed to apply thought and judgment to the 
proposed answers. It’s not doing all the work for you, but it 
can make some tasks easier.

Limitations of ChatGPT
You need to check all facts and the quality and accuracy of 
all references. By OpenAI’s own admission, ChatGPT may 
produce inaccurate information about people, places, or 
facts. In other words, it can say things that are not true. In 
a recent email exchange on AMWA Engage, participants 
noted that ChatGPT created fake references.
 Because of nondisclosure agreements in place, medical 
writers should upload only public data to this third-party 
application.
 ChatGPT uses personal information you provide to pro-
vide, administer, maintain, improve, and/or analyze its ser-
vices. Although ChatGPT provides information in its privacy 
policy on how you can opt out of their use of your content to 
train the models, uploading patient data and other private 
information would be a mistake.

—Melissa L. Bogen

In my opinion, the benefits of ChatGPT are in the eyes of the 
beholder. I don’t personally see any benefits from the medi-
cal writer’s perspective because the role of ChatGPT is to do 
the job of the medical writer. If we’re not doing the research, 
reading and synthesizing what we find, and distilling what we 
learn into clear, concise, and accurate language that is acces-
sible to our target audiences, then what are we doing? In that 
vein, ChatGPT has the potential to turn medical writers into 
reviewers, which may not be many medical writers’ cup of tea.

 ChatGPT has vastly deeper, broader, and faster access 
to information than medical writers will ever have. But 
currently, ChatGPT does not have the ability to filter infor-
mation from misinformation, and it cannot take responsi-
bility for its content as medical writers and authors must. 
If a reviewer wishes to question a sentence or a paragraph 
written by ChatGPT, who is there to ask? ChatGPT currently 
doesn’t have the capacity to explain or justify itself. It simply 
is. It is the medical writing equivalent of “because I said so.”
 So, who do I think can currently benefit from ChatGPT 
in the medical writing space? To a large degree, content 
mills, because they already don’t care about accuracy or 
accountability. Predatory publishers are another unscru-
pulous group that I think can immediately benefit from the 
speed and power of ChatGPT. But I do think there’s a legit-
imate side to ChatGPT’s potential as a medical writing tool 
by limiting the information it can source and what it can do 
with that information.
 For example, limiting ChatGPT to only the information 
contained within a specific set of resources and giving it a 
prescribed template in which to apply that information is a 
task for which I think ChatGPT is potentially well suited. But 
the content ChatGPT produces must still be reviewed, scru-
tinized, and when necessary, questioned. This may, in turn, 
create more opportunities for medical writers and medical 
editors who love to fact-check.

—Brian Bass

Benefits of ChatGPT include helping to amalgamate infor-
mation related to some of various research questions. An IT 
friend put >10 questions to ChatGPT on my behalf (because I 
have not yet started using it on my own computer). The ques-
tions related to medical/science issues, political topics, phil-
osophical/religious topics, and simple pragmatic queries. 
Many factual errors as well as errors of “narrowness” resulted! 
As well, it was clear that the AI may provide biased answers. 
 Serious questions, in my opinion, should not be put to 
ChatGPT (at least not at this time). Other alarming impedi-
ments include not providing published, bona fide (respect-
able) reference citations for ChatGPT’s opinions; one must 
specifically ask for references to be included; moreover, 
when we asked ChatGPT to include reference citations, 
some of them were incorrect ! Another danger is the risk/
temptation for a person to plagiarize ChatGPT (which has 
already plagiarized someone else, of course, with no attri-
bution). I suspect much of this is already taking place with-
out attribution. 
 I did, however, receive helpful information in response 
to a certain question: I had Googled and done other 
searches about growing a potted rosemary plant indoors. 
After several unsuccessful results, we finally got a very 

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helpful reply from ChatGPT, which not only amalgamated 
replies I had received elsewhere but elaborated more spe-
cifically on my geographic location, the dry climate, and 
high altitude. (In the end, after killing 6 rosemary plants, I 
learned that, in fact, the conditions inside my home are not 
amenable to growing rosemary. ChatGPT was the preferred 
source. So, I stopped wasting money on these plants.)
 At this time, I do not think we should be using this AI 
program for serious professional medical writing. Nor do I 
think we can do much to mitigate the problems other than to 
commit ourselves to doing our homework, maintaining our 
integrity and ethics, and not succumbing to the temptation 
of laziness, ie, allowing ChatGPT to do work for us that our 
human critical thinking/intuitive minds should be doing.

—Cathryn D. Evans

AI technologies such as ChatGPT have unleashed a 
Pandora’s box. Recently, Congress had the opportunity to 
hear from Sam Altman, the founder of OpenAI, the organi-
zation behind ChatGPT. Altman expressed concern about 
the potential for AI to spread misinformation, highlight-
ing the genuine threat it poses. In his address to Congress, 
Altman emphasized the urgent need for regulation to miti-
gate these risks. Although regulations are currently lacking, 
hopefully they will be implemented soon.
 As medical writers, we must grasp both the advantages 
and limitations of AI technologies. Despite the absence of 
regulation, AI is here to stay. We can harness the power of 
ChatGPT as an advanced search engine, but importantly, 
exercise caution and fact-check all the generated content. 
ChatGPT exhibits inaccuracies in developing references for 
its text; thereby, a critical evaluation of its generated refer-
ences is necessary. Some have drawn comparisons between 
ChatGPT and Wikipedia, with arguments against ChatGPT 
reminiscent of those once made against the reliability of 
Wikipedia. Nonetheless, Wikipedia has persevered and 
flourished despite the initial skepticism. Similarly, ChatGPT 
will continue to propagate and evolve, irrespective of 
whether we choose to employ it. 
 To illustrate the power of ChatGPT, I generated my 
response without the help of ChatGPT, and then I put my 
response in ChatGPT and asked it to expand on my answer. 
ChatGPT was able to summarize and expand on what I 
wrote while maintaining my ideas, focus, and flow. I did edit 
what ChatGPT generated, and what you read in the previous 
paragraphs is the result.
 Although AI may not yet replace medical writers, medi-
cal writers who utilize AI effectively could outperform their 
peers. AI should be viewed as a tool that complements and 
enhances our capabilities rather than directly threaten-
ing our profession. Adapting to this technology will enable 

medical writers to capitalize on the opportunities that AI 
provides while ensuring our continued relevance and suc-
cess in an increasingly AI-driven world.

—Ruwaida Vakil

* * *
Q2:  What ethical considerations need to be taken into 
account when using ChatGPT for medical writing, partic-
ularly in relation to patient privacy and data protection?

Bias, copyright, and informed consent around data use are 
serious ethical concerns with ChatGPT. AI like ChatGPT 
is trained on speech, text, and images it scrapes from real-
world content that is already in the public domain. Much 
of this content is structured by an existing inbuilt text and 
image bias that obscures heterogeneity in terms of gender, 
race/ethnicity, and other characteristics. Researchers 
like Timnit Gebru, founder and executive director of the 
Distributed Artificial Intelligence Research Institute, note 
that the data that large language models like ChatGPT 
encode are more likely to represent the perspectives of 
people who already occupy considerable internet real estate 
compared with women and people of color, who spend less 
time and have less access to determining online content. 
So, the idea starters and writing prompts that initially seem 
appealing as efficiency levers might already be culturally 
and racially biased, or at least lack cultural sensitivity and 
specificity. Unless medical writers are intentionally using 
ChatGPT and other AI tools through an equity and inequal-
ity framework, we will unwittingly reproduce bias. 
 Copyright implications for both image and text are also 
pressing. On the one hand, who owns AI-generated mate-
rial? The US Copyright Office is actively exploring this ques-
tion via a new initiative, but at the moment, if writers are 
using generative AI tools to create content, they do not own 
that content. Also, although many medical writers create 
content as employees or are bound by work-for-hire con-
tracts, if you use AI-generated content to write blogs or 
books in your own name, anyone can reproduce it without 
your permission. On the other hand, although copyright is 
meant to protect material that is the product of human  
creativity, various ongoing lawsuits point to the ways in 
which copyrighted materials are already being used to train 
AI tools like ChatGPT without attribution, compensation, or 
credit to their creators. 
 Another problem concerns the information we, as users, 
feed into ChatGPT. For instance, some clinicians have 
posted on social media how they are “testing” ChatGPT’s 
diagnostic capacities by feeding it anonymized history of 
present illness (HPI) data. Even if HPI data are anonymized, 
the data enter the public domain and are available to others 

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without patients giving consent for their own data to be 
shared publicly. 
 We cannot be Luddites and push against the tide of 
technology. AI is going to change communication processes 
and practices whether we like it or not. But the direction 
that AI takes is not inevitable. We can and must influence 
how tools like ChatGPT are applied in practice. 

—Alex Howson

I think there are several important ethical considerations to 
be taken into account with the use of ChatGPT for medical 
writing. First and foremost, ChatGPT lacks a moral com-
pass. Information that’s accessible is information that’s 
usable, whether it is accurate or inaccurate, biased or unbi-
ased, public or confidential. This is of particular concern 
with respect to protecting patient privacy and proprietary 
data in medical writing. I’m not a programmer, but it seems 
to me this challenge is potentially surmountable because 
the types of information that can reveal a patient’s identity 
are themselves identifiable and should therefore be able 
to be targeted as “off limits” to ChatGPT. It then becomes 
the job of reviewers to ensure that sensitive information is 
edited out of documents before they’re published.
 Another big ethical consideration with the use of 
ChatGPT in medical writing is accuracy. ChatGPT has 
every electronically accessible resource at its disposal from 
which to develop content, and as we all well know, not all 
that information is accurate. Furthermore, there’s growing 
evidence that ChatGPT can, and does, lie. This places an 
additional burden on reviewers to check and double-check 
ChatGPT’s work.
 But this brings me to my third big ethical concern 
regarding ChatGPT: accountability. No one—not even its 
inventors and keepers—knows how ChatGPT does what it 
does. Without the ability to question ChatGPT’s writing or 
hold it accountable for what it’s written, medical publishing 
ethicists like the Committee on Publication Ethics (COPE), 
organizations including the World Association of Medical 
Editors (WAME), and publishers such as the JAMA Network 
have all said that AI tools such as ChatGPT cannot be listed 
as the author of scholarly papers.
 Developers have put ChatGPT out there with all its faults 
and shortcomings, anticipating that real-world experience 
will teach and improve it. I’m sure it will. However, in a field 
as reliant upon sound ethical practices as medical commu-
nication, I think we currently have too much to lose by put-
ting too much faith in ChatGPT.

—Brian Bass

The 3,000 Springer-Nature journals, Elsevier’s 2,800 jour-
nals, Taylor & Francis, JAMA Network, WAME (and British 
Medical Journal), and the International Committee of 
Medical Journal Editors (ICMJE) ban the listing of ChatGPT 
as an author. The Lancet Digital Health (owned by Elsevier) 
published a commentary entitled, “Generating scholarly 
content with ChatGPT: ethical challenges for medical pub-
lishing,” complete with a response from ChatGPT in its sup-
plementary material on the effect of AI on publishing ethics 
in medical publishing.
 These updated journal guidelines require that authors 
report the use of ChatGPT during manuscript preparation 
in the acknowledgement section. The burgeoning popular-
ity of ChatGPT will undoubtedly lead to the development of 
more policies around its use and increase the importance of 
using human fact checkers.

—Melissa L. Bogen

* * *
Q3:  How can ChatGPT be used to assist medical writers in 
creating patient education materials, and what challenges 
need to be addressed in this context?

Despite the caveats I put forth earlier in Question 1, I do feel 
there may be some interesting uses of ChatGPT in this con-
text. (Assuming, of course, that one maintains personal and 
professional integrity and does one’s own work prior to que-
rying and relying on ChatGPT.)
 First, let me point out that I include in the category of 
“patient education” the following types of medical writ-
ing tasks with which I have personal experience—all of 
these require the simple clear language one should use for 
patients/consumers:

• Pharma/biotech regulatory affairs: Informed consent 
forms; lay summaries (plain language summaries); 
standard operating procedures; and other “instruc-
tional documents” for in-house or outside use

• Pharma/biotech med comm, marketing communica-
tion, sales, and public relations (corporate communi-
cation): Patient education materials of all sorts; slide 
presentations or other company website information 
targeted to the general public (and perhaps to inves-
tors as well); sales training materials; collateral  
advertising materials directed toward patients 

• Health maintenance organizations or managed care 
organizations: Letters to members and provider 
offices explaining services clearly; policies & proce-
dures (P&Ps)

• Hospitals, medical centers, doctors’ offices: Patient 
education materials; website copy intended for the 
layperson

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https://jamanetwork.com/journals/jama/fullarticle/2801170
https://pubmed.ncbi.nlm.nih.gov/36694020/
https://www.elsevier.com/about/policies/publishing-ethics/the-use-of-ai-and-ai-assisted-writing-technologies-in-scientific-writing
https://authorservices.taylorandfrancis.com/editorial-policies/defining-authorship-research-paper/
https://jamanetwork.com/journals/jama/fullarticle/2801170
https://wame.org/page3.php?id=106
https://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html
https://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html
https://www.thelancet.com/journals/landig/article/PIIS2589-7500(23)00019-5/fulltext
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• Nonprofit health care organizations: Parts of grant 
applications and their interim reports; patient educa-
tion fliers for their clients; P&Ps; other medical infor-
mation documents they may create for their clients

• Medical journalism: Articles for publication in lay 
magazines and trade journals reporting new informa-
tion about diseases and medicines; website copy tar-
geted to the layperson

Certainly, there are other areas, but all the mentioned 
examples require a voice similar to that required for “patient 
education” materials.
 One might use ChatGPT to assist in formatting and 
organizing a plain language summary—first by asking 
for samples of various companies’ formats for such sum-
maries (some of which are offered on the Food and Drug 
Administration website and elsewhere, but ChatGPT would 
offer several samples). This could help an inexperienced 
medical writer to understand how such summaries are best 
designed. One might also submit to ChatGPT the summary 
one has already written and request improvement.
 One might submit a less simple example of any of the 
mentioned documents one has already written and ask 
ChatGPT to revise it—just to see if the AI program does 
indeed offer improvement in structure or language (always, 
of course, being careful not to allow plagiarism to creep in).
 The main challenge, it seems to me, relates to discrim-
ination in fact-checking and ensuring that plagiarism has 
not occurred. Likely there are other caveats, but I have not 
used the AI program(s) extensively enough to identify other 
difficulties or challenges.

—Cathryn D. Evans

Additional Information: A Developer Interface
In addition to ChatGPT, OpenAI also has a developer inter-
face available for US $20/month. In a webinar I attended, 
attendees from a med comm company noted this private 
interface could be used by pharmaceutical or medical com-
munication companies on behalf of clients. Its advantages 
are that data could be kept confidential, larger data sets 
can be uploaded, and the user has more control over the 
responses. Here are some uses and examples.
 The developer interface could generate internal reports 
from multiple data sources and summarize advisory boards 
(eg, executive summaries). However, it will be a while before 
it can be trained to ignore the nonsensical chatter in an ad 
board transcript.
 The developer interface could be trained to act as a 
medical information chatbot (not for public release). The 
user could input prescribing information, a clinical study 
report, and published studies. These data could be used to 
draft medical letters or answers/replies. The interface could 
rewrite existing content from, say, a pharmacist geared 
toward another audience.
 The private interface could also provide consistency to 
omnichannel materials. It could ensure that the informa-
tion is relevant to different audiences and could repurpose 
material into new formats (eg, from video to slide deck) 
much faster than a person could. 
 But again, with the noted limitations, humans are 
needed for their thought, judgment, and discernment for 
accuracy and relevance.

—Melissa L. Bogen

General Principles of 
Word Usage

www.amwa.org/online_learning
Choose the right word for accuracy and clarity.

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