Newsletter: March 2024

Welcome to the chapter newsletter for March 2024.

CHAPTER NEWS 

FEATURES 

CHAPTER NEWS

West Metro Medical Writers Social Hour

Please join us for an informal get-together on March 16, 2024, at 9:30 am. We will meet at the Caribou Coffee in Lunds & Byerlys and hold the meeting in the large cafeteria in the grocery store. The address is 13081 Ridgedale Dr, Minnetonka, MN 55305. While this event is located in the west metro of the Twin Cities, everyone is welcome to attend.

Chapter Members Looking for Work

The following AMWA North Central Chapter members are looking for work. If you know someone who’s hiring, please reach out to them!

  • Sarah Kuyack, Medical Writer (skuyack@gmail.com)
    • Areas of interest: patient education, public health communication, website content, mental health, veterinary or human medicine
    • Job type: full or part time, contract, freelance
  • Kristen Hutchison (kristen.hutchison1@gmail.com)
    • Area of interest: continuing medical education (CME), clinical research work, literature reviews, patient advocacy, and healthcare policy work

If you’d like to add your name to this list, please contact the Publications Committee Chair Michael Franklin at franklin.editing@gmail.com.

FEATURES

News from National: A report from the February 2024 Chapter Advisory Council meeting

By Naomi Ruff, PhD, ELS, North Central Chapter Representative

Hello North Central Chapter! I am the chapter’s new representative to AMWA’s Chapter Advisory Council (CAC). As a reminder, the mission of the CAC is as follows:

The CAC serves to maintain a connection between chapter leaders and the AMWA Board of Directors by advising the AMWA board on the organization’s strategic direction as it affects the chapters and acting as a sounding board about issues that have an impact on chapters and the national organization.

It also serves as a way to bring news from the national organization to chapter members, and for the chapter (and its members) to bring issues of concern to the national board. Have an issue that you want discussed? Let the chapter board know: bod@amwanorthcentral.org.

Notable news

  1. In recognition of the breadth of medical communication and the need to cover more topics in depth, 3 new AMWA certificates will be rolled out over the next 2 years:
    • Medical Editing (Spring 2024)
    • Regulatory Writing (Fall/Winter 2025)
    • Health Communication (2025)
    • The content for each of these will primarily be offered as online webinars.
  2. The board continues to work with a consultant on a DEI strategic plan and will launch an initiative, including resources for volunteer leaders, later this year.
  3. The Member Experience Survey was launched on February 15. This is a good way to let national AMWA leaders know how you feel! The Survey will close on March 7, so take it soon if you haven’t already.
  4. A new Compensation Study (salary survey) will be launching in March.
  5. This year’s Medical Writing & Communication Conference will be held in New Orleans, from October 23 through 26—overlapping with 3 Taylor Swift concerts on October 25, 26, & 27. If you are planning to attend, be sure to book your hotel room as soon as reservations become available! The initial Schedule at a Glance will be posted by April.

Think you’re an independent contractor? Your client might disagree: The latest chapter in the freelance labor wars

By Naomi L. Ruff, PhD, ELS

Managing a freelance business requires knowing the labor laws covering employees and independent contractors (ICs). The laws themselves are clear: 1) employees are subject to a variety of regulations, such as tax withholding, and are entitled to a range of benefits, such as a minimum wage, and 2) ICs are not employees. The trouble lies in where and how to draw the line between these 2 categories of workers.

Origins of the modern problem: the Microsoft case

Efforts to distinguish ICs and employees have a long history, but the issue came to the forefront in the 1990s, when Microsoft was discovered to have misclassified numerous employees as ICs. The individuals in question signed contracts saying they were ICs and were sometimes paid more than employees but did not have taxes withheld or receive employee benefits. However, they were required to work regular hours on site, worked as part of regular project teams, received card keys and office equipment from the company, and performed the same functions as employees—that is, they were employees in all but name. The IRS cracked down, and later some of those “ICs” sued the company for back benefits and won, which was a very expensive outcome for the company. As a result, many large employers became a bit jittery about how they were classifying contractors.

Currently, several different tests at the federal and state levels are used to determine IC status, and employers must comply with all of them. Below, I will summarize these tests and some implications for those who truly are ICs.

Current federal tests

IRS

You may have heard of the IRS “20 questions”; these have now been combined into 3 categories to determine a worker’s status:

  1. Behavioral: Does the company control or have the right to control what the worker does and how the worker does his or her job?
  2. Financial: Are the business aspects of the worker’s job controlled by the payer? Examples of business operations include how the worker is paid, whether expenses are reimbursed, or who provides tools/supplies.
  3. Type of Relationship: Are there written contracts or employee type benefits (i.e., pension plan, insurance, vacation pay, etc.)? Will the relationship continue and is the work performed a key aspect of the business?

The answers to these questions need not all point in the same direction. Businesses are required to weigh all of these factors, consider which are relevant and which point to employee or IC status, and then make a decision based on how much control the business has over the worker. Businesses must also document how they made the decision.

Department of Labor: Fair Labor Standards Act

The new DoL Rule, which will take effect March 11, 2024, uses an “economic reality test” to determine whether an employment relationship exists. It considers 6 factors:

  1. Opportunity for profit or loss depending on managerial skill
  2. Investments by the worker and the employer
  3. Permanence of the work relationship
  4. Nature and degree of control
  5. Whether the work performed is integral to the employer’s business
  6. Skill and initiative

As I understand it, this rule actually reverts (more or less) to guidance that was in place before 2021. As with the IRS rules, in DoL’s latest rule no single factor has more weight than the others, and the overall balance of the factors must be used to determine the status.

The ABC test in current state law and possible future federal law

With the rise of the “gig economy,” notably rideshare companies like Uber and Lyft, new discussions emerged about whether the “ICs” working for these companies were actually misclassified employees. Ostensibly to address this issue, California passed Assembly Bill AB 5, which took effect on January 1, 2020, enshrining the “ABC test” into law. This test holds that a worker should be deemed an IC only if all 3 of the following criteria are met:

  • The worker is free from the control and direction of the hiring entity in connection with the work’s performance, both under the contract for the performance of the work and in fact;
  • The worker performs work that is outside the usual course of the hiring entity’s business; and
  • The worker is customarily engaged in an independently established trade, occupation, or business of the same nature as the work performed.

The immediate result was that many California companies were reluctant to hire freelance medical communicators: for example, is a medical writer performing work that is outside the usual course of a medical communications company’s business? The uncertainties made companies unwilling to take the risk.

In fact, the ABC test has all sorts of problems for all sorts of workers. Recognizing this, California originally exempted certain professions from the law (subjecting them instead to the Borello test). Protests from other groups led to updates with exceptions for “professional services,” a category that explicitly includes grant writers and “freelance writer[s], editor[s], or newspaper cartoonist[s] who [do] not provide content submissions to the putative employer more than 35 times per year,” among other categories.

Several other states have either adopted the ABC test or have considered it. So has the federal government, in a bill called the PRO Act of 2021.* Although it failed to pass in the Senate, many legislators (particularly Democrats, including both of our Minnesota Senators) strongly supported the bill and may introduce it again.

What you can do

The best defense is a good offense. Make sure that you structure your business in such a way that the majority of the various criteria used support your status as an IC:

  • Have multiple clients
  • Advertise your business (a website, LinkedIn, and freelance directory listings count) to show that, as a business, you are available to serve multiple clients
  • Invest in your own business equipment: computers, software, reference books, and so forth
  • State in your contract
    • that projects can only be terminated with advance notice in writing
    • the amount, timing, and conditions of payment (e.g., payment within 30 days of invoicing)

Conclusions

None of us went into this field to become experts on labor law, but it behooves us to stay informed about the laws being proposed and passed and to ensure that we structure our businesses accordingly. In some cases, we may need to educate our clients that we do, in fact, truly meet the standards for classification as ICs and to inform our representatives at every governmental level about the effects that these laws can have on our businesses.

* Not to be confused with the Minnesota Pro Act, which is about access to reproductive health

Additional Reading

American Medical Writers Association. AMWA Position Statement on Legislation That Negatively Affects the Livelihood of Freelance Medical Communicators.  2020. https://www.amwa.org/page/position_statement

Murray J. How the IRS Determines Independent Contractor Status: Independent Contractor Tests Explained. The Balance: September 19, 2022. https://www.thebalancemoney.com/how-the-irs-determines-independent-contractor-status-398618

Reuters. Don’t Treat Contractors Like Employees. 2009. https://www.reuters.com/article/idUSTRE53063S/

Stone & Sallus, LLP. Independent Contractor Rights.  Accessed February 22, 2024. https://www.stonesalluslaw.com/business-law/independent-contractor-rights/

US Department of Labor. Get the Facts on under the Fair Labor Standards Act [Infographic]. https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/misclassification-facts.pdf

US Department of Labor, Wage and Hour Division. Fact Sheet 13: Employee or Independent Contractor Classification Under the Fair Labor Standards Act (FLSA).  2024. https://www.dol.gov/agencies/whd/fact-sheets/13-flsa-employment-relationship

 

Grammar Talk: Subject-Verb Agreement 

By Tess Van Ee

Subject-verb agreement is familiar territory for medical writing professionals. We all know to write “The bones are broken,” not “The bones is broken.” Verbs match nouns, done.

But when the subject is unclear, subject-verb agreement can become less obvious.

Let’s start with relative pronouns in complex sentences. Relative pronouns (e.g., which, whom, that) refer to a noun mentioned earlier in a sentence. They streamline the flow of sentences with multiple clauses by removing repeating words.

However, relative pronouns can endanger subject-verb agreement because they add distance between a subject and its verb. The more words separating a subject from its verb, the greater the potential for confusion. Take the following sentence as an example. 

“The sensory nerve branches at T2-T6 emerge from the multifidus spinae muscles at a right angle, which makes them more susceptible to compression and injury compared to nerves elsewhere in the back.”

The verb in the dependent clause (makes) is singular, but what is its subject? In other words, what makes the nerve branches more susceptible to compression? Where they emerge? Or the angles? Rewriting the sentence clarifies the subject: 

“The sensory nerve branches at T2-T6 emerge from the multifidus spinae muscles at a right angle. This angle of emergence makes the nerves more susceptible to compression and injury compared to nerves elsewhere in the back.”   

Joining subjects with coordinating conjugations (and, but, or) can also cause subject-verb confusion. Your choice of conjugation depends on whether the multiple subjects form a single, plural subject or whether each forms a separate, singular subject.

Here’s an example:

            “My neurologist, gynecologist, and primary physician collaborate to care for my health.”

The three subjects are joined by “and” to show all three are involved. The plural verb (“collaborate”) reflects this trifecta of subjects. When the multidisciplinary care team is isolated by “or,” however, the singular verb reflects the change to three single subjects:  

“My neurologist, gynecologist, or primary physician sends the records.”

The verb must be singular since the subject could be one or the others and not all three.

To check subject-verb agreement when using “or” in a sentence, try reading the sentence aloud using one subject at a time. In this case, the sentence reads correctly even when “gynecologist” and “primary physician” are removed.

For more on subject-verb agreement, check out this overview by Grammarist and this example-rich article by GrammarBook.com.

 

AMWA Essential Skills Certificate Course: Thoughts and Observations (Part 4: Elements of Medical Terminology)

By Adam Fix

Part 4 of the AMWA certificate course deals with medical terminology. As someone without a medical background prior to joining AMWA, I found this part especially instructive.

How terms are combined

Many medical terms are calculated (so to speak) using this formula:

term = prefix + combining form + suffix.

Here are some examples:

  1. electrocardiogram = electro + cardio + gram
  2. hysterosalpingectomy = hyster + salping + ectomy
  3. cholecystography = chole + cyst + graphy

Easy enough, right? Just watch out for added vowels. Sometimes vowels are added to make a word more pronounceable. In example 2 above, an “o” is added between “hyster” and “salping.”

Be careful to balance proper terminology with ease of reading. These medical terms don’t exactly roll off the tongue, and tossing in too many will thicken your writing into an indigestible word soup. Use your judgment and decide which terms are necessary and which can be omitted.

Acronyms vs. initialisms

Did you know that a lot of the things we call acronyms are technically initialisms? Acronyms are pronounced as words, whereas initialisms are pronounced letter by letter. For example:

Acronyms: AIDS, ELISA, AMWA (if you say it like “Am-wah”)

Initialisms: HIV, CPR, AMWA (if you say it “A-M-W-A”)

How do you prefer to pronounce AMWA? In my experience, most people say “Am-wah,” but hey if you prefer “A-M-W-A,” more power to you!

Amusing terms coined by AMWA workshop attendees

These are just for fun, taken from the guide (p. 36). Feel free to make up your own and share!

  • akinophilia: the love of not moving
  • amourarrhythmia: the irregular heart rhythm resulting from being in love
  • androgenetic amaurosis (male-pattern blindness): the inability, more prominent in men, but also occurring in girls and young women, to see items they are searching for— even when they are in plain view!
  • bradymentosis: slow mind
  • cephalosclerograph: an instrument that measures the hardness of the head
  • hidrophobia: fear of sweating
  • hypercyanoblepharosis: too much blue eye shadow
  • hyperdynamic ectorectal pneumatogenesis (HEP): a condition characterized by overactivity in the production and release of gases from the rectum
  • hypermalapedostomatisis: state of excessive bad-mouthing by a child
  • hyperosteocephalopathy: condition characterized by excessively thick skull
  • hypojocularosis: abnormally low sense of humor
  • labiomegaly: enlargement of the lips (whether natural or artificial)
  • macropodologist: one who studies abnormally large feet
  • micropizzalatus: small pizza on the side
  • neurofrenetic: in a state in which one’s last nerve is being frazzled
  • polygnosia gravis: severe “information overload”: a stressful condition caused by a barrage of constant “knowledge”/info in daily work
  • postmenopausal mammamegaly: big breasts after menopause
  • pseudocerebromegaly: an unwarranted belief in the size (importance) of one’s brain
  • rhinocarcinophobia: an abnormal fear of nose cancer
  • rhinophage: something that eats noses
  • somnigenesis felinus: the ability of cats to induce sleep in nearby humans (by giving off “snooze rays”)
  • tachyglossal: pertaining to having a quick tongue
  • ultrahypnophilia: excessive love of sleep

Questions, comments or new additions to the newsletter? Please contact the Publications Committee Chair. And remember, you can also read this newsletter on the chapter website. You can find previous newsletters on the website as well.

March 14, 2024 · Filed under Newsletters