Category: Opinion piece

An article in which the writer expresses their personal opinion, typically one which is controversial or provocative, about a particular issue or item of news.

Why external validation is important for employee engagement and culture

by Diana Evans |

“It’ll never work” – the words heard repeatedly by Louise Sharp, Founder of Makara Health almost ten years ago when she set up an agency with a brand new approach. Long before COVID, Louise had a vision, and that was to tap into senior talent anywhere in the country, people that needed flexibility, understanding and the ability to work from home if needed. The point was getting the work done, not where you did it. The model was bold, there was no shiny central London office with pool tables and inspirational quotes on the wall. It was about hard-working, senior individuals who were trusted to get the job done the way they saw fit, because they knew their stuff.

Makara Health is now 80 people strong – but ultimately our model remains. We have a small hub office in Wiltshire (with an incredible support team) but predominantly people work from home. Makara has always prided itself on its culture; on being a fun and kind place to work where we understand that job satisfaction, and the discretionary effort so often expected in a fast-paced agency, can be earned through trust, flexibility, ownership and human empathy.

While COVID has driven a significant proportion of the workforce into their home offices, company culture is trying to catch up. At Makara, we have always worked this way, we grew up knowing the importance of connecting with each other from day one, we know how to build rapport in our virtual world, we know how to on-board new starters properly, so they feel part of a team from day one. We know how important our face-to-face opportunities are for everyone. That our weekly Zoom team meeting, whilst being a big investment of people’s time, is critical to feeling connected. We know when getting some real in-person time with someone is needed and a Teams call won’t cut it. We try very hard to check in with our people, even when we don’t see them every day.

Our recent employee engagement ‘outstanding’ accreditation from Best Companies – has been clear external validation of what we knew to be true – that Makara has agility in its DNA and this is something that brings true value to a workforce if handled with integrity, intelligence and kindness.

Make mental health and wellbeing for all a global priority

by Georgia McGlasson |

The World Health Organisation recognises World Mental Health Day every year on the 10th October. It’s a chance to talk about mental health, think about how we can look after it, and encourage those who need help to seek it. This year’s focus is ‘Make mental health and wellbeing for all a global priority’.

In the past, mental health hasn’t been very well recognised let alone prioritised. People who had mental health problems were deemed ‘crazy’, and were often separated from communities and subjected to inhumane ‘treatments’. Thankfully, in 1959, the UK Parliament passed The Mental Health Act which started a chain of events that integrated mental health services into the wider NHS. Treatments are now less invasive and more effective, and there are increasing numbers of mental health charities to help support people. The Equality Act of 2010 also means it is now illegal to discriminate against people dealing with mental health problems in the workplace, while using services such as hotels, hospitals and public transport, or when buying/renting property. We have come a long way, but there is still work to do. Unfortunately, mental health services are overwhelmed, and waiting lists for treatment can be years long, making them inaccessible for many of the people who need them, when they need them.

The public perception towards mental health has also been shifting over the years, but some stigma still remains. Unfortunately, 90% of people with a mental health problem will experience shame and discrimination, whether that be within their relationships, at work or during treatment. Even more heartbreakingly, 26% say this resulted in suicidal ideation. It’s for these reasons that I love to hear people talk openly about mental health; normalising this is so important. The shame I felt on being diagnosed with an eating disorder in 2012 prevented me from talking to many of my friends and family about it for years, which consequently meant I didn’t get the support from them that I needed, and it took me a lot longer to recover. On average, it takes people who are suffering over a year to tell their families and friends about their mental health problem which exacerbates their difficulties, and delays their treatment even more. Now, out the other side of recovery, I’ll happily talk to anyone about my experience with mental health in the hopes that it raises awareness, improves understanding, and helps anyone who is suffering feel less alone and more open to talking.

I like to think about mental health in the same way as physical health, and with the same level of importance (the two are actually very intertwined); we all have mental health and it’s important we take care of it. This comparison also extends to when we experience ill-health; sometimes this is a result of not taking good enough care of your physical or mental health, and other times it’s just pure bad luck. It’s vital that we attach the same value to mental health as we do to physical health. If there are signs of a serious problem, we should address them at our earliest convenience, and seek professional help if necessary. We should feel no shame for this, and even when there aren’t signs of problems, we should still be engaging in behaviours that are protective of our mental health, just like we do with our physical health.

On that note, here are some things I find helpful to maintain or improve my mental health:

  • Journalling/free writing – when I’m feeling confused, anxious or overwhelmed, I like to get my thoughts out onto a page. There’s no judgement on a page, and getting your thoughts out helps to process them, and maybe see patterns or understand behaviours that you couldn’t before
  • Getting out in nature – living in a city centre can sometimes make this difficult, so I’ve also turned my flat into a mini jungle by building up a collection of houseplants to take care of
  • Going for a walk, or if I’m feeling energetic, a run – the benefits of exercise reach far beyond the physical; regular exercise has been shown to lower stress levels and improve mood
  • Yoga and meditation – I find regular practice, no matter how long, is really helpful to slow down my mind when it’s racing, and help me think about things clearly even in times of stress

Most importantly, if you need extra support, you should talk to someone, a friend, a family member, a colleague, a therapist, or all of the above. You are entitled to help. Talking openly and honestly about how we feel is not only helpful for our mental health, it also encourages others to be more open about theirs. This ultimately plays a part in reducing the stigma that is still attached to mental health problems. Next time someone asks “How are you?”, I challenge you to give the honest response (it’s a lot harder than it sounds!).

With 2/3rds of the people who are suffering with mental health problems believing that work stress was a contributing factor, I am so grateful to work for a company that promotes employee wellbeing and offers a range of resources to support this. We have an internal, online POD containing a wealth of wellness resources including articles, recipes and affirmations from the Reward Hub, documents about how to look after your mental health, and inspirational videos and workshops. There’s also a Wellness Action Plan available to go through with your line manager if you want to, which delves deeper into the specifics about what can be done to support your mental health in the workplace. I personally find the existing flexibility around work hours at Makara hugely beneficial to my mental health – if I’m having a bad day, I know I can take breaks whenever I need, and make up the time when I am able to. There is the understanding that, although work is important, we all have lives outside of the office too, and it’s okay to work around our other priorities. Working alongside friendly and supportive colleagues is, of course also a huge benefit. Maintaining a good level of mental health improves our productivity, our physical health, our relationships, and our quality of life. This alone, in my opinion, is a good enough reason to make it a priority in our lives. But there is another reason it needs to be a priority – sadly, 1 in 4 people will experience a mental health problem every single year, and some of whom will likely struggle in silence. Creating environments where people feel supported, respected and safe to talk about their mental health is crucial if we are to reduce the stigma, and encourage those who need it to seek help. Show compassion to others always; you never know what they’re going through. But, just as importantly, be equally as kind to yourself.

Time for reflection: The best advice I would give to my younger self

by Gurjit Chahal |

Throughout my career I’ve been passionate about helping others through coaching and mentoring. I’ve been lucky to have been inspired and supported by great leaders and it is important for me to do the same and give back.

This is why I chose to take part in the Taylor Bennett Foundation mentoring programme this year. Designed to address the need for greater ethnic diversity in the communications industry, the 6-month programme enabled me to support a talented Junior Account Executive who had started her career in a healthcare communications agency. It was a very rewarding experience as we both learned a lot from each other. My mentee got support with building her skills, knowledge and confidence and is now due for a promotion. I got insight into the experiences of young professionals working in this industry and what more needs to be done to champion change for the future. In particular, I took away the importance of:

  • Having more open and honest conversations about diversity, equality and inclusion at work
  • The need for ongoing education
  • Listening to different perspectives
  • Supporting diverse talented people so that once they’re in this industry, we’re able to retain them, make them feel valued and help them thrive.

Listening to my mentee’s challenges and opportunities, made me think about how similar my experiences were when I started working in healthcare communications. It’s helped me reflect and if I was to do it all again, the 5 pieces of advice I’d share with my younger self would be:

  1. Be curious and keep learning: Read, get involved in new projects and learn from other industries – it doesn’t have to just be healthcare. Energy and enthusiasm go a long way!
  2. It’s ok to ask for help: Teamwork is vital in this industry and it’s good to hear different points of view and it doesn’t need to rest on one person’s shoulders.
  3. Stay positive: This can be tricky when things go wrong but a solutions mindset has really helped me from going on a downward spiral and learning from challenging situations.
  4. Slow down: While we work in a fast-paced industry, slowing down can help with coming up with new and fresh ideas and delivering quality work. Also, career progression doesn’t have to be a rush – gaining knowledge, experience and appreciating opportunities in the moment is valuable.  
  5. Be yourself: I certainly felt different from others when I started in this industry over 14 years ago because of my ethnic background and how others sometimes negatively perceived where I was born and raised in the UK. However, my life experiences have helped build my confidence, resilience and shaped the person I am today. I’ve learnt that I don’t need to shy away from my background and can educate others about my heritage. And while it’s important to be professional, showing your personality and fun-side has really helped me enjoy work and make great friends along the way.

Writing this blog has made me reflect on my experiences at Makara Health. Although I’ve only been with Makara Health for just over 18 months, it has felt much longer (in a good way!). I’ve been privileged to work with so many diverse and talented people who are not clones of each other! What I’ve really valued is the support, growth opportunities and being ‘in’ it together. As I prepare to go on maternity leave this month, I’m excited about the next chapter in my life and returning next year as a mum, ready to learn and continue to grow 😊.

Keeping the ship afloat: Boldly changing course to avoid ‘sunken’ costs

by Matt Wheeler |

Reasoned decision-making is a vital skill in all walks of life. In a vacuum, this means examining all the options and rationally picking the best course of action. But, in the real-world, there are factors that might cloud judgement or introduce bias, and it’s important to keep a look out for these. One such tendency is known as the ‘sunken cost fallacy’.

Oxford Languages define the sunken cost fallacy as “the phenomenon whereby a person is reluctant to abandon a strategy or course of action because they have invested heavily in it, even when it is clear that abandonment would be more beneficial.” This theory could relate to any number of steps within healthcare. Ideally, it should not inform decision making, but, in reality, the human nature is susceptible to it.

It’s often quoted that only 10% of drug development projects make it all the way from Phase I to approval. The other 90% of ‘failures’ may fall at many different hurdles, for instance due to a lack of efficacy, an unacceptable safety profile, or acknowledgement of likely lack of commercial interest. Significant resources, both financial and time expended, will have already been invested in development when these warning signs appear, but clearly the rational (and ethical) decision is not to pursue these drugs further, regardless of ‘sunken cost’.

When it comes to clinical decision making, there are ways in which, in theory, sunken cost fallacy could impact decision making. If a healthcare provider has started a patient on an expensive therapy, but it becomes apparent that it is not working, might they be susceptible to continuing the treatment, rather than switching to something less expensive? Or would a doctor be less willing to entertain an alternative diagnosis if they had already spent considerable time on the original investigations that have led to a potentially incorrect conclusion? A cross-sectional, in-person survey of 36 medical residents, conducted by Bornstein et al in 1999, found that their evaluation of treatment decisions “reflected good reasoning, in that they were not influenced by the amount of time and/or money that had already been invested in treating a patient.” Interestingly, these skills were not shown to extrapolate to the evaluation of non-medical situations by the same people.

What of pharmaceutical marketing? Perhaps a pharma giant has invested millions of pounds over a number of years in cultivating a presence at an international congress, every year constructing the same eye-catching booth and updating their panels with the latest data for their brand (and serving great coffee…). They’ve formed great relationships with the organisers, and are well into preparation for the 2023 event in Melbourne. Unfortunately, COVID-19 Upsilon (sorry) means that whilst the congress will go ahead, no HCPs will be able to travel into Australia from any of the key target markets for the brand. Should they continue to invest in the event, or cut their losses?

Perhaps this all sounds a bit far-fetched – we all like to think we are (at least largely) rational in our decision-making. But the lesson seems a good one: investment in a project or idea should not preclude abandonment, if it is the right thing to do, whether this applies to healthcare professionals, pharmaceutical companies, or in fact within healthcare communications; hard though those conversations with clients might be. Not much use in updating the reference access dates and re-approving that beautifully designed, cutting-edge website that nobody has visited since 2018, after all; far better to expand the range of targeted, data-driven emails that have demonstrably increased market share and sales… This is not to dissuade investment or creativity, by any stretch – just to point it in the right direction boldly, and to have the bravery to change course when necessary.

Juggling work and the menopause

by Becky Pamplin |

About 10 years ago, a friend of mine brought a handful of leaflets about the menopause to a social evening. I carried on drinking and chatting and didn’t pay any attention to the leaflet. I thought I was way too young and didn’t need to know about that yet. And then of course, I didn’t recognise the symptoms.

The crippling anxiety – I thought it was just how I was now. Forgetting words – signs of dementia? Disturbed sleep every night – is this what happens as you get older? Hot flushes, night sweats – I started to get the picture.

The effects of these symptoms were far-reaching and had a significant impact on my work-life. Events at work such as making an important presentation or attending a meeting somewhere new, which I would previously have taken in my stride, had me feeling physically sick with anxiety for days beforehand. I went from being someone with an excellent memory to someone who could forget an ordinary word in front of a room full of people. And the disturbed sleep made it difficult for me to concentrate at work and affected my ability to shrug off a difficult day. (I’m sure those of you who have young children can empathise with this too!)

After trying various solutions, I eventually went to the doctor for help. I found out that I was perimenopausal (‘perimenopause’ meaning the time in which the body is making the transition to the menopause), and a range of treatments were suggested: herbal remedies, medication for the anxiety and sleep-related symptoms, or HRT.

I never did get as far as trying HRT, because I ended up having treatment for breast cancer last year. The cancer was oestrogen-receptor positive, meaning that it uses oestrogen to grow. So HRT is ruled out and I now have to take an oestrogen-blocking medicine, which has side effects that are effectively menopausal symptoms. Just what I need!

I always try to look on the bright side – and there are many actually, so here are a few of them. I changed my job – and I’m so much happier now. I learned how to crochet; I love it, it helps with managing anxiety, and I even sell some of my creations. I faced the onslaught of breast cancer treatment-related side effects fairly pragmatically, as I’d already been dealing with most of them for several years. And now that I’ve started telling people at work that I’m menopausal, we can have a shared laugh about the unpleasant symptoms too.

My work is home-based, and I’ve discovered some coincidental advantages to this. If I suddenly feel boiling hot, I can change my outfit. If my face goes bright pink on a Zoom call, I can turn my camera off for a bit! Now that I’m not commuting, I can go for a walk before starting work, which helps me sleep better.

Why am I telling you all of this?

Menopausal women may need flexibility and understanding in order to keep working, but there is still quite a taboo around talking to people about it. Maybe we keep quiet about our experiences due to embarrassment or fear that we will be judged as less able to do our jobs.

There has definitely been some progress. There have been two documentaries on Channel 4 presented by Davina McCall about the menopause which, together with her social media campaigns, have really made a difference in raising awareness and enabling conversations about what women going through the menopause are experiencing.

The UK Government’s cross-party Menopause Taskforce met for the first time this year. The taskforce will tackle issues including increasing access to treatment and ending the taboos that still surround conversations about the menopause, including in the workplace. An increasing number of companies now have a menopause policy and specific menopause-awareness training.

There is noticeably more talk on LinkedIn about the menopause now. There are various websites set up to provide menopause advice. Products are now specifically marketed for menopausal women (from shampoo to tea), and the TENA #LastLonelyMenopause campaign on TV brings a tear to my eye every time I watch it. All of these things help to normalise the conversation and break down stigma, and it feels like we are moving in the right direction.

Menopause facts and figures

  • Women going through the perimenopause/menopause can experience a wide range of symptoms, which may have a significant impact on daily life.1
  • The most common symptoms include host flushes, night sweats, difficulty sleeping, low mood/anxiety, joint aches, and problems with memory and concentration.1,2 In fact, as many as 48 symptoms have been linked to the meopause.3
  • In a survey featured as part of Davina McCall’s latest documentary on Channel 4, 44% of women said their ability to work has been affected by menopausal symptoms.4
  • One in ten women who have been employed during the menopause have left work due to menopause symptoms.4


  1. NHS. Symptoms of the menopause. Available at: Accessed July 2022.
  2. Menopause Matters. Menopause symptoms. Available at: Accessed July 2022.
  3. GenM. The 48 symptoms of the menopause. Available at: Accessed July 2022.
  4. The Fawcett Society. Menopause and the Workplace, 2022. Available at: Accessed July 2022.

Teamwork or: How I learned to stop worrying and love the QC

by Vicky Laker |

You get to the end of a piece of work, you’ve checked it over, run the spell checker, checked it again, checked everything is aligned properly, checked it again, read it aloud to check the grammar, checked it again. You think it’s looking great and perhaps it is ready to share with the client. But as a final check, you send it to a colleague to QC and there it is… all your bullet points have no full stop at the end except one. How many other inconsistencies have crept through? Great start to a bad day, right…?

As you know, our brains are so clever that they will automatically correct errors we have made so we simply do not see them. That’s amazing, isn’t it? Yet we automatically lean towards chastising ourselves for these minor errors even when it is our own incredible minds that override us. What is a perfectionist like me to do?


In my time at Makara, I have learned so much about what it means to work together as a team, and utilise the incredible power of the QC. Within the Client Services Team it is not unusual for us to openly discuss the seemingly simplest of tasks so that we can attack a job from all angles and aim for the smartest outcome. Acknowledging the areas that you struggle with is not a display of weakness, it is a display of strength, and utilising all the skills of the people around you means a swifter and more robust answer to the challenge you are looking at. When writing blog pieces I will always send them over to my friend and colleague Gina Gough. Her interest in writing and editing means she is kind when she reminds me that I have a tendency to use too many hyphens… I openly acknowledge that, whilst I can get ideas down on the page, my strength does not lie in finding the best grammar, structure and phrasing. But it is one of her strengths so it makes sense to embrace her skills and use this incredible resource that I have within my own team. At the end of the day, everyone wins when we combine our collective talents.

I’m not going to lie, I do love a QC job. Maybe it is the inner child in me who once pretended to be a teacher,  taking the register or marking homework with my red and green biros. I confess that when I receive a QC job from one of my colleagues who is renowned for their attention to detail, there is a small and very discreet celebration when I find an error. We all find reassurance in the fact that even the most intelligent and accomplished people can still make a mistake. I often think of the story that a colleague recently shared about a space rocket launch scuppered by a misplaced character in the coding. That doesn’t mean I gloat about it. I couldn’t write any of the medical material my colleagues do, but I can sniff out an errant double space from 100m away. When we acknowledge our own weaknesses, but can still recognise the strengths both in ourselves and others, then we are on the best path to creating something great.

By working with others who constructively critique our work, we in turn learn to pick up better habits, implementing them in our future work. The editing superhero in your team will help you to become a better writer. And, as you will have no doubt noticed, there are no hyphens in this blog… perhaps I am growing as a writer? (Though I fear she may have something to say about my use of ellipses).

My reflections on World Health Day: Our planet, our health

by Georgia McGlasson |

Every year since 1948, on April 7th the World Health Organisation (WHO) celebrates World Health Day in an attempt to bring awareness to a particular global health issue. I can’t help but think that they must’ve felt very spoilt for choice earlier this month. Previous years have focused on topics such as health equality, depression, and diabetes. This year’s theme is a big one: “Our planet, our health”.

It’s hard for me to know where to start with such an all-encompassing topic of health, but it doesn’t feel right to recognise World Health Day without mentioning the health emergency that just 2 years ago led to lockdowns across the globe. Throughout the COVID-19 pandemic, many people have been forced to deal with a reality they never thought possible. Each of us has been impacted by the pandemic, whether that be through loss of loved ones, financial insecurity or increased social isolation. Despite this, I’ve noticed many positives throughout the pandemic. In the early days of lockdown, I was in awe of the 436,000 NHS volunteers who risked their health to ensure the safety of vulnerable people, despite uncertainty about the virus being at its height. On top of this, several vaccines were developed in record-breaking time,1 a huge triumph for the scientific community. To me, this is proof that when people work together we can achieve things thought to be impossible.

According to the latest Intergovernmental Panel on Climate Change (IPCC) report, it is “almost inevitable” that temperatures will rise above the 1.5°C aim agreed in the Paris Agreement, resulting in irreversible climate breakdown.2 It’s estimated that half of the global population live in areas “highly vulnerable” to climate change even at current levels of heating, and mass die-offs of species are already under way.2 We have a colossal challenge on our hands if we want to prevent a catastrophic global health crisis. It is a challenge that is going to require individuals, organisations, and governments to work together to find a solution. Although the data are clear and it’s easy to feel overwhelmed, it’s important to remember what can be achieved when humans work together, as demonstrated by our response to the pandemic. We all have our part to play and we have to work together.

The environmental benefits of the pandemic give us a unique insight into the types of things we need to do to curb carbon emissions; fewer people driving to work or flying overseas for business meetings or holidays meant that global carbon emissions fell by 8.8% in the first half of 2020.3 Naturally, as vaccines allowed us to return to ‘normal’ and restrictions were eased, carbon levels started to rise again to pre-pandemic levels.4 However, this does not mean that all progress is lost. More organisations have learned to adopt more flexibility when it comes to working from home, and platforms such as Zoom have retained a large customer use for business meetings.5 Throughout the areas of my life, I am hearing more people talk about what they are doing to reduce their carbon footprint, which fills me with hope. A shift in what’s ‘normal’ is exactly what we need to improve the health of our planet, and to ensure the safety and survival of generations to come.

At Makara, we are constantly adapting to new challenges and seeking innovative solutions. When it comes to the turbulent times of the pandemic, with an existing home-working structure in place and a holistic approach to employee health and wellbeing, Makara was well equipped to deal with the challenge. As a reputable and rapidly growing company, we have a respectable sphere of influence within the healthcare industry. I am proud to see initiatives such as the virtual forest, where hundreds of trees will be planted by Makara to support the health of the planet and increase awareness of this important issue. Continuing efforts such as these will have both direct and indirect environmental benefits, as we encourage and inspire each other to think more proactively about the environment.

The WHO has produced a really informative and inspirational video for World Health Day that I’d highly recommend giving a watch: or you can read more here:

If you want to read more about how you can further help the environment, Imperial College London have put together a useful guide:


  1. Brothers W. A Timeline of COVID-19 Vaccine Development. BioSpace. 2022 [cited 5 April 2022]. Available from:
  2. Intergovernmental Panel on Climate Change. Climate Change 2022: Impacts, Adaptation and Vulnerability. 2022. Available from:
  3. Liu Z et al. Near-real-time monitoring of global CO2 emissions reveals the effects of the COVID-19 pandemic. Nature Communications. 2020;11. Available from:
  4. Tollesfson J. Carbon emissions rapidly rebounded following COVID pandemic dip. 2022 [cited 5 April 2022]. Available from:
  5. ‘This Could Have Been a Zoom Meeting’: Companies Rethink Travel. 2022 [cited 5 April 2022]. Available from:

Seeing the wood for the trees: Patients are the real story

by Matt Wheeler |

As a medical writer, it’s easy to get caught up in the nuts and bolts. Accuracy, readability and a clear, concise story (usually revolving around scientific data) are paramount. Of course, the understanding that the patient is at the core of the whole narrative, its reason for being, is never lost; but if you’re reviewing a 90-slide PowerPoint consisting of Kaplan-Meier curves, forest plots and adverse event tables, in reality, at least in my own experience, sometimes it’s hard to see the wood for the trees.

A few years ago I gave a ‘Lunch and Learn’ presentation titled ‘Powerful Patients’ to colleagues. I wanted to talk about people who had been through extraordinarily difficult experiences with their medical conditions, but had also achieved incredible things as patient advocates and role models.

There are two in particular that I still think of often, not necessarily because I’ve been involved in working with a medicine for their particular condition, but due to their achievements and zest for life. If you’ve worked with me before, you can probably guess who they are! Their incredible resolve has kept me going on tough days when that reference pack just isn’t coming together…

I hope that you find their stories as inspiring as I do.

Claire Wineland

Claire was born with cystic fibrosis in Austin, Texas in 1997. A few days after her 13th birthday, after a routine surgery, she developed septicaemia leading to full lung failure. Given only a 1% chance of survival, she emerged from a medically-induced coma after 16 days.

She would stay in the hospital for three months, during which time she decided to found ‘Claire’s Place Foundation’ to provide support to children and families affected by cystic fibrosis.

Claire would go on to be a prominent voice in the cystic fibrosis community, doing a number of Ted Talks – this one when she was just 14!

She was also part of my personal favourite healthcare communications campaign, Breathless Choir (winner of the Grand Prix in Pharma prize at the Lions Health awards in 2016).

Sadly, following a double lung transplant in 2018, Claire passed away due to complications at the age of 21. Her legacy continues to live on through her foundation. Shortly afterwards she was the subject of a documentary film that is also on YouTube, a tribute to a young person wise beyond their years, who undoubtedly had an enormous amount more to give.

Deborah James

Deborah was diagnosed with Stage IV bowel cancer in 2016, at the age of 35. I first heard of her as a member of the You, Me and the Big C podcast on the BBC, originally with herself, Lauren Mahon and Rachael Bland (who sadly passed away in 2018), discussing their lives with cancer and exploring many issues such as mental health, fertility and chemotherapy. Their informal and welcoming style has given a real community feel for people living with cancer, and the podcast continues to this day.

Deborah has been through an absolute litany of treatments and procedures, as anyone who follows her popular Instagram account, @bowelbabe, will know. She writes for a number of national newspapers and fundraises alongside major UK cancer charities, and has a best selling book, ‘F*** You Cancer’, a self-help guide to living your best life with cancer.

She has also been instrumental in helping bring new treatments to patients in the UK, acting as a case study for NICE submission as part of a clinical trial.

Her resolve and persistence in the face of adversity, still determined to help others, is amazing.

Hope is a powerful theme in healthcare communications, and both of these inspiring people have been determined to tell its story. That shared ideal only reinforces our job as creators to make sure that patients are always the focus of our work, weaving a narrative around the backbone of data to form a whole.

When East meets West: What I have learnt from working in two different worlds


Since the very first moment I arrived at Heathrow airport to begin my journey in the UK a year ago, my life has been a roller coaster of emotions. My formal education and work experiences have been deeply grounded in eastern values and principles, which makes moving and working in a western, multicultural country not only exciting but also nerve-racking, not to mention pressured and alienating.

Cultural differences…

Obviously language was a barrier for me at first. Having studied in an international environment and achieving a decent IELTS score of 8.0 could not guarantee my effective communication with colleagues. I struggled to understand different English accents, absorb medical terms and transition my ideas into words fluently. Even though I had a few years’ experience working in Public Relations in Vietnam, it felt like starting all over again, especially when I jumped from doing PR for the consumer/tech industry to healthcare, a highly specialist sector in which I had no background.

My colleagues were super friendly and welcoming, but I also found that politeness is the key for business communication here and maintaining pleasantries like saying ‘please’ and ‘thank you’ is extremely important, which sometimes gives me a bit of pressure. Vietnamese people do not say ‘thank you’ as much as westerners, and it is totally common if you say ‘thank you’ in Vietnam and do not receive any response.

Another significant difference between two workplace cultures is that: while asking questions is a standard practice in the west, it does not come naturally to a deeply rooted Asian employee like me. When I was in Vietnam, questioning the ideas and viewpoints of senior team members  was often frowned upon and we must be extremely careful and sensitive whenever discussing any issues with seniors. Therefore, it took me a while to gradually embrace the differences, adapt and be more open, honest and no longer hesitate to ask questions whenever needed.

And…. here comes the joy!

Hard work and long hours have always been the standard in our eastern working culture and I used to normalise working overtime and bringing work home. Leaving work at 5.30pm, which was the time that I was supposed to, might even create gossip around the office and my ex-colleagues would think about me as being lazy and not a team player. For that reason, working at Makara Health has been a gamechanger. Everyone in our company constantly strives for work-life balance. My line manager used to call me out for a discussion when I sent an email late at night, just to make sure I wasn’t working overtime unnecessarily. It goes without saying that Makara promotes a holistic understanding of performance, always encouraging healthy working hours and sustainable methods of working.

What is even more exciting is that even before the pandemic, many employees at Makara could already choose whether they would prefer to work full-time remotely, from the office or a combination of the two. The majority of employees at our company, especially the account-handling team, are used to agile working with flexible work hours. Speaking myself, I am a PR and Communications Assistant living in Bournemouth who used to work two days in the office and three days at home, but have recently switched into working remotely full-time.

My stressful commutes have been swapped for morning yoga and instead of having quick sandwiches at my desk, I spend the lunch break in my kitchen away from my closed laptop, giving my brain a chance to recharge and allow me to come back feeling energised to tackle the rest of my day. I believe that where you work is not nearly as important as getting the job done. I’m flattered that Makara understands the effectiveness of remote work and trusts me to deliver from any location. Adding remote work into our company dynamics has successfully created a team of talented people from different locations.

What more could I want? I have a workplace environment that promotes diversity and inclusion, a globally minded leader who supports their diverse employees, and an amazing team who support each other to reach their full potential. No one in my team speaks Vietnamese, but they understand where I am coming from. They never celebrate Lunar New Year, but they shared the joy and excitement with me. I made mistakes, but they are more than happy to a give me great advice and constructive feedback. Our company culture has successfully and undoubtedly drawn colleagues from diverse cultures closer.

All in all, working anywhere in the world comes with its own benefits and downfalls and ultimately it is up to each of us to decide what suits our personality and working style. Although my life in the UK has been a rollercoaster, I have managed to enjoy the ride and happily landed on my feet with unforgettable memories, and supportive, warm-hearted people around.

Talking the talk: Speaking patients’ language in medical writing

Writing for patients is my favourite part of medical writing. I find it rewarding and fun. It is where my passion for medical writing started. I love the challenge of translating complex scientific and medical information into easy digestible content. It is a fine balance of simplifying whilst not patronising the reader. I always remember attending a training course about writing ethics applications in my early days in clinical trials. One of the key messages I took away from that training was that the average reading age in the UK is between 9 and 12 years of age.

I have always tried to apply that in my patient writing. Although it can be a real challenge when you have to explain a complicated drug mechanism of action or a rare genetic disease.

The drive for a shared care culture in healthcare is stronger than ever, so enabling people to make informed health decisions has never been more important. The ability to effectively engage and empower patients in their own healthcare has the potential to improve their treatment adherence, health outcomes and their quality of life.1,2 This creates a demand for better information for patients and the general public in the medical, pharmaceutical and healthcare sector. Plain language materials are essential tools to help patients translate and understand complex medical and health information.3

In England alone, just below half of working aged adults (aged 16-65 years) are unable to understand or make use of everyday health information.4 It is important to keep this in mind whilst developing content for the patient population and pitch it at the right level. Patient understanding can vary widely depending on their condition, severity and length of time since diagnosis. For example, a newly diagnosed cancer patient’s understanding of their health and medical information compared to someone with a life-long medical condition that requires frequent intervention is very different. Therefore, to gain insight on the level of understanding and specific terminology certain patient groups use, it can be helpful to access patient specific websites and forums.

There are many good practices around writing for patients, such as using simple words, cutting the jargon, using short sentences, increasing white space on the page, using graphics and using the active voice. However, knowing the rules and applying them takes a certain skill. Many health information producers feel they lack the skills to develop appropriate resources to meet the needs of people with low health literacy.5 It can be really easy to lose the key message, so always consider removing any information that may not be relevant to the patient.

Writing should be focused on what the patient really wants to know.

The majority of people access information about their health online and more than half of these people will be influenced by the information they find.6 Now more than ever, it is important that patients and the general public have access to unbiased, trustworthy information that is evidence-based. It is our job as medical writers to make sure that we produce health and medical information that is really what they need. So let’s make sure we talk the patients’ language.


  1. Vahdat, S. et al Iran Red Cres Med J. 2014; 16(1): e12454
  2. Chen, J et al Health Educ Behav 2016; 43(1): 25-34
  3. Warde, F. et al CMEJ 2018; 9(2): e52-e59
  4. Rowlands, G. et al Br J Gen Pract 2015: e379
  5. Health literacy survey 2013 (accessed March 2022)
  6. Profiles of Health Information Seekers 2011. Available from: (accessed March 2022)