
Acad Psychiatry 32:183-187, May 2008
doi: 10.1176/appi.ap.32.3.183
© 2008 Academic Psychiatry
Practical Strategies for Becoming a Successful Medical Book Author
Robert E. Hales, M.D., M.B.A.,
John J. McDuffie, M.A.,
Glen O. Gabbard, M.D.,
Katharine Phillips, M.D.,
John Oldham, M.D., M.S. and
Donna E. Stewart, M.D.
Received August 24, 2007; revised November 30, 2007; accepted December 12, 2007. All authors are affiliated with the Books Division, American Psychiatric Publishing, Inc.; Dr. Hales is affiliated with the Department of Psychiatry and Behavioral Sciences, University of California, Davis School of Medicine, Sacramento, Calif.; Mr. McDuffie is Editorial Director, Books, at American Psychiatric Publishing, Inc., in Arlington, Va.; Drs. Gabbard and Oldham are affiliated with the Menninger Department of Psychiatry, Baylor College of Medicine, Houston, Tex.; Dr. Phillips is affiliated with the Department of Psychiatry, Brown University School of Medicine, Providence, R.I.; Dr. Stewart is affiliated the Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Canada. Address correspondence to Robert E. Hales, M.D., M.B.A., Department of Psychiatry and Behavioral Sciences, University of California, Davis, 2230 Stockton Blvd., Sacramento, CA 95817; rehales{at}ucdavis.edu (e-mail).

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ABSTRACT
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OBJECTIVE: The authors, all senior editors in the Books Division of American Psychiatric Publishing, Inc., provide practical advice to authors who may be considering writing or editing a medical book. METHODS: The authors summarize strategies for developing a book proposal and outline an approach to developing a focus for a book. They also list a number of common errors that authors frequently make when they develop a book proposal. The authors provide guidance on publishing research and discuss how authors can collaborate with a publishers marketing department to publicize their book. RESULTS: By employing a systematic and well-considered approach to preparing a book proposal and writing or editing a book, authors may achieve professional success and personal satisfaction. CONCLUSION: Writing or editing a medical book requires a different series of steps than authoring a journal article.

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INTRODUCTION
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The purpose of this article is to provide general guidance to psychiatrists and other mental health professionals who may be considering writing a medical book. Journal editors have provided valuable advice to potential authors in getting their papers published. Some have discussed the preparation of manuscripts and responding to reviews (1). Others have emphasized selecting the journal most appropriate for the paper and the need to follow closely the journals most recently published guidelines for authors (2).
In addition, articles have been published that summarize why manuscripts are rejected (3–5). Some of these reasons, such as poor writing and failure to respond to peer reviews (3), are relevant to book authors but many are not. Because the process of writing or editing a book is sufficiently different from writing a journal article, the book editors and deputy editors at the American Psychiatric Publishing, Inc., wanted to provide the readers of Academic Psychiatry with some practical advice on writing or editing a book.
Developing a Book Proposal
The journey to becoming the author or editor of a medical book begins with an idea or concept. If you believe you have a unique idea, first discuss it with colleagues to sharpen your focus. Those who have authored or edited medical books can be especially helpful. The key question to ask is, "What is the void in the literature that this book would fill?"
It is also important to identify the target audience. Do you plan to write for medical students, residents, or clinicians? Is this a book for someone with experience in or knowledge of the topic, or is it for someone with limited expertise? For instance, a book on childhood development disorders written for child psychiatrists would be quite different from one written for general psychiatrists or psychiatry residents.
As the potential author, you should conduct a thorough online literature search on the topic area in which you plan to publish then go to your medical school bookstore and library to examine recently published books on the topic. Attend professional society meetings and listen to presentations on the same subject. Some larger meetings, such as American Psychiatric Association annual meeting, have a publishers row in the exhibit area. Examine the books displayed at the different publishers exhibits, pick up their catalogs to read later, and speak with their staff to learn more about the types of books that they would like to acquire. Purchase books from various publishers on your topic to learn how other authors have approached the topic and how different publishers have presented the material.
Contact the authors or editors of similar books to learn about their experience with a particular publisher and why they approached the subject in a particular manner. Usually in medical publishing, someone else has already written a book on a similar topic or idea. However, various formats and styles can convey different perspectives (Table 1) on a wide range of topics (Table 2).
Every publisher has different requirements for book proposals. As shown in Table 3, some general criteria apply to most proposals. Shown in Table 4 are the usual components expected in most book proposals. Successful proposals identify the needs of a specific audience and respond to these needs. A book may be of interest to a specific audience, such as practicing clinicians, teachers, or trainees, or may discuss a topic of interest to a lay audience, patients with a particular mental disorder, patient advocacy groups, family members of patients with mental illness, and others.
Different publishers focus their list of books on different potential readers. You should examine a publishers most recent list of books to determine the audience for that publisher. If you are writing for a clinical audience, the book proposal should provide useful clinical information and articulate the clinical significance of any research presented. In writing for patient advocacy groups or family members, you will need to simplify clinical information so it is more accessible to the readers.
Developing a Focus
In developing a focus for your book, examine your own special expertise. You should know your field of interest quite well, have a wealth of clinical experiences in the specific area, and be thoroughly familiar with the research or published literature. You should be able to answer a few key questions about your book proposal.
- Is the topic of your potential book new and not well represented in the literature?
- Is what you want to write about better accomplished through a book than a review article for a journal?
- Can you prepare a book manuscript that will do a better job in communicating information than what has already been published?
Publishers need to sell enough books to recoup their investment in you and the book. Consequently, the focus of your book should be directed at a specific audience but broad enough to attract as large a potential audience as possible. For instance, a manual on eating disorders may appeal to clinicians who occasionally treat patients with these disorders (a specific audience), but the book also may be of interest to residency training directors in designing a curriculum for residents (wider appeal).
Authors should not be hasty in developing a book proposal. Take the time needed to think about your topic and what you want to accomplish in a book (Table 5). Develop a sound foundation of background knowledge, clinical experience, or research expertise in the area that you wish to write about before embarking on a book proposal.
Finally, do not get discouraged with the book proposal process. Good book ideas developed by goal-oriented and motivated authors are usually published; it just takes time and the patience to revise your ideas. If your proposal is rejected by one publisher, you may find another publisher that is better suited for the target audience of your book. Just as you respond to peer review comments when submitting manuscripts to journals for possible publication, respond to critiques from the publisher or peer reviewers who comment on your proposal. As with most journal articles, rarely is a book proposal accepted unchanged.
Also in developing a focus for your book, read as much as you can about the topic. Remember that writing begins with reading. Focus not only on books that have been published on your topic but also review journal articles that discuss the research background or clinical aspects of your topic. For instance, if you want to prepare a book on the topic of posttraumatic stress disorder, you should review books that have been previously published on posttraumatic stress disorder and also journal articles that have been published about the assessment, diagnosis, and treatment of this condition.
Common Errors
A frequent error would-be authors make is failing to identify a target audience. Although you want to have as large a target audience as possible, you should write a book for a specific readership. By trying to expand your potential readership to too great a number, you may lose the uniqueness or "voice" of your book.
Also keep in mind that your book cannot be all things to all people. If you are writing a book for clinicians, researchers are probably not going to be interested in it. If you are writing your book for patient advocacy groups, clinicians may be less interested because of the tone and level of sophistication in the material presented.
Another common problem is that authors try to accomplish too much in one book. A massive 40- to 50-chapter textbook may not be needed. There is room only for a limited number of textbooks in the field of psychiatry. Trying to accomplish too much through one publication will certainly limit sales of your book. Many American Psychiatric Publishing authors start with small, single-authored or multiauthored books that focus on a particular subject. If the book has robust sales, the author can then consider expanding the books size and scope.
Authors also make the mistake of feeling that their book must be perfect. You should prepare a high-quality manuscript that is current, informative, well-written, up-to-date, and of interest to a specific audience. However, do not strive for perfection since this will only hold up the completion of your manuscript.
Potential authors should also examine their motives for writing a book. If you are writing a professional medical book, you are probably not going to make a lot of money. In other words, keep your day job. Also do not invest too much in the outcome. Do the best job you can with your manuscript but keep in mind that often a books critical reception and sales depend on many factors beyond your control.
Publishing Research
A book that focuses on a research question can help the psychiatry field in a number of ways. It can synthesize a body of work published by multiple authors. It can give the author/editor more leeway to present various clinical perspectives and impressions about the topic. It may also reach a broader audience.
Take as an example the genetic aspects of various psychiatric illnesses. Because the topic is extremely complex, research articles related to genetics are often very challenging to understand. Authoring or editing a book on genetic findings related to psychiatric illness may educate a wide range of psychiatrists and other mental health professionals about the importance of this new research area and its clinical applications.
In preparing a research-oriented manuscript, do not emphasize obscure scientific data that is of interest only to researchers. They generally are not going to buy your book. Clinicians who wish to learn more about the potential clinical implications of research will. You do not need to write extensive reviews of the literature with a laundry list of recent publications on a particular topic. In other words, you do not need to discuss every study that has been published in the last 5 years. However, you should provide general conclusions concerning a variety of research findings or emphasize your own interpretation of their clinical relevance.
In writing about research material, include summary tables and figures to describe the complexity of the work (6). Tables can summarize data from numerous articles that have been published. Figures are also very important to illustrate mechanisms, neuro-anatomical findings, or images.
If you are serving as an editor and have requested chapters from outstanding investigators in a particular field, you should critique these researchers and recommend changes to their manuscripts. Often senior faculty may recruit junior faculty as chapter coauthors because they can provide a fresh outlook concerning the research findings. Junior faculty may also be more clinically focused than their senior colleagues.
Marketing and Publicity
Your work does not end with acceptance of your complete and revised manuscript. It is very important that you work collaboratively with the marketing department of the publisher to assist in selling your book. Prepublication promotion usually begins about 6 months before the book is actually published. Most publishers use author questionnaires to acquire information about authors travel plans. Authors are also asked to identify potential specialty or subspecialty society meetings that may be appropriate for displaying your book, both in the United States and in other countries.
You should suggest prepublication reviewers who will be asked to write a short comment on your book. It may appear on the jacket of the book or in marketing materials. Also list potential journals that may be interested in reviewing your book. Publishers routinely send books to a select group of high-profile journals. However, depending on your topic, it may be equally important to send your book to the subspecialty journal that is read by the potential purchasers of your book. Do not be shy about discussing your book if you are giving a talk or presentation. Consider bringing along marketing materials on your book to give to individuals who are interested in learning more about the topic of your presentation.
Authors generally feel that publishers could do a better job at marketing their books. You can help do so by working collaboratively prior to publication and especially during the first year of publication. Keep your publisher informed of your travel schedule and presentations. Let your publisher know about new research findings that may be related to your book. By doing so, you can actively engage the publisher and build excitement about your book.
Certain books might serve as course texts for residents or medical students. Most publishers would provide your book for free to course directors. However, the publisher needs to know who should receive the book. Most publishers would also provide additional copies to selected influential individuals throughout the United States. Develop your own list of individuals who might be helpful for future sales.
Summary
It is as hard to publish a book today as it is to receive an NIH grant. The psychiatry departments that are most successful in obtaining research grants often have developed their own peer review process prior to submission of the grant to the appropriate funding agency. Such internal peer reviews considerably increase the success rate. Using a similar process among colleagues and friends prior to submitting a book proposal will also considerably enhance the chances that the proposal will be accepted and your book will be published.
Most publishers accept only a small percentage of book proposals that are submitted. American Psychiatric Publishing, Inc., accepts about 10% of the unsolicited book proposals it receives. However, if you systematically approach your topic, conduct adequate research prior to preparing the proposal, and investigate closely the potential market, you can enhance the probability of success.

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