Notes on re-writing the email

Last updated: Sunday, September 20, 2015

Here is the original email again and, below it, we have provided some notes suggesting how it might be improved.
Date: Fri, 18 Sep 2015 12:28:15
From: A.Newbie@LordEllpus.nhs.uk
To: Leonard.McCoy@nhs.net
Subject:

Dear Dr McCoy,

A large number of medicines interact with alcohol to cause drowsiness. However, alcohol is metabolised via alcohol dehydrogenase, cytochrome p450 and catalase and prescribed medicines are not known to induce or inhibit the activity of alcohol dehydrogenase or catalase. However, many prescribed medicines are metabolised with the cytochrome p450 enzyme system and some of them can potentiate or inhibit the enzymesʼ activity but interaction between medicines and alcohol via cytochrome p450 is unlikley. However, the route of metabolism for anotherine is not known and unlike a lot of centrally active drugs it does not appear to potentiate the affects of alcohol and this has even emboldenned the manufacturer to state in itʼs SPC that ʻAnotherine does not appear to potentiate the effect of alcohol on cognitive functions in healthy volunteers.

Yours faithfully,

Anne
A. Newbie
Lord Ellpus NHS Foundation Trust

The biggest criticism of the original email is that it does not really answer the doctor’s question very well. It introduces themes and ideas but does not expand upon them in a way that is meaningful. Relevant facts are produced but not put into context. Good examples of themes introduced but not explained in the original email are:

  • A large number of medicines interact with alcohol to cause drowsiness’. Is this relevant to effects upon blood levels? If not, why mention it? If it is relevant, say why it is.
  • Alcohol is metabolised via alcohol dehydrogenase, cytochrome p450 and catalase’. The relative importance of these three enzymes in metabolising alcohol is hinted at, but not properly explained. It is actually a crucial point in understanding the answer.
  • ‘...interaction between medicines and alcohol via cytochrome p450 is unlikely’. Why is this? It seems fairly important, but it is glossed over.

However, there are a number of other areas for improvement:

  • The email has no title. This means it might sit in the consultant's inbox for ages and be ignored or just deleted un-opened.

  • There should be a summary of the consultant's question at the beginning of the letter. At the moment, the email just ‘starts’ and there is no orientation for the reader to explain what the email is about and why it has been sent.

  • There is some pharmacy jargon. Specialist words like ‘induce’ and ‘SPC’ may not mean much to doctors. At least they may not understand the implications.

  • Given the importance of the enquiry the answer is not detailed enough, and there are no references.

  • The text is not very well organised. It is all bunched up at the top of the email and so is not presented in a very attractive manner. Major, different, themes are all also lumped together into one big paragraph. These need to be split up for clarity as much as for presentation.

  • Most of the sentences are too long.

  • There is no punctuation in the original email other than full stops, so it does not read well.

  • There are some poor uses of English – e.g. ‘effect’ instead of ‘affect’, ‘it’s’ instead of ‘its’ and ‘metabolised with’ instead of ‘metabolised by’. There are also spelling mistakes e.g. ‘emboldened’ and ‘unlikely’. ‘Emboldened’ is an odd choice of word.

  • There is irritating and needless repetition of certain words e.g. ‘however’ and ‘potentiate’.

  • These days, people usually sign off their professional emails with words such as 'regards', ‘kind regards’ or ‘best wishes’. In very formal emails and in letters to a named individual you can also conclude with ‘yours sincerely’. The alternative, ‘yours faithfully’, is reserved for letters (or sometimes emails) to unnamed individuals: i.e. those that might begin with ‘Dear Sir/Madam’ or ‘Dear Colleague’ for example.

  • It is good practice to include a summary of your conclusions at the end, and to offer to provide further support if required.

  • The writer's job title is missing; only her place of work is given. You may wish to add your qualifications too in your email sign-off, but that is a matter for personal preference.

We have rewritten this email. Take a look at our new version on the next page.


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