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  • Writer's pictureSteph Carter

Life as a freelance medical writer: A 3-year check-up

Updated: Aug 24, 2023

Hello. For those that don't know me, my name is Steph Carter and I've been running Lyrical Medical Writing Services, a small freelance medical writing company, for three years.


I started freelancing at the start of the COVID pandemic and shared my early experiences in a blog post. Now three years on (and thankfully no longer in the middle of a pandemic), I thought I'd give an update on my freelancing experience and also share my thoughts on the current state of Med Comms freelancing in the UK.


18 clients and counting


I started off working with just 2 clients, but a quick look back through my records reveals that I’ve worked with 18 clients during the past 3 years, including:

  • 14 Med Comms agencies,

  • 2 pharma companies, and

  • 2 journals.

Most of my clients are based in the UK, but I've also worked with four clients in Europe and one in Japan.


Some clients have needed help on just one or two projects whereas others I’ve worked with fairly regularly over several years.


I've never worked full time for any one client and typically I balance 3-4 clients each week.


On top of my paid work, I've also done a small amount of copywriting as a volunteer for the Muscle Health Foundation, a small charity that works with children with muscular dystrophy.


Working in pubs


As a freelancer, I spend probably at least 80% of my time working on publications.


Fortunately, I like publications.


And fortunately, there has been a lot of work available for freelancers who specialise in publications.


My day-to-day life generally revolves around writing journal articles and abstracts, preparing posters, and putting together oral presentations. But with growing interest in publications extenders, I've also worked on plain language summaries, summary slides and scripts for videos and animations.


However, I'm not just a publications specialist. Over the past three years, I've also worked on a wide range of other projects, including:

  • Ad Boards/workshops (virtual and face-to-face)

  • Popular science articles

  • Slide kits

  • Fact checking and editing

  • Standard response letters

  • Medical society newsletters

  • Literature searches (systematic and narrative)

  • Delphi studies

  • Needs assessments

Variety really is the spice of life


One of the great things about working as a freelancer is the opportunity to work on a really wide range of therapy areas.


It can be challenging at times to work on projects in unfamiliar areas, but it's a great way to broaden your knowledge.


In the past three years alone, I have worked on projects in:

  • Anticoagulation

  • Asthma

  • Autoimmune diseases

  • Cardiology

  • Diabetes

  • Diagnostics

  • Gene therapy

  • Infectious diseases

  • Oncology

  • And a whole host of rare diseases, including aromatic L-amino acid decarboxylase deficiency, haemophilia, muscular dystrophy, pulmonary hypertension, spinal muscular atrophy, and tuberous sclerosis complex.

Marketing tactics: Hits and misses


It's safe to say that marketing doesn't come naturally to most medical writers, myself included. While a handful of freelance medical writers do a great job of marketing themselves through social media, websites, newsletters etc, they're definitely the exception rather than the rule.


Of course, the Med Comms business has been booming over the past few years and for many freelancers, marketing and networking have taken a backseat. After all, why spend time unpaid on your business when there is money to be earned on paid work?


However, the good times don't last forever and it is clear that there is less freelance work around in 2023 than in previous years (see below).


My marketing efforts have been fairly limited, but this is what I have done so far, ranked in order of their effectiveness.


Leveraging my existing network

A significant proportion of my business comes from repeat clients within my existing network. If you do a good job and prove yourself to be a safe pair of hands, then clients will often come back to you time and again. You don't always need to be proactive to get repeat business but it sometimes helps to get in touch with existing contacts if work is starting to dry up.


Utilising LinkedIn

Next on the list is LinkedIn. I have several clients who have found me on this platform and got in touch to discuss potential projects. While I'm not the most proactive, I do make an effort to keep my profile up to date and to share posts occasionally.


Maintaining a website

I've had a website since I began freelancing. I created it using Wix and try to keep it up to date. It began as a simple overview of my background and services, but over time I've expanded it to include extra sections such as testimonials, portfolio and fees.


Whilst it's generated some work for me, it hasn't been a major source of clients.


Directory listings

I joined the MedComms Workbook shortly after becoming a freelancer. I've gained some work from this so I think it's worth the small annual fee.


I'm also on Biome Professionals and I used to be listed in the EMWA freelance directory. I got a couple of bites from these but nothing that turned into a paying client.


(I've never used Upwork or Fiverr or any of the platforms that are specifically aimed at medical writers (Talus, Kolabtree, Difference Collective, Work Crowd etc) so I cannot comment on how well they work.)


Cold emailing

I've also occasionally tried experimenting with targeted cold emails. This is basically identifying clients that you are potentially interested in working with and sending them a prospective email explaining why they should consider working with you.


So, does it work?


Well, out of 15 or so emails sent, I have so far received one reply (and that hasn't yet turned into tangible work). The rest of my carefully crafted emails went unanswered.


I posted about this on LinkedIn and other freelancers largely agreed that cold emailing may not be the best way to go about getting clients.


Has IR35 had an impact on my business?


When I began freelancing, IR35 was a hot topic and it's still being discussed today. Although the legislation had been in place for around 20 years, changes were planned for 2020 that would shift responsibility for complying with the rules from freelancers to clients*. Due to COVID, this change was delayed but eventually implemented in Spring 2021.


So, why were freelancers worried given that this removed the risk from them?

The main concern was that clients would stop working with freelancers and demand would plummet. However, I think that most freelance medical writers would agree that this hasn't been the case (or at least not so far). While there are some agencies that only work with freelancers on a PAYE or inside IR35 basis, they are in a minority. Most agencies are still engaging freelancers on an outside IR35 basis and are using various methods to ensure IR35 compliance.


What about indemnity clauses?

For most freelancers, the biggest concern now relates to the inclusion of indemnity clauses in contracts that pass responsibility back to them. Some experts suggest that these clauses may not hold up in court, but, understandably, most freelancers don't want to be the test case. IR35 experts generally recommend getting these clauses removed and some Med Comms freelancers have had success with this. In my experience though, most agencies are currently unwilling to remove these clauses.


How have I managed the IR35 risk?

I'm definitely not an IR35 expert, but I read up on it as much as I could before I started freelancing and have generally implemented most recommendations. This means ensuring that my contract and working practices are free from mutuality of obligation and control and that there are no restrictions on the use of a substitute. Additional recommendations include having IR35 insurance**, having some contracts reviewed**, working with multiple, concurrent clients, having a company name, website and marketing materials, taking on some fixed-price work, having professional indemnity insurance, and keeping emails that support my working practices.


*Please note that this is not currently the case for small companies or companies with no UK base.

**I have used the services provided by IPSE, but there are other contract review and IR35 insurance providers who are probably just as good.


Has demand for freelance medical writers changed in 2023?


The Med Comms industry has been extremely busy over the past few years and most freelancers have been in the fortunate position of having to turn down work.


However, since the start of 2023, there have been persistent rumours that freelance demand has dropped.


Personally, I was a little quiet at the start of the year but business picked up again in February and I've been consistently busy ever since. Nevertheless, there does seem to be less freelance work around, with surveys suggesting that almost 40% of freelancers still find the market too quiet.


I have noticed that workload from individual clients tends to ebb and flow. But having a wide client base does protect against this to some extent. Generally, as workload from one client falls off, another one seems to pick up again.


So, what is driving this reduction in demand for freelancers? End clients having tighter budgets may be a major contributor. However, agencies have been training more junior writers over the past couple of years and we may now be seeing the impact of this on the demand for freelancers. Perhaps the impact of the IR35 rule changes is also now filtering through.


But if there is less freelance work around, then it is clear that competition between freelancers will increase. We will all need to dust off our marketing hats if we are going to survive in a more competitive environment.


If you'd like to know more about me, my medical writing background and the services my company offers, please take a look at the rest of my website for details.


If you have any questions or comments, please feel free to get in touch.

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