How to rewrite complex medical text into plain English

Effective communication in healthcare is crucial for ensuring that patients understand their conditions and treatments. Medical jargon and complex terminologies can create barriers, leaving patients confused and intimidated. By using plain English, medical writers, medical editors and healthcare professionals can bridge this gap. In my previous article about plain English, I explained what plain-English editing is and how it helps to puts the readers first by helping them to understand and absorb the information you want to present. In this follow-up article, I give examples of this practice in action showing how plain-English editing can be applied to medical writing to make it clearer and simpler.

Example 1 Medical symptoms rewritten for a patient-information website:

Before: ‘The symptoms present as erythematous papules and pustules indicative of acne vulgaris.’

After: ‘You may have red bumps and pimples, which are signs of common acne.’

Explanation: The original sentence uses technical terms like ‘erythematous papules’ and ‘acne vulgaris,’ which may not be familiar to most patients. By simplifying the language to ‘red bumps and pimples’ and ‘common acne,’ the information becomes more accessible. As well, the passive voice has been changed to active voice. The end result is a sentence that is more direct and clearer.

Example 2 Medication instructions rewritten for a patient-information leaflet:

Before: ‘The intramuscular medication will be administered in the gluteal region twice daily.’

After: ‘The medicine will be injected in your buttocks twice a day.’

Explanation: The terms ‘intramuscular medication’ and ‘gluteal region’ will be unfamiliar to many patients. Rephrasing it as ‘injected in your buttocks’ provides clear instructions that are easy to understand.

Example 3 Surgical procedure edited for a report, which will be read by non-medical professionals:

Before: ‘The patient underwent a laparoscopic cholecystectomy.’

After: ‘The patient had keyhole surgery to remove the inflamed gallbladder.’

Explanation: ‘Laparoscopic cholecystectomy’ is a technical term that might not be understood by the layperson. ‘Keyhole surgery’ is a more familiar term, and explaining that it is to ‘remove the inflamed gallbladder’ provides the necessary context. You may have noticed that there are more words than the original. This is because some terminology needs more explanation than it would for healthcare professionals; however, the end result is plainer and easier to understand.

Example 4 Postoperative care instructions rewritten for the patient:

Before: ‘The patient should ambulate postoperatively to prevent thromboembolism.’

After: ‘You should walk around after your operation to prevent blood clots.’

Explanation: The original sentence uses technical terms such as ‘ambulate’ and ‘thromboembolism,’ which can be confusing and intimidating. Rewriting it as ‘walk around after surgery to prevent blood clots’ makes the advice straightforward and easy to follow.

Example 5: An extract of a letter written between healthcare professionals, rewritten to the patient

Before: ‘There is a history of hypertension and hyperlipidemia, necessitating ongoing treatment with an antihypertensive and statin.’

After: ‘You have high blood pressure and high cholesterol, which you will need ongoing medicines for.’

Explanation: Terms like ‘hypertension’ and ‘hyperlipidemia’ can be unclear. Using ‘high blood pressure’ and ‘high cholesterol’ ensures that the patient understands their conditions and the need for continued treatment.

Example 6 Extract from a diagnostic CT scan report rewritten for the patient:

Before: ‘The CT revealed a hepatic lesion.’

After: ‘Your scan showed a spot in your liver.’

Explanation: ‘Lesion’ and ‘hepatic’ are medical terms that most people won’t be familiar with. Simplifying them to ‘spot’ and ‘liver’ makes the medical findings easier to grasp.

Example 7 Lifestyle recommendations on a public-health website about diabetes, rewritten in plain language aimed at patients:

Before: ‘It is advisable to adhere to a nutritionally balanced diet for glycemic control.’

After: ‘You should follow a healthy diet to help control your blood sugar levels.’

Explanation: The original recommendation uses complex language like ‘nutritionally balanced diet’ and ‘glycemic control.’ Simplifying this to ‘follow a healthy diet to help control your blood sugar levels’ makes the advice easy for the patient to understand.

Example 8 An extract from an information pamphlet aimed at healthcare professionals about recruiting their patients into a clinical trial. The information needs rewriting to go into a new pamphlet to give to patients to explain about the clinical trial:

Before: ‘This is a randomised, double-blind, controlled study that is currently recruiting patients with metastatic oesophageal carcinoma with chemotherapy-induced peripheral neuropathy.’

After: ‘You have been given this pamphlet because your doctor thinks you may be interested in joining a clinical study. We are looking for people who have cancer in their oesophagus (also called the gullet) and secondary cancer. We are doing the study to find out the best way to treat symptoms like pain, numbness, tingling and weakness in your hands, arms or feet (called peripheral neuropathy) when you had treatment for your cancer.’

Explanation: We’ve changed passive voice to active voice, and we've replaced medical terminology with words that a layperson can easily understand, making the language more direct and clearer. There are more words than the original because some of the terminology needed more explanation than healthcare professionals would need, but we split the information into shorter sentences, making it easier to digest.

Some tips on how to write in plain English

• Use short sentences: Long sentences can be difficult to follow. Break them up to improve readability.

• Avoid jargon: Technical terms can confuse readers who are not familiar with them. Use common words instead.

• Be direct: The passive voice can make sentences unclear. Use the active voice to make your writing more straightforward.

• Use lists and headings: Breaking information into bullet points and separating with headings can make it easier to digest.

Let’s put some of these tips into practice. Here’s some sample text that we want to rewrite into plain English:

Before: ‘MDT discussion recommended neoadjuvant chemotherapy with a regimen of FOLFOX to reduce tumour burden prior to surgical intervention. Interval imaging and post-chemotherapy imaging revealed partial response, with a significant decrease in primary tumour size. The patient subsequently underwent a radical resection with lymphadenectomy. Histology confirmed clear margins. Postoperative care included adjuvant chemotherapy and targeted therapy with bevacizumab. Follow-up with regular surveillance CTs and serum tumour markers to monitor for recurrence.’

Firstly, let's replace medical terminology with words that a layperson can easily understand, making the language more direct and clearer. So, for example, we can change MDT (which refers to a multidisciplinary team meeting) to explain that this is a group of HCPs from different disciplines. Patients are generally familiar with the term 'chemotherapy', so it's okay to leave that, but we'll explain the different drug names and take out the word 'regimen' so that it's plainer. We'll change 'interval imaging' to explain that it's done during treatment, and we'll change 'partial response' to say that the tumour shrunk. It's okay to use more words than the original because some of the terminology will need more explanation for laypeople than for healthcare professionals, but we can split the information into shorter sentences and into paragraphs, making it easier to digest.

After: ‘A team of staff from different areas of healthcare recommended chemotherapy. The patient was treated with a combination of chemotherapy drugs called FOLFOX (folinic acid, fluorouracil and oxaliplatin) to shrink the tumour before surgery. Scans during and after treatment showed the tumour had shrunk.

'The patient then had surgery to remove the tumour and nearby lymph nodes. Tests confirmed that no cancer was left at the edges of the removed tumour. After surgery, more chemotherapy was given and a type of targeted therapy called bevacizumab. This helps stop the cancer from growing new blood vessels so it cannot grow any bigger. The patient will have regular check-ups, including CT scans and blood tests, to watch for any signs of the cancer coming back.’

Conclusion

Using plain English in medical documents is not about dumbing down the information but about making it more accessible. By simplifying complex medical terms and explanations, you can ensure that your intended audience grasps your message without unnecessary confusion.

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A note on terminology: The terms medical copyeditor, medical proofreader and medical editor are often confused and used interchangeably. To add to the confusion, there are yet other terms used for different niches such as plain-English editor, medico-legal copyeditor or editorial assistant (the latter is commonly used in medical communications). I personally use medical editor to describe my role, and medical editing to describe both medical copyediting and medical proofreading, as this suggests a hybrid approach as per my own clients' preferences ... plus, it's simpler! See here for more detail on the traditional differences between proofreading and copyediting.

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Plain-English editing is a specialist editorial skill. If you need an editor to turn your complex medical text into plain language, please get in touch.