Monday, October 22, 2012

So You Want to Write A Book (Open Session 1)


By Amy Karon

At AMWA's recent national conference, attendees chuckled and scribbled notes while authors and former journalists Alisa Bowman and Debra Gordon dispelled myths and offered practical tips on breaking into the book business.

The two know the market. Bowman spent several years as an editor at Runner’s World magazine before her husband negotiated her first book contract during a magazine gala at FAO Schwartz.

“I loved my job at Runners World,” said Bowman, who has since ghostwritten* and co-authored seven New York Times bestsellers. “But it was apparent to me that I could make much more money working for myself.”

Gordon’s titles include When Sex Hurts and The Idiot’s Guide to Type 2 Diabetes, and, with her husband, a fellow enthusiast, Wine on Tuesdays. “We managed to do it with our marriage intact,” she grinned.

Read on for Bowman and Gordon’s advice on taking nonfiction health and medical books from inspiration to publication.

Tip: Books published under your own name often pay little. 

In traditional publishing, Gordon said, authors receive only about 15 percent of book sales, and that first goes to repay the publishing company’s advance. “The vast majority of authors never receive royalties,” she added. “Write a book because you want the experience and exposure.”

But self-publishing and e-books have gained popularity as potentially lucrative alternatives. Authors pay a self-publishing company for services they choose, such as copy editing and printing, Bowman said. Because no agent or publisher are involved, the author earns 100 percent of the sale price of every book and can still sell it on Amazon.com.

Another way to make money by writing books is to ghostwrite or co-author with someone else, an accepted practice in the publishing world.

“Most of the bestsellers out there are written by people like Alisa and me,” said Gordon, adding that she just signed a $70,000 contract for a book on mobile health.

To break in, tell clinicians and academics you can help them write books for consumer audiences. If you see a study you think can make a book, contact the authors and pitch the idea.

Tip: Unless you self-publish, you’ll need to hire an agent. 

Writers can be so emotionally invested in a project that they accept tens of thousands of dollars less than they should, Gordon said. But an agent’s job is to negotiate, and she or he won’t shy away from getting the best deal possible.

Agents also can serve as liaisons between a medical writer, the person they’d like to write for, and that author’s agent, Gordon added. That approach can spare writers from burning bridges with medical professionals they may have worked with for years.

Tip: Publishers won’t pay for a great book idea, even if it comes with a cover letter and outline. 

To successfully pitch a publisher, you need a good proposal and marketing plan, Gordon said. Proposals tend to run 50 pages without a sample chapter, which some publishers also require.

Don’t write proposals for free, cautioned Gordon, adding that she charges about $8,000 whether a publisher accepts a proposal or not. “I tell clients, I don’t go to Las Vegas and gamble,” she said, “and I don’t gamble with my business.”

Proposals should focus on what makes the book sellable and unique. Perhaps it will include patient narratives, or a sidebar with the latest advice on disease management.  Add a detailed marketing plan.

“I think this is almost more important than what’s in the book,” Gordon said. For example, is your blog receiving a lot of hits? Do you have a mailing list you can use to promote the book? Do you or your co-authors speak at medical meetings or other venues? Can you secure a high-flying expert to write a cover blurb?

A proposal’s table of contents should list each section and chapter, Gordon added. She writes the first two paragraphs of every chapter and the major topics she’ll go on to cover.

Tip: Don’t plan to blow your whole advance on a home remodeling project. Use it to cover your essential needs while you write. 

Advances are usually paid a third or a quarter at a time over months or years, Bowman said. They must pay for illustrations and marketing consultants, such as search engine optimization experts or people who will help secure deals to write guest posts on blogs.

Tip: Tackle a book as you would any other project–by outlining and breaking it into pieces. 

Gordon does not turn down all other assignments while writing. “Instead of telling yourself you need to write 80,000 words,” she added, “tell yourself you need to write one chapter and turn it in by the end of the month.”

Bowman calculates how many chapters and words she must write every week, keeping in mind that her pace will be slower at first because of time spent researching. “If you’re in a panic at the end, you’re not going to be able to write a great book,” she said, especially because the first chapter must convince customers to pay for the product.

Tip: Book writing requires skillful communication and ego management. If you can’t work with your co-authors, agent, and editor, you might not get another book deal, Bowman said. “This is a word-of-mouth business,” she added. “I very rarely have marketed myself.”

If a co-author has an idea Bowman knows will not work in the book, she suggests it become another book or a blog post. Gordon tells co-authors it’s their book and they have the final word on its contents, but that it’s her responsibility to share what she knows of the market and intended audience.

If the book targets people who don’t know much about science, for example, Gordon makes sure co-authors understand that dense medical prose could harm readability and sales.

Bowman said she has only cancelled a book deal once, and that was when a co-author repeatedly took others’ ideas without credit, even after she talked to him about it. “It was the only time I’ve broken up with a client,” she added. “But I do not regret that decision.”

Tip: Length matters. Stick to the agreed-upon word count. Publishers study consumer behavior to set a book’s price point, and price depends on number of pages, said Bowman.

“You don’t want your book to be the most expensive one in the category,” she added. “You also really hurt your editor’s job of making your book better if you come in way over the word count.”  Publishers have even canceled book deals when drafts are too long or short, she said.

If you choose to write an e-book, study the market. Short e-books are selling the most copies on Amazon now, Bowman noted, partly because readers face time crunches.

Tip: Word of mouth won’t turn you into a household name. You have to market yourself. Books only stay in the store for 3 months, Bowman said. To create the biggest impact possible during that period, you must generate buzz before the book comes out.

Publishers also expect authors to do much of their own marketing these days. That means learning about search engine optimization and social media. Bowman and Gordon suggested getting on a local TV station, such as the Fox channel’s morning programs.

“You have to know as much about marketing, interpersonal skills, and being an entrepreneur as you do about words,” Bowman said. “You don’t want this to be your only book. You really want it to make a splash so you can write a second and a third.”


*Editor's Note: This article discusses ghostwriting in the context of books written for the consumer audience. Ghostwriting of medical research manuscripts in peer-reviewed journals is considered to be an unethical practice by many organizations, including AMWA. For more information about AMWA's position on the importance of acknowledging the contributions of medical communicators, please see http://www.amwa.org/default.asp?id=308.


Thursday, October 11, 2012

Workshops at the AMWA Annual Meeting vs. Home Study


by Mark Bowlby

As a newbie to AMWA, but as an experienced scientific meeting attendee, I’ve been curious as to how AMWA workshops at the annual meeting would compare to the home study courses. I’ve attended several of the essential skills workshops at this year’s annual meeting in Sacramento, and they’ve been a great experience—not just for the instructor’s knowledge that is on display, but also for the experience and skills that the audience brings.

Workshops combine the experience of home study, in the form of homework to be completed prior to the meeting, with a classroom setting which combines lecture, class discussion and group exercises. The workshop venue encompasses a mixture of new and experienced students, led by a passionate and expert workshop leader. The high quality of the leaders has not been a surprise; however, the knowledge and interest that the students all bring to the table has been a bonus. Indeed, the breadth of experience and diverse job functions that are brought together for this brief time is part of the key to this learning experience.

So how do the workshops compare to home study, of which I’ve taken 3 courses? They are similar in nature, but different in form. Home study allows a slower pace of learning, shorter bursts of learning, but also a very in-depth level of study. Workshops, however, are an intense 3 hour block with information coming at you quickly. Home study allows one to try out solutions on the side, look for resources that enhance learning, and they always have that motivator of the “scary” exam at the end. Workshops lack this latter motivator, but the engagement of the class and instructor keeps everyone involved and engaged. Last, of course, home study is an endeavor solely taken to master the course material and apply it to one’s work and passion. Workshops, however, are embedded in a larger AMWA meeting, and thus the networking, personal interactions, and other open sessions all combine to enhance the experience and build enthusiasm for being a better, more effective, writer.

Now which method of learning is better? That, of course, depends on how one learns best, your budget (dollars and time), and many other factors. Perhaps the best answer is to do both. Take a few home study courses first, then attend a local or national AMWA chapter meeting and try a few workshops. They’ll enhance your knowledge, broaden your thinking, and open you to new possibilities and ideas. What more can you ask for as a writer?

Links:
AMWA education program
AMWA workshop descriptions
AMWA self-study workshops
AMWA chapter conference schedule



Tuesday, October 9, 2012

Dial 911: Emergencies in Medical Writing (Open Session 21)


by Amy Karon

Nearly every seasoned medical writer can recall clients and contracts that evolved into the stuff of nightmares. Maybe endless requests for revisions are eating into your sleep time. Or perhaps you realize a high-profile faculty member is self-plagiarizing.

Stay in the profession long enough and scenarios like these are bound to make you hold your head at times. But there’s help. At the 2012 AMWA conference, Scott Kober, MBA, CCMEP,  and Anne Jacobson, MPH, CCMEP, reprised their popular open session on emergencies in medical writing.

Using digital keypads, attendees anonymously chose how they would handle a variety of problems. Lively discussion followed. Here we summarize those debates and dilemmas.

Scenario 1: Your work from long-term clients is drying up after more than 20 years of freelancing. Do you really need a web presence?

You do need a consistent and varied online presence, said Kober and Jacobson. But there are two ways to go about it—by dipping your toes, or going all out.

More cautious medical writers might start by creating their own simple website and LinkedIn profile. Others might hire a marketing and social media consultant to help develop a brand, website, detailed LinkedIn page, and professional Twitter account.

Whichever way you go, your website should include a resume and some sample writing or editing projects. If you’re under a nondisclosure agreement, keep that in mind. Some writers create pieces specifically for their online portfolios.

Scenario 2: Your last client burned you. How do you vet a new one to prevent this from happening again?

“My first-line approach is to e-mail people whom I trust,” Jacobson said. “Luckily, I know a lot of freelance medical writers whom I can vet clients through." She said she tends to avoid asking for feedback from members of AMWA's online discussion groups.

Kober and Jacobson also suggested crafting a checklist of the kinds of clients and projects you want. This will help you develop a broader perspective on whether prospective clients fit your business goals.

Scenario 3: You discover an author whose review article you’re editing is recycling chunks of text from a previous article. Whom do you tell, and how?

Make your client aware of this taboo practice and consider proposing a solution, said Jacobson and Kober. But don’t approach the faculty member yourself. Let the client handle it.

Be aware that copyright infractions can come back to haunt writers, they added. “Some faculty don’t even realize that self-plagiarism is a problem,” said Jacobson. “When this has happened to me, usually the remedy is just to rewrite (a piece) because it obviously can’t go out as it is.”

If a client tries to say self-plagiarizing is all right, rewrite the piece anyway and then don’t take any more work from the client, Kober said. Participants also suggested ensuring clients know that journals use software to detect plagiarism and copyright infringements and that such infractions can result in their being blacklisted.

As for red flags for plagiarism, watch out if a manuscript’s first draft is clean, with perfect punctuation, Kober said: “Plug it into Google and see what comes up.”

Scenario 4: You have a major deadline in three days and your father has been rushed to the emergency department. His physician thinks he’ll be okay, but has to run some more tests.

Do you go and bring your work? Tell your client you can’t make the deadline?

“Mild emergencies come up all the time and you find yourself schlepping your work all sorts of places,” said Jacobson. “The real question is whether to alert your client that there could be a problem. It depends on the client and the relationship.”

But from a client’s perspective, Kober said, “I would want to know as soon as possible. There is nothing worse than hearing on the day of the deadline, ‘Oh, I’m sorry, my dad has been in the hospital for a week and a half.’ I’m sympathetic, but I also wonder why you didn’t tell me before.”

Others recommended giving clients the names of three people they trust to get the work done.  Communication is critical, they agreed – let the hiring manager or the client know right away that you are working at a hospital. Most will appreciate the heads up and adjust their expectations accordingly.

Scenario 5: A client asks you to cover the cost of purchasing full-text references, which is not the norm. Do you renegotiate your contract?

Kober retrieves needed references for freelancers, but encourages them to get what they can on their own. “Ideally, from a client’s perspective, it would be great if we didn’t have to dig up references for you and find them.”

Said Jacobson, “When a client is nickel and diming you about project costs, they are unlikely to be willing to renegotiate a project fee.” She suggested searching on PubMed and restricting access to free, full-text articles. “Open access sources are now pretty good,” she added. “Every once in a while, I spring at the last minute for a $30 reference for a big project.”

Participants noted that AMWA membership includes access to MD Consult. Alumni organizations also sometimes offer limited journal access, and entering the full title of the article in quotes in online search engines also sometimes yields a PDF.

DeepDyve also offers lets you “rent” full-text articles for small amounts of money, members added, although you can’t print or save them to your computer.

Be careful about downloading PDFs and giving to clients, participants added; that can be seen as illegally selling them.

Scenario 6: A client is asking for many more revisions than expected. You are being paid for the extra time, but you’ve taken on other scheduled projects and this one is now keeping you up nights and weekends.

Think about how much you want to keep this client, Kober and Jacobson advised. If you don’t want to work with him or her again, consider politely extracting yourself by explaining that your contract does not include project management. You can also try to renegotiate for more money per hour.

Another approach: Say that you have taken on other projects because the plan did not include this much extra time.

Attendees also suggested building milestone payments into bigger projects so that at the end of 6 months, you’re not crossing your fingers hoping the client doesn’t refuse to pay (because you finally drew the line at further revisions) or goes bankrupt.

Scenario 7: You are writing multiple needs assessments for the same client on the same topic. Can you reuse your work?

“If you’re not willing to turn a blind eye to a faculty self-plagiarizing his own work, how are you willing to turn a blind eye to yourself?” Kober said.

Added Jacobson, “Once you have already done the mental work of understanding the same disease states, it is easier to crank it out. You do have an obligation to submit original material.”

But try for a bit of wiggle room when working with the same client on certain projects, Jacobson suggested. For example, agree to write updated needs assessments for the same client, rather than reinventing the wheel each time.

Scenario 8: After 5 years of full-time freelancing, you’ve decided to take a job. You just interviewed for what seemed like a terrific position, but half the interviewers did not show and no one explained why or followed up. Do you give the company the benefit of the doubt?

Jacobson said she is working on noticing red flags and steering clear of clients and companies who raise them.

“There are far too many employers who think they are doing an employee a favor by giving them the time to talk to them,” added Kober. “It’s a slap in the face. It’s rude and disrespectful.”

One option: Write a courteous letter to human resources explaining what happened and your disappointment. HR departments often appreciate hearing this, participants said. But don’t address your letter to the people who didn’t show up to the interview!

Scenario 9: You (in a client’s role) hire a freelance who checks out and has great references and clips, but turns in awful work. What do you say?

Attendees said they definitely want to hear feedback. Kober said he makes it a personal rule to give it. Jacobson recommends asking for an edited version of a document. If a client is constantly changing a certain word, for example, you can modify your writing style for that client accordingly.

When hiring and applying for work, require and send raw copy, suggested participant Debra Gordon. She added that she plans to send clients an anonymous SurveyMonkey questionnaire so they can provide honest feedback on her work without worrying about jeopardizing their business relationship.


Monday, October 8, 2012

The Passing of the Gavel

Outgoing AMWA President Barbara Snyder passes the gavel to incoming President Douglas Haneline at the organization's annual business meeting, then tries to grab it back!

video
(Video by Mark Bowlby)

Friday, October 5, 2012

Keynote Address: Can Fictional Television Make a Difference in Public Health Education?

Dr. Neal Baer receives the John P. McGovern Medal from Melanie Ross, AMWA past president, as  Barbara Snyder, current president, looks on. The award recognizes preeminent contribution to medical communication.

by Whitney Smalley-Freed

“People don’t get moved and inspired by data,” Dr. Neal Baer, writer for ER, Law and Order SVU, and A Gifted Man, explained to the large audience attending his keynote address on Thursday morning. Dr. Baer told attendees, “reporting on evidenced-based medicine is not enough,” you need the data, but you also need a story to get people to be passionate about a health care topic.  Public story telling draws from our personal experience and lives to tell a story to the public.

Using video clips from Law and Order SVU, Dr. Baer demonstrated how the private stories of patients and clinical data can be turned into public stories that can teach health information to the general population. The first episode addressed the issues raised by a study published in the journal Science showing that children who witness gun violence are more likely to commit gun violence and related it to the child catching an infectious disease. Another episode delved into whether parents have the right to decide not to vaccinate their children and how this could be detrimental to the health of other children.

“Did my show make a difference?” Dr. Baer questioned. A study on an episode of ER depicting a patient diagnosed with cervical cancer caused by HPV indicated that only 19% of viewers knew that HPV could cause cervical cancer before watching the episode but 60% were aware of this after watching the episode.

Dr. Baer explained how BubbleTweets could be used to tie video clips to news articles and actionable steps for addressing health care topics raised by TV dramas. Social media can be used to further the knowledge of seeds planted by television.

During the question and answer session, Dr. Baer stressed the responsibility that television shows have to present health topics accurately since a large portion of the population accepts them as fact. When asked “who is your peer-review,” Dr. Baer explained the review and oversight committees involved in all of his shows.

Dr. Baer suggested that medical writers have the responsibility to start discussions and raise issues that can help establish ethical boundaries for medical frontiers.

Dr. Baer’s charge to AMWA members, “take your own stories…and make them public.” Find stories that move your audience to action.


Thursday, October 4, 2012

Opening Reception in Exhibit Hall





Photos by David S. Durgin www.durginphoto.com


AMWA Starts Early

Hundreds of conference-goers showed up at 7:30 am Thursday for breakfast roundtable discussions of dozens of medical writing and editing topics. (Photo by Mark Bowlby)

A Quick Welcome to AMWA's 72nd Annual Conference

AMWA's 2012 Annual Conference Administrator Brian Bass with a quick audio message for AMWA members in attendance at the AMWA meeting in Sacramento and those at home.



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