For many years, my best friend Conchita (not her real name—but she’ll appreciate this reference) and I lived accidentally parallel lives. We were band geeks together, shined in the back row of the chorus during high school musicals, and scrambled to compose an extremely derivative opera (a recording of which I’m pretty sure still exists, unfortunately) to satisfy a creative writing assignment in physics class. But whereas I dreaded said physics class with the fire of a thousand burning suns, Connie excelled in all things scientific. It was no surprise to me when she earned her Masters in Public Health, but it was a surprise when we both ended up in careers relating to the medical field. What was especially enjoyable was that the idle chit-chat usually reserved for whichever high school classmate had just had a baby could now be applied to hyperspecific work-related things, including our beloved AMA style.

Although initially I seized on our collective use of AMA style to complain about authors who had only used abbreviations 4 times, I became interested in learning how she used it in her corner, as I had previously assumed that AMA style was the domain of journal manuscript editors. So I gathered some questions together and polled both Connie and Edgar (name also changed), a former colleague of my fellow blogger Iris, to ask how they used AMA style in different areas of medical communications.

Edgar is an editor for a global advertising company whose clients provide products such as pharmaceuticals, medical devices, and guides relating to health and wellness. The writers and account managers creating their copy are required to be familiar with AMA style, and the style guide for each account has a template of “[X drug] uses AMA style with the following exceptions.” These exceptions usually come in the form of client preferences for the text and layout, which leaves Edgar with the challenge of how to be the resident style stickler while keeping the client’s dictates in mind. Ultimately, while a client’s spatial limitations may not allow for the correct number of thin spaces between P values, “no client style guide can match the AMA for depth and breadth” and it is an important organizing tool.   The final product represents a mix of both AMA style and client preferences, but, as Edgar puts it, “One veteran editor told me years ago, rather cheekily, ‘Not even AMA uses AMA style.’ … What he was getting at was that it’s a great tool to be adapted rather than followed in strict orthodoxy.”

In Connie’s previous role in the editorial services group of a medical communications agency, “The AMA Manual of Style was THE BIBLE. Past colleagues achieved mythical status for their ability to recall which section of the AMA manual housed the elusive answer to the day’s grammatical conundrum.” (As you can see, Connie also excelled in English class.) She now works for a pharmaceutical company in their labeling and product packaging divisions, which comes with its own set of complicated rules. The documents she works on (such as a product insert for a specific drug) are not organized with any one editorial style in mind, but rather in terms of their audience (eg, patients vs prescribers). Because these documents are written by multiple authors and pass through many hands before Connie sees them, the text can sometimes represent a hodgepodge of styles. However, because the text is also regulated by the FDA and any changes beyond simple typos would be subject to review by medical, legal, and regulatory teams, these inconsistencies often remain intact. In the rare opportunity when Connie is allowed to make edits on small items, she uses AMA style as a guide on things like italicization, reference lists, and capitalization to make her process more straightforward and efficient.

So my takeaway from these conversations is that while nobody will probably ever apply AMA style as strictly as manuscript editors do (and if we’re honest with ourselves, we probably take some proud satisfaction in that!), AMA style is a useful and important fall-back in other areas of medical communications because of its consistency, specificity, and efficiency. But for your sake, I promise that Connie and I won’t compose an opera about it.—Amanda Ehrhardt