As medical writers, we strive not just to survive but to thrive. Threats, opportunities, and complications come from many directions, and how to best position ourselves, our departments, and our companies requires much thought. Money is important but so too is finding the best way to operate within the competitive business of medical writing.

A recurrent topic in the medical writing business – and one that frequently creates a great deal of concern – is the threat of cheap outsourcing. Related to this is how to convince clients to pay decent rates for quality work. I myself have had several conversations in the last year about this and have spent much time thinking about it. Michelle Guillemard takes on this subject directly, asking ‘Is cheap outsourcing a threat to your career?' Her answer is no – with caveats – and she tells us how to combat it. Julia Forjanic Klapproth takes on this question from a different angle, explaining how clients can optimise outsourcing to professional medical writers. In essence, their conclusions are the same: in the end, you get what you pay for.

Those of us working as freelancers or for agencies understand that the business of medical writing is competitive. Clients are always trying to get more for less, and freelancers and agencies are trying to beat their competition for good-paying work. But is it time for medical writing agencies to not just compete but to cooperate for the common good? Karen Wooley and colleagues describe the results of the Agency Executive Forum, sponsored by ISMPP (the International Society for Medical Publication Professionals). The Forum came up with a number of areas of potential collaboration, including proposing best practices for working with freelance medical writers and for responding to procurement-driven requests for information.

As individuals, we often ask ourselves if another type of business would be better for us. For example, many medical writers working for an employer fantasize about the independence of freelancing. Other medical writers might be thinking about creating their own company or running a medical writing department within a company or institution. For someone thinking about switching business types, there is much to consider. Kathryn White gives some practical advice about taking the leap from employee to freelancer and provides helpful advice for those already freelancing who want to maintain or grow their business. Helen Baldwin, founder of Scinopsis, follows with an article about setting up a medical writing company and what she has learned about how to build and maintain its success. Stephen Palmer and Marianne Mallia add their experience in setting up and running the Section of Scientific Publications at the Texas Heart Institute, an excellent model for a scientific or medical writing service within a company or institution.

For providers, the medical writing business is about selling. But selling is not limited to services; it also applies to the writer. As explained in Laura C. Collada Ali's profile of professional coach Dawn Bentley, whether you realise it or not, you are a brand, even if you are an employee. Your work, behaviour, and ability to communicate leave an impression – a ‘personal brand' – that you sell to clients or employers. Dawn describes the benefits of this way of thinking and provides tips on how to create and polish your own personal brand.

I hope that these articles and the regular features in this issue of Medical Writing provide you with information that can help you better navigate the medical writing business.

Bonne chasse!