Last month, at Psych Congress in New Orleans, we officially launched Psych Congress Journal. As part of that launch, I had the privilege of speaking with many outstanding clinicians and learning what they would like to see from the journal, what topics matter most to them, and what role this journal can play in their practice. I also spent quite a bit of time encouraging them to consider authorship.

During one of those conversations, someone asked: “If I am just a practicing clinician, why would I write something? Isn’t publishing really for academics?” I suspect this question reflects how many clinicians view medical publishing.

For much of medicine, scholarship has been closely associated with academic appointments, promotion, tenure, research careers, and university medical centers. If none of those things are part of your career goals, it is reasonable to wonder why you would spend your already-limited time writing an article. I think that question deserves an answer.

Publication is not simply about career advancement. It is one of the ways that clinicians contribute to the collective knowledge of our profession. And as a practicing clinician myself, I know that we have some of the most important knowledge to contribute.

Clinical experience has value beyond the individual patient encounter

Every day, clinicians accumulate knowledge that rarely appears neatly in clinical trials.

We learn which treatment recommendations patients accept and adopt. We see unexpected adverse effects, treatment sequencing dilemmas, and gaps between what guidelines recommend and what is realistically possible.

You may have developed a particularly effective way of introducing a difficult treatment discussion. You may have noticed a clinical phenomenon that deserves greater attention. You may have learned something from a treatment failure that would help another clinician avoid that same mistake. Writing gives clinical experience the opportunity to become shared professional knowledge.

Some of medicine’s most consequential advances originated through clinical observation. John Cade’s observations ultimately helped establish lithium as a treatment for mania. Roland Kuhn recognized the antidepressant effects of imipramine while studying a drug that had been intended for an entirely different psychiatric purpose. In each case, the important first step was a clinician observing something unexpected and sharing those findings.

The evidence base is incomplete without clinicians who actually deliver the care

Research is foundational to evidence-based medicine. Randomized controlled trials, systematic reviews, and carefully designed observational studies provide important inferences about efficacy, safety, and treatment outcomes. A trial may help establish a causal relationship of a treatment under carefully defined conditions. But our real-world patients are not trial patients. Real-world patients have comorbidities, poor adherence, and other confounders that are intentionally removed from research models. The patients sitting in front of us rarely meet the inclusion criteria of a clinical trial. This highlights why research and clinical experience need one another. If practicing clinicians only consume the literature but rarely contribute to it, our published evidence risks becoming increasingly separated from the environments in which care is delivered.

Writing makes us better clinicians

There is also a more personal reason to write: the process makes you think differently. It is relatively easy to say, “In my experience, this seems to work.” It is much harder to sit down and write an article defending that position. Writing forces us to think critically about our positions. What does the evidence actually show? Am I accurately representing the literature? Am I generalizing too broadly from my own experience? Many times, I have started writing or preparing a presentation believing I understood a topic, only to discover how much more complicated it became once I tried to explain it clearly and support every conclusion. That is one of the great benefits of scholarship. Writing is not merely a method of communicating what we know. It is a method of discovering what we understand.

We should share what works and what does not

Healthcare has an enormous information dissemination problem. Across the country, clinics frequently solve the same problems independently. While one institution develops a better workflow for monitoring a particular treatment, another may figure out how to improve follow-up. And far too often, no one outside those institutions hears about it. Scholarship can allow the next clinician, clinic, or health system to receive that information and start further ahead.

Epistemic iteration is the process of repeatedly updating what you believe or know as new evidence, experience, or critiques become available. For example, a clinician might begin with a mechanistic hypothesis, compare it with clinical observations and trial data, recognize where the model fails, and then modify the approach to generate better questions. That is why it is important to publish our failures as well as our successes. Some of the most valuable lessons in medicine come from interventions that did not work as expected, implementation strategies that missed the mark, or assumptions that turned out to be wrong. Sharing those experiences is also scholarship.

Practicing clinicians should help shape the literature

There is one final reason I believe clinicians should publish. The literature ultimately shapes how our profession understands itself. It influences guidelines, education, treatment priorities, future research questions, and sometimes healthcare policy. If most of those conversations are driven only by people who primarily work within traditional academic environments, important perspectives can be lost. Questions of feasibility, access, patient burden, staffing, reimbursement, workflow, and real-world implementation may look very different from inside a busy clinical practice. Those perspectives are an essential contribution to the literature.

Take that first step

So, if you have ever thought about writing but wondered whether you have anything meaningful to contribute, consider a different question: what do you know now that you wish someone had taught you five or ten years ago? There may be an article hiding in the answer. You do not need a laboratory. You do not need protected research time. You do not need an academic appointment. Scholarship can take many forms: clinical reviews, perspectives, case reports, quality-improvement projects, practice innovations, commentaries, and descriptions of new models of care. The goal is not simply to publish for the sake of adding another line to a curriculum vitae, but rather to contribute. And if something you have learned can help another clinician ask a better question, avoid a mistake, improve a system, or provide better care to a patient, that knowledge deserves the opportunity to travel beyond the walls of your own practice. When that happens, that will fuel the very mission of Psych Congress Journal.

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