The medical communication field provides fertile ground for medical writers who want to establish and grow a freelance business. But before you start thinking that freelancing is a great way to break into medical writing, we urge you to think again.
Clients expect the freelancers they hire to already know what they’re doing, so freelancing isn’t a suitable training ground for medical writers. If you’re new to medical writing, we recommend you start with the Ultimate Guide to Becoming a Medical Writer. With at least a few years of professional medical writing experience under your belt, you’ll be better prepared to explore the many possibilities that freelance medical writing has to offer.
These tips provide a behind‑the‑curtain peek into what it truly takes to launch, build, and maintain a successful medical writing business. They include priceless insights and advice from seasoned professionals who are willing to share their experiences and expertise with you. Whether you are just thinking about freelancing, are ready to get started, have some experience, or are a seasoned freelance pro, AMWA has expert tips for you.
NOTE: The experts quoted here are experienced, professional freelance medical communicators, and the advice they provide is their own. They are not attorneys, accountants, or financial planners. Readers are encouraged to seek appropriate legal and financial counsel from professionals in these areas.
“For the new freelancer who is also new to medical writing:
— Brian Bass
“What advice do you have for new freelancers?
And if you’re a well‑established medical writer thinking about retiring to freelancing:
— Brian Bass
“Before I started my business, I consulted with 2 business advisors, 1 in New York (American Women’s Economic Development, which offered free advice for women starting a business) and 1 in Palo Alto (paid). Additionally, I took the Small Business Association’s SCORE workshop (free) on starting a new business. I recommend anyone planning to start a business take a SCORE workshop—and consider paying a professional consultant in the future, as necessary.
What I wish I had been told but was not (or perhaps did not listen well enough) was how critical it is to set up your own 401K or other retirement plans immediately, from Day 1. Always take a percentage of all income and put it aside for retirement (the amount and investment medium at your own discretion). I was advised quite clearly to put aside money as a cushion to draw upon during lean times—and indeed I did this, much to my advantage. But I did not put quite enough away for a robust retirement.
So...all you newly self‑employed medical writers heed this advice: start saving now, regardless of your age, today!”
— Cathryn D. Evans
“If you want more success and less stress, do the hard work early. Many freelancers start out thinking that clients will just somehow find them. I call this magical thinking, because it just doesn’t happen. We attract clients by doing the right things: developing a marketing infrastructure that’s focused on the needs of clients and then actively marketing to them. This is work.
Your LinkedIn profile, AMWA Freelance Directory listing, and website are key parts of your marketing infrastructure. They all need to clearly explain what you do and how what you do benefits your clients.
But having a great marketing infrastructure isn’t enough. If you want clients who give you work you enjoy and pay you well, instead of taking whatever work comes along, you need to find them and then market to them. Developing prospect lists and then crafting a customized email to each client is an effective way to attract clients.
You also have to network actively through professional associations. This will help you get clients (mostly through referrals) and meet other freelancers who can provide advice and support (this is really important when you’re starting out and aren’t sure what’s normal and what’s not).
Once you’re established, if you do great work for your clients and build a strong network, more clients will find you (through referrals). But you need to build your business before this happens.”
— Lori De Milto
“Some advice for a new freelancer:
— Gail Flores
“New freelance editors (<1 year): One of the biggest questions for freelancers just starting out is what to charge. Many people don’t like to talk about money, so finding out what others charge can be challenging. Begin researching rates by checking AMWA’s 2019 Medical Communication Compensation Survey results. The 2019 Survey results noted mean hourly rates of $113/hour for writers and $93/hour for editors, which is higher than the rates from the 2015 survey.
If you wish somebody, anybody, would just give you some idea of the going rate for various editorial tasks, then you could look at the editorial rates chart published by the Editorial Freelancers Association. The big caveat is that the EFA rate chart is on the low side (consider them beginning rates), and should be considered only as a rough guideline because the posted ranges apply to all sorts of industries. The medical communications industry commands higher rates, perhaps 60% or more than what’s listed in the EFA’s chart. For example, the EFA chart lists $60 to $70/hour (80¢ to 95¢/word) as the range for medical writing.
Part of what to charge comes from knowing your expenses and having a business mindset. Read this book from cover to cover: What to Charge: Pricing Strategies for Freelancers and Consultants, by Laurie Lewis. Without telling you specifically what to charge, Laurie reveals the factors that go into deriving a rate for yourself, so you can apply them to your specific situation.”
— Melissa L. Bogen
“First and most importantly, trust your gut instinct. If something doesn’t feel right about the project, politely decline it. If the project seems too good to be true, it probably is.
Good opportunities pay well and don’t have unreasonable deadlines. Expectations for what you’ll do and what the client will do, and when, should be clearly defined in writing. Asking colleagues what they know about various organizations is also helpful in sorting good opportunities from bad.
Sometimes a seemingly good opportunity can turn into a disaster. Learn what you can from the experience and move on. For example, once, after providing a very clear scope of work for covering a meeting, I arrived and found that the client (who had approved the scope of work in my estimate) expected me to work 15 hours 1 day and 13 hours the next (instead of 10 and 8 hours as per my estimate). I did charge them for the extra time, but it wasn’t worth it. After this experience, I added a clause to my estimate template that any project that required more than 10 hours of work a day would be billed at 2.5 times my normal rate for the additional hours. If I find myself in this type of situation again, at least I will be well compensated.”
—Lori De Milto
“Securing a client who agrees to sign your (lawyer‑approved) contract is one way to distinguish a good opportunity, at least one that may give the freelancer an opportunity to collect in court should the client default. Such a contract, at the very least, includes project type and name, client name, designation of specific person(s) responsible for approvals and payment, timing (eg, due dates), provisions for overtime, and limits of uses for the finished product.”
“You have to kiss a lot of frogs to find a prince or princess. Fortunately, it’s not quite as difficult to find a good freelance opportunity. But there are still frogs out there. Good freelance opportunities come from good clients with whom you have a good partnership. This is because you know what to expect from them, they know what to expect from you, and your experience with each other enables you to communicate at a deeper level of understanding. It’s like twins who share their own special language.
Then there are clients with whom you’ve already worked and had a difficult or unrewarding experience. If you’ve had a bad experience with a client, don’t expect a better experience the next time around. You might get lucky, but more likely you will get another reminder of why you don’t want to work for that client. I usually give clients like this a second chance, and I usually kick myself for having done so. After 2 strikes, they’re out.
The challenge is learning how to tell whether a new client will be a good opportunity or a bad one before you start the first assignment. Here are some warning signs I look for to identify a potentially bad freelance opportunity and steer away from it:
It’s better to misread a good freelance opportunity as a bad one and miss out, than to misread a bad freelance opportunity as a good one and wish you had missed out. Best of all is to read every opportunity properly and realistically. Trust your instinct. If it looks like a frog, hops like a frog, and croaks like a frog, it’s a frog.”
“For the freelancer with 3 to 10 years of freelancing experience:
— Brian Bass
“It’s time to start thinking strategically about your business. When you’re starting out, you’re so busy launching your business, getting your first clients, and then doing great work for them that it’s difficult to see the big picture. But once you’ve been freelancing for a few years, take some time to think about where you are and where you want your business to be.
I didn’t do a strategic business review for many years, until I lost a few big clients. When I looked at the type of work I had been doing, I realized that much of it wasn’t what I liked best. So, I refocused my marketing and started going after—and attracting—much more of my preferred work. I should have started thinking strategically much earlier.
After your initial strategic business review, do a year‑end review to continually evaluate your work, your clients, and other aspects of your business.”
— Lori De Milto
“Some advice for an experienced freelancer:
— Gail Flores
“At midcareer, freelance editors may be wondering how to increase productivity and gain more clients. You can increase productivity by keeping abreast of tech trends and ensuring all your software and hardware is up to date. Never scrimp on your business. Always spend the money to have the best printer, software, etc. that you can afford. Because as freelancers we almost always work remotely, our reputation rests partly on our virtual presence in a company. Make sure, for example, that you have the full professional version of Adobe Acrobat to match what your clients use, or, if you’re opting for a less‑expensive program that’s a ‘reasonable facsimile’ of Acrobat, you know exactly how that PDF program interacts with Acrobat files. You don’t want your clients to be dismayed at your output because the functionality doesn’t match the software they use.
For gaining more clients, you should have a well‑developed LinkedIn profile and a network of colleagues gained from volunteering in AMWA and word of mouth who may refer you for work.
Looking for techniques to develop your business? Check out Lori De Milto’s website, The Mighty Marketer, and read her practical and inspirational blogs on finding high‑paying clients.”
— Melissa L. Bogen
“Never stop marketing and always do great work for clients. Networking with colleagues, which is one marketing tool, and doing great work are the keys to referrals from colleagues and clients, respectively. Referrals are the simplest and easiest way to get new clients.
Up to 90% of the time, clients aren’t ready to hire you when you first contact them, so following up with prospects, especially those who’ve responded positively to you but not yet hired you, is another easy way to even out your workflow. The client needs to be thinking of you, and not another freelancer, when he or she does need freelance help.
These strategies can help you move toward a perpetual feast of freelance work. But balancing your work so you have just the right amount is really difficult. If you never want to have a famine, be prepared to sometimes work more than you want to.”
—Lori De Milto
“For several years I was on retainer with a client, who paid me enough each month so that there was never a famine time. I’ve never been able to find that again. Today, many pharma/biotechs/contract research organizations (CROs) want you to be a ‘temporary employee’ rather than a consultant on retainer or a freelancer on a project basis—which means they want 40 hours a week of your time for X months or a year. This is not self‑employment, and laws are being passed to prevent employees from being misclassified. One other important step I took, when the money was flush, was to be sure I always had at least $50,000 in a money market account so the famine times would be covered. However, it is important, I think, to remember that the feast/famine condition is not in our control; we can take steps to cope with it, but in truth we must accept that this business (like life) brings constant change.”
—Cathryn D. Evans
“I’m lucky in that in 16 years I can’t recall having a famine. That’s because I am continually marketing. In the early years it was more active marketing—sending letters of introduction, identifying potential clients, applying for jobs. Today it is more passive—word of mouth, website, newsletter, etc.
By tracking your projects on a spreadsheet, you can see where things are beginning to slow a few weeks out. That’s a sign that it’s time to send out a newsletter, or email some clients you haven’t heard from lately. I always like to say, ‘I’m booking for the next quarter and wanted to see if you have any projects coming up.’
If possible, make sure you’re working on more than one project at a time. This way you can turn one in and move onto finishing the next. If you only work on one project at a time, then you better make sure you’ve got the next one booked by the time you’re halfway through with the first.”
“Bad things happen to good freelancers. No matter how good you are, things will not always work out with clients. I have been working with some of my clients for as long as I have been in business, and with most of my other clients for years. But I have also had my share of bad experiences, usually because the client hired someone who hadn’t been involved in the project’s design and wasn’t happy when I did what I had been asked to do. These things happen and shouldn’t be taken personally.
Never ignore your instincts. When your instincts tell you to walk away from a project or a client, run. During my early years in business I knew that I needed to fire a client. But when they asked me to work on a project I had submitted a proposal for, I felt obligated to do so. This client ended up not paying me for part of the work, and I later learned that a colleague had a bad experience with the client on the same project. Later in my freelance career, when I faced similar situations, I fired the client and felt great about it, even in one case where the client represented about 40% of my business.
IT challenges decrease dramatically when you use a Mac. When I launched my business in 1997, the only thing I worried about was managing my own IT. As it turned out, I was absolutely right to worry about this. When I had a problem, the PC maker would tell me it was a software problem and the software maker would tell me it was a PC problem. No one would help me, and I was wasting a lot of time. Then I bought a Mac, and my technical problems almost disappeared. From my perspective, Macs just work better than PCs. And when I have a problem, there’s great support available. I can go to a Mac store and meet with a Mac genius (they actually like to help), or I can pay for phone support as needed. Apple also offers a reasonably priced service plan for phone support and online support.”
—Lori De Milto
“As a freelancer, I have learned that what I miss most about working full time at a company is the in‑house IT support. I have found that it is useful to buy my PC from a local computer shop that services the computer and not online or at a big store. I may have paid a little bit more for my PC than I would have had I bought it at a big store, but if I have any IT questions, I can tap the local computer guy’s brains for help. I have also had them come out and hook up the computer to my printer at my house, so I didn’t have to worry about where all the wires went, or how to get all the components to sync properly with the Wi‑Fi network.
Another thing I have learned is that keeping meticulous records of receipts helps at tax time. I use Shoeboxed because otherwise the receipts just sit here gathering dust and distracting me from my work. I send Shoeboxed all my receipts in a blue envelope they provide; they scan them and make the data captured available in various output forms that can be used with Quicken, QuickBooks, or other programs. I export my data to MS Excel spreadsheets by category for itemizing purposes. From the receipt, they’ll give me vendor, date, amount, and type of expense. If there are any errors, I can correct them and give them information so they know in the future, for example, that all receipts from ‘Panera Bread’ should always be in the meals/entertainment category.”
—Melissa L. Bogen
“The one major aspect of a freelance business I wish we had known when we started our business was the vital importance of having a diverse client base. It was only after a dramatic loss of income that we realized that working on six different prescription products for eight different clients/departments within one pharmaceutical company is not a diversified business.
We were heavily involved with a pharmaceutical company in our early years, mostly to the exclusion of all other clients. We worked with six different product managers plus the medical affairs department, international division, medical meetings, corporate communications, public relations, and sales training departments. Then one day, all budgets for all departments and products companywide, including the prescription products we were involved with, were cut dramatically. We were able to finish some already‑contracted work, but most planned future projects were canceled. We scrambled long and hard to replace the lost revenue and sadly, lost one of our best clients.
Our solution was to develop a mixed client base among pharmaceutical, medical education, advertising, and communication companies; medical associations; and medical publishers. Today, although a month or two may go by when we are only working for a few clients, we are constantly aware of the dangers of our client base not being fully diversified and work hard to rectify the imbalance when it does occur.”
—Elizabeth L. Smith
“I have freelanced throughout my career as a professional writer. Still, when I started my full‑time freelance business in 1989, I was naïve to the business aspects of the business. On one hand, this is probably a good thing because I was naïve and never imagined I couldn’t be successful. But on the other hand, at the time I didn’t know as much about the business aspects of running a freelance business as I wish I had.
Things like setting project fees, knowing what other writers charged for their services, knowing what the ‘traffic would bear,’ and the dynamics of negotiating were new to me. I learned most of my lessons the hard way. That’s good for me because I learn much better from my failures than from my successes.
My AMWA friends and colleagues, plus the many workshops and open sessions I attended, all fueled my education. Today I continue to attend every educational and networking opportunity I can because there is always something new to know, a different way to do something that I’ve never considered. I value greatly what everyone—from the most experienced freelancer to the most inexperienced—has to offer.
Another important aspect of what I want to share here, and that some readers may not expect, is that I am very glad for my naïveté during my early years as a freelancer—the things I didn’t know then that I know now. How can that be? Just as we are responsible for our successes, I believe we are equally responsible for holding ourselves back from succeeding. The funny thing is, I believe a big part of what holds us back are the things we know, or think we know, that keep us from attempting.
One of my favorite business quotes comes from William Shakespeare’s Measure for Measure, and I kept it pinned to the wall in my office for many years where I could always see it and always be reminded of it. It says, ‘Our doubts are traitors, and make us lose the good we oft might win, by fearing to attempt.’ In 2002, when I began evolving my business model to include subcontracting, I was my own worst enemy. On the basis of what I ‘knew,’ there seemed no way possible for subcontracting to be financially successful. This is a perfect example of me getting in the way of my own success. I got past it by erasing what I ‘knew’ from my mind and moving ahead, learning and adapting as I went, and believing I could be successful.
So as thankful as I am for the business knowledge I have today that I wish I knew earlier, I am most thankful for the inexperience that makes anything possible. There is an opportunity for us to use our naïveté to our advantage at any stage in our careers.”
“The most honest answer I can give is ‘everything.’ Looking back over the 25 years that have passed since I made the decision to become a freelance medical writer, it is difficult to pinpoint just one thing that I know now but didn’t know then, because it really is just about ‘everything.’ I would have to say, however, that collecting payment in a timely manner was the most important thing I had to learn—and I learned it the hard way. When I first started out, I never sent a bill until I was sure the job was completed to the client’s satisfaction. That seemed to work until one of my clients declared Chapter 11 protection from bankruptcy while still owing me for several jobs. From then on, I began billing a third of the project price as a project initiation fee, another third upon delivery of a first draft, and the final third when the project was fully completed.”
—Donna L. Miceli
“This is a tough question for me because I’m a recovering workaholic. Yes, step 1 is admitting you have a problem. When I started my freelance business many years ago, I worked 3 years straight before I realized I hadn’t taken a vacation or a day off. Actually, it was my wife who pointed it out. But in my defense, we didn’t miss any mortgage payments, either, which was especially impressive during those early years.
I’ve always struggled with work/life balance—it’s a work in progress. But before you judge me too harshly, I think that I have had a much better work/life balance than many people I know who don’t work for themselves. I started my freelance business when one daughter was 4 years old and the other was 11 months old. I set up a playpen (remember those?) right in the doorway of my home office because it was barely large enough for me, my desk, and my computer. My breaks were my younger daughter’s feedings. I delayed teleconferences when either girl was inconsolable or in dire need of a book being read. Deadlines deferred to diaper changes, billing to Barbie dolls.
As my girls grew older and were in school, I am proud to say I didn’t miss a thing they had going on during or after school. I simply told clients I had a meeting and scheduled around it. By their late teens, if you’d asked them what it was like having their dad around all the time they would have responded, ‘He was always working.’ That’s what it seemed like to them at the time. But now that they’re working adults and one has a daughter of her own, they both realize how good I had it. Alas, neither of them works for herself—yet.
My wife has been a great force behind what little work/life balance I do have. The evil eyes through the glass door of my office at 6:30 ᴘᴍ. The plane tickets tossed on my desk with the directive to ‘put this [vacation] on [my] calendar.’ She’s had a lot of patience with me over the years.
But when I do go on vacation, I go on vacation. No work calls. No email. No talking about work. No thinking about work. Complete decompression. The day my clients think is my first day of vacation is always 1 to 2 business days before my actual first day of vacation, because craziness comes out of the woodwork the moment clients realize you’re leaving ‘tomorrow.’ And I always give myself a day at home after a vacation to reconnect with reality. So if I get home from vacation on Sunday, I tell clients my first day back in the office is Tuesday.
To sum it all up, my strategies are mostly lame, but I do have some semblance of work/life balance. I recommend:
“After working so many hours during the first 3 years of starting my own business, and ending up with mononucleosis, I made a few self‑preserving decisions, to which I have adhered about 90%.
In my opinion, these actions are precisely why I have been able to stay so long in this high‑learning‑curve industry, writing journal articles, patient education, sales training, clinical study reports and other regulatory documents, editorial review of complex books and papers, etc. The contrast between my career in medical communications and these other activities is dramatic! I strongly recommend any or all of the above, or immersing oneself in playing a musical instrument or creating art if that’s your thing. Just as long as it is something completely ‘other.’”
—Cathryn D. Evans
“I didn’t always do such a good job with maintaining work/life balance, and several years ago I did burn out. I was lucky enough to be able to take a 3‑month sabbatical that helped immensely, as did a good therapist with experience working with clients who had work/life balance issues. That was 4 years ago, and I’m happy to say that I’m much better. Here are some things I learned:
“For the freelancer with a well‑established business:
— Brian Bass
“It is essential to stay current with the various ways of doing business today, to be more careful about contracts and terms of payment, and to consider carefully whether and when to accept or reject projects. And it is important to try to put away at least 20% of gross earnings when/if you can!”
— Cathryn D. Evans
“If you’re close to retirement, like I am, you should be thinking about whether you’re doing the type of work you really want to be doing, and you should have a retirement plan. Although I don’t plan to retire for at least a decade, I am thinking about what I want my future to look like.
I’m focusing now on the type of work I like best: content marketing mostly for hospitals/health systems, health care marketing agencies, and disease‑focused associations. I still do other types of work for a few long‑term clients, but I’m not actively pursuing other types of work. If your current work isn’t optimal, this is the time to start making changes. Now that you’ve got a lot of experience, it will be easier for you to do this.
In developing a retirement plan, freelancers don’t have to choose between working full‑time or not working at all. We can work part‑time in ‘retirement’ to stay busy and make some extra money. That’s what I’m planning to do. I’d like to taper off my work from about 50 hours a week to eventually about 10 to 20 hours a week. And I’m only going to do work I really enjoy for low‑ or no‑stress clients (I always only work with clients who pay me well).
The other big part of a retirement plan is investing enough money to live well. I’m not a financial expert, so all I’m going to say is that if you haven’t been investing enough, start putting away as much as you can in a SEP (Simplified Employee Pension) plan or another retirement plan for self‑employed people.”
— Lori De Milto
“I’m going to work until lunchtime before my funeral! Realistically, though, long‑time freelancers need to appraise how they can remain relevant in our field. Continuing education—brushing up on tech skills—remains a priority. Don’t let your reluctance to learn something new lead clients to look elsewhere for needed skills.
Need a refresher on statistics? Take a course at an AMWA chapter meeting or the annual conference.
Have multiple clients asked if you can create, fix, or edit an EndNote library? Buy AMWA’s online learning course, Harness the Power of EndNote: Manage Your Library’s Data, by Stephen Palmer. If you need to buy the EndNote program, use your AMWA member 20% discount.
Lastly, as a seasoned freelancer who is not approaching retirement soon, I advocate that every freelancer should have an emergency fund, especially if you do not have short‑term disability insurance. This fund can be an online savings account, which often has a higher annual percentage rate for interest than a regular bank. I’ve set up a certain amount of money to be diverted automatically and regularly from my checking to my savings account.”
— Melissa L. Bogen
Freelancing gives medical writers an opportunity to take command of their careers in the growing, dynamic, and important field of medical communications by establishing and managing their own businesses. Building on a solid foundation of knowledge, skills, and abilities in medical writing, freelancing offers a valuable career option in this interesting and ever‑changing field.
We thank the expert freelance medical writers and editors who contributed their advice to this resource:
Brian Bass, MWC
Melissa L. Bogen, ELS
Lori De Milto, MJ
Cathryn D. Evans
Gail Flores, PhD
Debra Gordon, MS
Donna L. Miceli
Elizabeth L. Smith
You can read more of their expert guidance in the Freelance Forum, Ruwaida Vakil, Section Editor, in the AMWA Journal.