Writing Clinic: Choosing an Approach, Part 1

Michael Gerchufsky, ELS, is the managing editor of Consultant. E-mail him with thoughts on this post at

In the first Writing Clinic blog post, part 1 of "Choose Your Topic Carefully," I recommended a few first steps to authoring and contributing a clinical case report or review article to Consultant. In part 2 and part 3, I discussed choosing a topic with the appropriate scope and finding your article's "hook" or "angle," and I discussed zebras vs horses and the pros and cons of choosing either as a topic.

Now that you've identified your topic, let's talk about choosing the best approach to covering that topic.

What Kind of Article Should I Write?

Articles in Consultant and the medical literature in general can take a great many forms, depending on the subject matter. Among the most common varieties in Consultant are clinical review articles, clinical quizzes, and commentary articles. But the most common and most popular by far are case studies, including our "Case in Point" feature and our "Photoclinic" department. And of course, most quiz articles are based on a case report, too.

As I mentioned in a previous post, an article's "hook" in Consultant often is a clinical image. In fact, we rarely publish articles without a photograph, radiologic image, or other graphic element. Case reports of unusual dermatosis make little sense without a photo, and descriptions of orthopedic conditions are incomplete without radiographs or an MRI image.

So if the topic you have chosen is based on a patient you have seen, and you have good clinical images to accompany the text, I strongly recommend approaching the article as a case study.

What’s in a Case Report?

Take a look at any "Case in Point" article here at for examples of effective case reports. While the components of a case report vary widely and must be individualized and adapted to your case, here's a list of sections to consider in your write-up, not all of which will apply:

• History

• Physical Examination

• Etiology

• Epidemiology

• Pathogenesis

• Histopathology

• Clinical Manifestations

• Diagnosis/Diagnostic Studies

• Differential Diagnosis

• Treatment

• Complications

• Prognosis

• Follow-Up

Generally speaking, but not always, case reports are divided into two basic sections: the patient presentation, and a discussion of the condition in general terms.

And effective case reports always have a teaching point, so keep that in mind as you assemble the narrative. Does your patient's case increase awareness about a condition, or suggest an effective approach to diagnosis or management of the condition? Or, is the case an unusual presentation of a common condition, or was there an unusual complication, or an unexpected cause underlying the signs and symptoms?

Crafting a Quiz

Clinical quizzes are among the most popular features in Consultant. Many are a variation of a case report, and you may decide that your patient's case would make a great quiz.

Speaking from experience, however, I can say that not all case reports make great quizzes. Often, either our peer-reviewers or I will sense that a given case study would make a great quiz, and I'll then approach the author to help convert the case into quiz format.

If you do decide to approach the case as a quiz, take a look at our lineup of quiz features—"Radiology Quiz," "Photo Quiz 360," and "What's Your Diagnosis?"—to determine which might be the best fit for your topic.

Photo as Case Report

A "Photoclinic" article is a great choice if you have an excellent clinical photo or other image that might not lend itself to an extensive write-up but that nonetheless has a strong teaching point.

Coming Soon

In the next posts, I'll cover some of the other possible approaches to writing an article for Consultant, particularly the review article. Stay tuned, and thanks for reading.