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Growing Your Writing Practice

Posted on July 14, 2026 by | Leave a comment
by Sarina Schrager, MD, MS, Family Medicine Editor-in-Chief, and Jose Rodriguez, MD, FAAFP

“It’s none of their business that you have to learn how to write. Let them think you were born that way.”

—Ernest Hemingway

Writing is hard; there are no two ways about it. Starting a paper or narrative can be daunting. How should I start? What if it is not good? Will anyone want to read it? These questions arise even for accomplished writers. The best writers still work very hard at writing. In this blog, I share lessons I have learned during more than 30 years of writing in academic family medicine, along with resources I have found helpful. I encourage you to read these suggestions and share what works for you.

Find Time to Write and Block Your Schedule

It may seem like an oversimplification to say, “Just find the time to write.” We all know it can be difficult to fit writing into busy schedules filled with clinical, teaching, and administrative responsibilities. However, if you do not block time on your calendar to write, writing will continually be pushed to the bottom of your to-do list. You have to make the time to write.

In his 2009 article, “Tuesdays to Write,” Lowenstein describes restructuring his schedule so that his academic work occurred on Tuesdays, allowing him to carve out dedicated writing time each week.1 Some people write best early in the morning, whereas others are most productive late at night. For example, I write best early in the morning, whereas a colleague does their best writing at night. After 4 PM, my writing brain simply does not work.

Similarly, some people can write productively during a spontaneous 30-minute opening in their schedule, whereas others need at least a 2-hour block. Consider scheduling dedicated “writing time” on your calendar so other meetings are less likely to replace it.

Plan to Revise

“Almost all good writing begins with terrible first efforts. You need to start somewhere.”

—Anne Lamott, Bird by Bird

Becoming a good writer—or producing good writing—takes time, effort, and multiple revisions. In Draft No. 4, John McPhee describes routinely writing at least 4 drafts of every manuscript.2 By the fourth draft, the manuscript has usually become coherent enough to share with others. His process can be summarized as follows:

  • Draft 1: Get something on the page.
  • Draft 2: Develop your argument.
  • Draft 3: Refine word choice and improve the flow of your argument.
  • Draft 4: Polish the writing, use a thesaurus if needed, and read the manuscript aloud.

Ask for Feedback

Once you reach Draft 4, you are ready to seek feedback. Many authors submit manuscripts without asking colleagues or friends to review them first. Although the peer-review process provides valuable suggestions, colleagues often identify many of the same opportunities for improvement before submission.

There are several low-stress ways to receive feedback. An accountability partner or writing partner (eg, Prolific Partners) can be helpful. Writing groups are another excellent option because everyone shares their work, reducing the self-consciousness that often accompanies sharing your writing.

Reflect on Your Writing Process

Everyone writes differently, so there is no single perfect list of writing tips. Think about the times when you are most productive. Where were you? What time of day was it? What aspects of the setting contributed to your productivity?

Before I begin writing, I spend time thinking about how I want to structure the piece and how I want to begin. I create an outline, although it often resembles a stream of consciousness. Draft 1 is the hardest part for me because getting started is difficult. Once I have something on the page, revision becomes much easier.

Others find drafting easy but struggle with editing, searching endlessly for the “perfect” word. Still others never reach Draft 4 because they continually discover new ways to improve a sentence. Every writer is different.

Other strategies may also improve writing productivity. Consider working on 2 projects simultaneously. Pairing a small project with a larger one—or a challenging project with one you enjoy—allows you to switch between them and maintain momentum. Joining a writing challenge can also provide encouragement and accountability. Writing challenges vary in length, lasting anywhere from 1 week to 1 month, but they all encourage participants to write consistently each day.

The STFM community is filled with prolific, talented writers. What strategies have helped you develop your writing practice?

References

  1. McPhee J. Draft No. 4. Farrar, Straus and Giroux; 2017.
  2. Lowenstein SR. Tuesdays to Write: A Guide to Time Management in Academic Emergency Medicine. Acad Emerg Med. 2009.

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Writing With a Team

Posted on November 18, 2025 by | 1 comment
by Sarina Schrager, MD, MS,
Family Medicine Editor-in-Chief

Writing for publication is hard work, especially if you are doing it alone. I find that having a team to write papers with makes the experience easier and more engaging. But, in order to make the process move smoothly, it makes sense to spend a little bit of time at the outset to set some ground rules.

  • Delegation of responsibilities—There are a lot of details to address when writing a paper and I find that is pays off at the end to be clear about who is going to do what at the beginning.  My colleagues and I divide tasks, including being in charge of the reference manager, finding author instructions for potential journals, and delegating one person to be the “corresponding author”. The designated corresponding author will be responsible for sending calendar invites, Zoom meeting information, and reminders throughout the process.
  • Authorship guidelines—You want to avoid any misunderstandings about author order or even who is included in the author list. There are myriad ways to decide who will be the first author and the senior author. It is helpful to talk about this order at the beginning. There may also be decisions about who is going to be an author vs being acknowledged at the end of the paper. I have had situations where one of the co-authors ended up doing much more work than the person who was designated as the first author and the group had a conversation about reordering author lists.
  • Outline of paper—Before starting to write, the group should sit down and develop an outline of what needs to be covered. During this process, different authors may volunteer (or be assigned) different sections. You may elect to use a Google Doc or have people write their sections in Microsoft Word to be forwarded to one designated person to integrate each section into the whole document.
  • References—You may also want to decide how to designate references at this point. Should authors put citations into a comment?  Or at the end?  It is helpful to be clear about this at the beginning. Some people may want to number their references, but this makes integration more challenging, so I usually recommend writing the author’s name and a date in parentheses and just adding the citation somewhere in the document.   It is also helpful to decide at the beginning how you are going to manage references. It can be tricky to integrate several different reference lists from different (or even the same) reference managers. One way to manage this aspect of your paper is to assign someone at the beginning to be in charge of references and have each author forward citations to that person.
  • Deadlines—One thing I love about writing in a group is that everyone is accountable to each other. Unless you are planning to submit to a special issue with a rigid time frame , writing a paper comes with artificial deadlines. But, that said, setting firm deadlines and scheduling regular meetings can keep a project moving forward.
  • Editing—Once each author has written their first draft and the sections have been assembled into one unique document, one author may take the lead in making the paper sound like it has one voice. People write differently and it can be distracting to read a paper that is obviously written by different people. Each author will then want to edit for content and readability using track changes. Ultimately, the corresponding author will accept all track changes and finalize the paper.
  • Post–writing tasks—After you are finished writing the final draft of your paper, someone needs to take the lead and submit the paper to the desired journal. This process, even after reading the author instructions carefully, can take a couple of hours. The corresponding author (often the first author but sometimes the senior author or one of the other contributing authors) will need to upload information about each author, designate suggested reviewers (for some journals), and write a cover letter among other tasks.  Also, it is a great idea to discuss who will take the lead in revising the paper if you get a revision request from the journal and who will be responsible for resubmitting to a different journal if your paper is rejected.
  • Opportunities for mentoring—Writing in a team is an excellent way for more experienced authors to provide support and mentoring to more junior authors. By using clear communication and empowering junior faculty to take ownership of the writing process, mentors can role model a streamlined and effective way to write for publication.

See our recent FM Focus on this topic, “Team Writing Etiquette in Verse”  Team Writing Etiquette in VERSE

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Reading in Turbulent Times

Posted on July 11, 2025 by | 3 comments

By Bill Cayley, MD, MDiv

“Literary experience heals the wound without undermining the privilege of the wound.” —C S Lewis (Goodreads)

In turbulent times, withdrawing to a quiet place with a good book seems more tempting than ever. Escaping to another story, another place, or another time can seem the best refuge from chaos and uncertainty. Yet escaping in reading can also feel like a guilty pleasure when it seems that something should be done. While rest and refuge are important for pacing oneself and avoiding burnout, reading can also provide inspiration as the stories of others give us insight into how they faced turbulence and chaotic change. Perhaps, as we face the current moment, a good book might be just the right thing.

Looking back over recent history, it is hard to think of a more turbulent time than the 1930s and 1940s, when the world learned that the “war to end all wars” (World War I) actually was not. In 1943, Langdon Gilkey was a teacher in China and one of about 2000 expatriates interned at the Weihsien compound for “safety and comfort” during the Japanese occupation of China in World War II. Shantung Compound (HarperCollins) is Gilkey’s story of that experience, as the interned expatriates were essentially left to themselves to organize and run life inside their compound. From dealing with hunger, jealousy, boredom, and fear (and even an exploding egg) to finding ways to make life more civilized and tolerable, the book tells a story of community and humanity in the face of isolation and deprivation. As Gilkey concludes, “Out of apparent evil, new creativity can arise if the meanings and possibilities latent within the new situation are grasped with courage and with faith.”

From World War II also comes the story of Le Chambon, a French village that was the center of a movement which sheltered nearly 5000 people (including more than 3000 Jews) between 1940 and 1944. While many find the stories of Raoul Wallenberg and Oskar Schindler inspiring, most of us are not diplomats or industrial magnates. Lest Innocent Blood Be Shed (HarperCollins) tells the gripping story of how “goodness happened” in Le Chambon as ordinary people daily risked their ordinary lives to overcome an extraordinary evil. As the author concludes his book, he reflects on the way the Chambonnais affected him during his research and writing: “I know now that I want to have a door in the depths of my being, a door that is not locked against the faces of all other human beings. I know that I want to be able to say, from those depths, ‘Naturally, come in, and come in.’”

The biographies of individuals can also motivate us and inform us with the wisdom of others who have trod paths of challenge. In Man’s Search for Meaning (Beacon Press), psychiatrist Viktor Frankl tells his own story of finding meaning in life as he faced the horrors and loss of life in a Nazi concentration camp. Coming to more recent times, the stories of those who fought for civil rights during and since the 1960s provide more than ample inspiration. While nearly all are familiar with Martin Luther King Jr, the name of John Lewis may be less familiar. The great-grandson of an enslaved man, Lewis first aspired to be a preacher, later took part in many central events of the 1960s civil rights movement, and subsequently served 17 terms in the US House of Representatives until his death in 2020. In His Truth Is Marching On (Penguin Random House), Jon Meacham tells the story of Lewis’s decades in public service, shaped by his faith-based belief that one should love one’s neighbor as oneself. Another influential leader shaped by the civil rights movement, family physician David Satcher served as US Surgeon General from 1998 to 2002. My Quest for Health Equity (Johns Hopkins University Press) is Dr Satcher’s autobiographical account of his decades-long work on equity issues through academia and public health.

Finally, at a time when the essence of family medicine seems at risk of being lost amid politics, culture wars, and threats to the integrity of science, stories of others who have walked the path of general (or family) medicine can be grounding. The breadth of medical autobiographies can be overwhelming, but a small sample of noteworthy narratives includes A Fortunate Man (AbeBooks), the story of an English country doctor in the mid–20th century; A Fortunate Woman (AbeBooks), the story of another physician (this time a woman) in the same English rural town; and What Matters in Medicine: Lessons From a Life in Primary Care (University of Michigan Press), Dr David Loxterkamp’s stories from a career in rural Maine.

How to face the current moment? Take a deep breath, take some time for reflection, and consider taking time to find inspiration and wisdom from those who have gone before.

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