Notes on rewriting the e-mail

Last updated: Sunday, September 25, 2022

Here is the original e-mail again and, below it, we have provided some notes suggesting how it might be improved.
Date: Fri, 18 Sep 2022 12:28:15

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 SmPC that ʻAnotherine does not appear to potentiate the effect of alcohol on cognitive functions in healthy volunteers.

Yours faithfully,

A. Newbie
Lord Ellpus NHS Foundation Trust

The biggest criticism of the original e-mail 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 e-mail 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 e-mail has no title or subject. 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 e-mail. At the moment, the e-mail just ‘starts’ and there is no orientation for the reader to explain what the e-mail is about and why it has been sent.

  • There is some pharmacy jargon. Specialist words like ‘induce’ and ‘SmPC’ 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 e-mail 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 e-mail 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’.

  • People usually sign off their professional e-mails with words such as 'regards', ‘kind regards’ or ‘best wishes’. In very formal e-mails 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 e-mail sign-off, but that is a matter for personal preference.

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

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