Series 1 Week 5 Know Your Audience

We all have a reader in our minds when we write. Even now, I sit at my computer putting words on a page, and my mind is on the person who will process these words. It’s a beautiful event that transcends time and space. I am imagining you, and you wherever and whenever you are, imagine me in this moment. This is one of the many beautiful things about writing. The relationship between author and audience is extraordinary.

But more often than not, we imagine our phantom reader to be highly educated, hypercritical, and overly concerned with the most minor details of our writing. The truth is that our readers do not care that much. They are not analyzing the writer but attempting to understand the content. A good writer will make that easy, which is what even the most educated audience wants. When we succumb to our inner critic, we tend to focus on the things the reader does not care about, and neglect the things that they do.1

“Writing up,” to an elite phantom reader is a common mistake in medical writing. Even as academics, we envision professors, advisors, or committees judging our work as juvenile and writing to a level we think our audience expects.1 This is more transparent and harmful to writing than we realize. Stay true to yourself as a writer and never replace an appropriate short word, for a longer less applicable one, to sound articulate.2 Even the most expert audience has a much lower literacy level than the writer realizes.3 Most scientific journals, even those aimed towards highly advanced audiences, should be written at a level consistent with high school.3 The goal should be understanding. A writer can convey a theory with brilliant clarity and have continuity with the audience. Even if the theory is proven wrong later, it should not affect the reciprocity between author and audience. But clarity and understanding are no longer the focus when confidence crosses over into arrogance.4 “Writing down” to an audience can be just as dangerous as “writing up.”1

This danger is not limited to the highly advanced audiences, but is true for all audiences regardless of education level. The NIH and CDC recommend writing at 2-5 grades lower than the average grade level of the audience. In addition, stress can compound the readers' inability to comprehend, and literacy level can drop up to 4 more grade levels.3 According to the CDC, this translates to an 8th-grade reading level for the general public, and only a 5th-grade reading level according to the AMA.3 Most academic writers consider their audience to be peers, at the same education and literacy level, and write without consideration beyond that audience.1 This mentality confines the author's thinking and can limit a potentially more impactful piece than if a larger audience were considered.3

So, who is our audience? How can we wrap our minds around a mental image of everyone? We can’t. We tend to imagine those whose approval we seek, like friends and family, peers and colleagues, and influential people we admire.5 Ultimately, your primary audience should be yourself.6 If you don’t like your work, chances are no one else will either. But remember the audience is out there, write a letter to them and not a diary to yourself.1 You must write in an authentic way for yourself, but never lose sight of the outside reader, or else your writing becomes noise.2 It is critical to establish that rapport by being genuine and accessible to your work's specific audience.1 

A great tool to do just that is vulnerability. Vulnerability is particularly effective in reaching more marginalized groups, such as women and minorities.1 A great way to be vulnerable is with a narrative. A narrative is engaging and brimming with humanity, but is also too powerful in some situations. Sword points out that many materials on breast cancer use patient narratives effectively to bring awareness and engagement. However, there are almost none used for ovarian cancer due to the graphic nature of the symptoms and treatments.1 It is important to note the desired reaction from your audience. If it is a call to action piece to show precisely how much some women suffer, then perhaps a graphic narrative is needed. But more likely you will use a narrative for empowerment than for instigation.

This all sounds like a contradiction. Write for yourself, but write for others. Be aware of your specific audience, but don’t limit yourself to it. Don’t write up to an audience on a pedestal or write down to an audience with condescension. With this kind of self-analysis in your head, it will be impossible to write well! So, to simplify, find balance. Write honestly and humbly, and you will reach your audience and beyond.

References

1.     Sword H. Air & Light & Time & Space: How Successful Academics Write. Harvard University Press; 2018.

2.      King S. Stephen King on Writing a Memoir on the Craft. SIMON AND SCHUSTER; 2000.

3.      Herron C. How to Transform Your Scientific Writing to Maximize Your Impact. Redwood Ink; 2025. Accessed March 24, 2025. https://redwoodink.ewebinar.com/webinar/19501/join/13673944.  

This webinar has been referenced with the permission of the creator.

4.     Pinker S. The Sense of Style: The Thinking Person’s Guide to Writing in the 21st Century. Penguin Books; 2015.

5.     Clear J. Atomic Habits. Manjul Publishing House Pvt Ltd; 2020.

6.     Zinsser W. On Writing Well. Harper Paperbacks; 2016.