Self-publishing a medical book
Self-publishing gives an author control of a medical book and responsibility for its production, distribution and promotion.
Control and commercial expectations
An author can establish a publishing company and issue a book through Kindle, as one clinician did to keep control of her message and remain self-employed. Control can also motivate a move from traditional publishing after a publisher is bought out. Self-publication has a long history: in 1685, physician Martin Lister self-published a heavily engraved four-volume work on molluscs and shells, illustrated by his two daughters, keeping control and avoiding the expensive commercial route.
A traditional publisher typically controls the cover, interior design, fonts and formatting; a self-publisher sets the price and either pays a designer or does the work. A second reader, such as a professional editor, should still review the book.
Views on commercial prospects differ: a 2015 recommendation favoured self-publishing as the most practical and economical route, naming BookLocker, while a 2012 view held that it had become quite lucrative. A more pessimistic 2018 assessment expected few commercial sales or royalties because authors often lack the time, resources and distribution support to sell the book.
Success can instead mean reaching a small intended audience: a self-funded illustrated family history published in 2010 sold few copies to relatives but was treasured by the family and remained available online in early 2018. Distribution can defeat a commercial project: two authors who acquired translation rights and printed a lay medical book had sparse bookstore sales and advertising that failed to cover its costs; even after a publisher bought the rights and achieved national distribution, printing and advertising costs exceeded royalties.
Time and financial terms
Considerations when choosing a publishing route include market research, time, royalties, sales, marketing and control. A 2019 comparison described electronic self-publication within months and revised editions within days, against traditional publication taking more than a year after manuscript completion, with no quick revision route. It also described many large publishers as closed to unagented submissions and waits of one to six months for exceptions.
For the children’s book Life’s Code, an idea in June 2018 became an uploaded pre-final print version seven months later; proof copies went for beta and advance reviews, with sale planned several weeks later, a little over eight months from concept.
A vanity press accepts work regardless of quality and puts all financial risk on the author, earning money from authors rather than readers; a subsidy press publishes under its own imprint and may share financial risk. Providers may supply an ISBN, the unique numeric commercial identifier for a book, and authors should read reviews before committing to a self-publishing company.
Formats and production
Advice in 2015 favoured both ebook and print editions, with limited print quantities for reviewers, promotion and sales because most purchases were expected to be ebooks and most sales through Amazon. In 2019, Amazon was described as charging nothing to upload ebooks or print books and using print-on-demand to avoid stored inventory; buying and proofreading a proof copy before publication remained essential.
A 2019 Word-based production method avoided templates that some writers felt made books look alike:
- Set the page’s trim size, headers containing the title and page number, and images before writing.
- For print, save a PDF with embedded fonts; for an ebook, save as a filtered web page.
- Upload to Amazon.
Covers should catch the eye and keep the title and key details readable at thumbnail size. In 2019, Amazon required a front cover for ebooks and front and back covers for print books. A print-cover method was:
- Enter trim size and page count in Amazon’s cover-template tool to establish spine width.
- Download the template.
- Place front- and back-cover images in it using an image editor.
- Save as a PDF for upload.
Cover designers and manuscript-to-Kindle conversion specialists can be hired through freelance marketplaces such as Fiverr. A 2019 diabetes-book cover used large type and bright colours, while Life’s Code used illustrations and a cover made by the authors’ great-grandchildren.
Resources listed in 2019 included Kindle Direct Publishing’s instructions, Amazon’s service-company directory, which listed providers without endorsement, how-to books including some free ebooks, the Nonfiction Authors Association’s self-publishing checklist and Helen Osborne’s account of moving to self-publishing.
Promotion
Promotion is demanding and ongoing; authors should choose a sustainable strategy and create a dedicated book website or at least a page on their business site. Traditional publishers may offer marketing suggestions or local signings, but a 2019 assessment put most marketing responsibility on authors other than VIPs and favoured hiring a professional or doing the work themselves. More successful marketing means more people hear the book’s message, even when clinicians feel uncomfortable with the business side.
An ebook can also be offered on the author’s website and promoted through affiliates. Affiliates use their communities, blogs, websites or social media to promote it and receive a set fee for each resulting sale.