Johns Hopkins University Press

Julie Silver, MD is director of Harvard Medical School’s CME course on Healthcare Leadership and Publishing. I have interviewed her before on how to write a health book and earlier this year on publishing trends and tips. With the second edition of Before and After Cancer Treatment just out–and people all over celebrating breast cancer awareness, it seemed a perfect time to bring Dr. Silver back to answer questions about when and why to write a second edition, how to write a second edition, specific challenges authors face in updating to a new edition and also specifics of what readers will get out of this important book.

Lisa: I’d like to start with the idea of a second edition: Why is a second edition of a book needed? When is it necessary? I imagine that with a book like Before and After Cancer Treatment new treatment methods come up, new research—so that at least some of the information is eventually out of date. Is that the main reason Johns Hopkins University Press published a second edition? Were there other reasons?

Dr. Silver: The second edition of Before and After Cancer Treatment has a lot of new updates that are due to medical advances that support survivors’ recovery. For example, the concept of “prehabilitation” is introduced for the first time in this new edition, and I explain how it is different from “patient education.” Prehabilitation involves actual interventions that improve outcomes for survivors—it helps to empower them and focuses on things that will make a difference in their physical and emotional health. The first edition was called After Cancer Treatment, and for this new edition we added “Before and” to the title to emphasize that this is a book for people who are newly diagnosed as well as those currently going through therapy or finished with treatment.

Lisa: Had you gotten reader feedback that inspired any new features or content? Things that readers had requested or questions they’d asked that spurred new material?

Dr. Silver: The excellent Amazon reviews for this book, and the number of hospitals that ordered bulk copies to give to every newly diagnosed patient has made this book such a worthwhile endeavor.

Lisa: Once you decide to write a second edition, what’s the process of updating the book? What steps do you take and how long did it take?

Dr. Silver: It took about 6 months to do the actual research and writing and then another 6 months for editing and getting to the finished book.

Lisa: [bctt tweet=”What are the pitfalls to watch out for in writing a second edition?”]

Dr. Silver: I was tempted to rewrite more than I needed to. I had to remind myself that the first edition really resonated with and helped survivors. I wanted to be sure that I didn’t change it too much and lose that strong connection with the readers.

Lisa: Great point. Was writing the second edition much quicker than writing a book from scratch or not?

Dr. Silver: Yes, it is definitely faster and easier! As long as you focus on an update and don’t try to rewrite the whole thing.

Lisa: You share some personal details that you reveal are very hard to admit—for instance how hard it was to care for your children at some points, that you just “sat around” at some points during your treatment. Was it a process to decide what to reveal and to feel safe enough to do so? Any tips for authors on how to do that?

Dr. Silver: Yes, that part was and is definitely hard. It’s important to let readers understand your story, but at the same time, I wanted them to focus more on the medicine than on me. So, striking that balance was something I spent a lot of time on.

Lisa: That’s great advice for any self-help author—to consider how much of their story to provide depth and context and how much to leave out, as well. In Before and After Cancer Treatment you share the story of when and why you decided to write this book. It’s a great example of there being books on the subject but that you had something unique to offer that wasn’t out there in the marketplace, in particular, you and your colleagues developed a model for cancer rehabilitation care that you call “STAR” – Cancer Survivorship, Training and Rehabilitation, and developed programs so that institutions could adopt this model which helps maximize long-term survival and prevention of recurrence. When did this idea come about? Did it happen as you were writing the book?

Dr. Silver: A few years after the first edition came out, I developed the STAR Program which is a turnkey solution for hospitals and cancer centers to offer survivors rehabilitation services. Cancer rehabilitation medical care is generally covered by health insurance, but too few survivors get these important services. This means that they live with more pain, fatigue, weakness and disability than is necessary. There is a lot of suffering in cancer, but there’s no need to have unnecessary suffering when cancer rehabilitation can help. Survivors can find a STAR Program near them by putting their zip code into the STAR Program finder on the STAR Program website. If there isn’t a STAR Program near them, they should ask their doctors if they know about it. Many new hospitals are adopting it every week!

Lisa: What are some of the things you are doing to spread the word about Before and After Cancer Treatment?

Dr. Silver: There are quite a few people like you who believe in my work and are willing to share it with survivors. It’s a privilege to be able to help people when they are sick.

Lisa: What would you like to leave our readers with?

Dr. Silver: No book can replace excellent medical care—I want people to read Before and After Cancer Treatment, but I also want them to ask their doctors about cancer rehabilitation medical care and to find a STAR Program near them.

Ask your questions about the book, writing or publishing–our favorite question or comment wins a free copy of Dr. Silver’s book!

98% of the time, my answer to the question of how to get a publisher used to be “Get a literary agent first.” Literary agents bring so much to the table—from their ability to garner several offers at a time, to their understanding of which acquisitions editor might be a perfect match for your book to their ability to negotiate a book deal.

In fact, I would still say, if you think you can interest a literary agent, that is still generally my recommendation if you want to traditionally publish. And, most of the time, to get a literary agent and get a publisher—in particular, a large trade publisher—one ingredient you need is a significant author platform (or online and/or offline following). However, the smaller and mid-size presses may not require quite as huge a platform—and could be a good fit for your book.

The issue is that since smaller and mid-size publishers are giving smaller advances than they used to—small enough that it may not be efficient use of an agent’s time to try to sell a book that they know will likely go to a smaller or mid-size publisher—you’ll need to approach these publishers yourself (or work with a book coach who has connections to smaller and mid-sized publishers).

[bctt tweet=”Here are some reasons to directly query smaller and mid-sized #book publishers:”]

1. The publisher specializes in your audience and has very specific ways to help you reach that audience, whether through speaking gigs, a targeted mailing list, publications or other avenues.

2. You want to do some targeted marketing and promotion for your book but you’re not interested in doing the type of campaign that would be expected by a larger publisher.

3. Your book appeals to a smaller, niche market, such as an academic market or a specific niche such as people with a specific medical condition.

4. You don’t have a big enough reach to interest a larger publisher and you don’t want to do lots of up-front work growing your following before sending out queries.

5. The smaller publisher shares your vision for your book, while an agent or larger publisher wants you to go for the largest audience possible, requiring adjustments to the book concept that don’t resonate with you. This may be especially true if the book is already written and you feel ready to publish.

Here are a few examples of client books recently published by smaller, niche publishers:

book cover ocd — Leslie Shapiro is a Harvard Medical School CME Leadership and Publishing course graduate and her book, Understanding OCD came out this March.

Understanding OCD by Leslie Shapiro: A specific niche, a book that can appeal to both practitioners and patients; an author who definitely did not want to do things like national TV but was certainly willing to do modest publicity like interviews for print media and speaking at conferences. Published by Praeger / ABC-CLIO. When I first queried the Acquisitions Editor, Debbie Carvalko, Debbie immediately e-mailed back, “I’m looking for a book on OCD and have saved a slot for 2015 or 2016,” and she encouraged us to send the proposal right away.

Dream Therapy for PTSD by Bruce Dow, MD received some interest—and feedback—from literary agents, but all agreed that to appeal to a larger publisher, the author would need to add chapters to deal with additional types of trauma that the author had not dealt with, such as working with children. This was not a fit at all for the author and his interests. The book was written and very engaging. He wanted an avenue to get it out there. The acquisitions editor at Praeger/ ABC-CLIO, again Debbie Praeger, loved the extensive case studies and felt no need to broaden the examples (which were soldiers, policemen, policewomen and a few civilians) for their audience.

And authors who recently signed with smaller publishers:

Vicki Tidwell Palmer recently signed with Central Recovery Press, a publisher I have recently gotten to know. Hers is a niche audience and CRP is uniquely positioned to help Vicki reach her target audience in the addiction treatment and recovery community, including behavioral healthcare professionals, as well as friends and families of people experiencing the type of addiction addressed in her book. Given their special focus, CRP will also be an asset in bringing Vicki’s book to the library market, having invested focused resources in reaching librarians with a special interest in her topic.

As Eliza Tutellier of CRP says, “The advantages of going with a smaller press, especially for a first-time author, can be numerous. Your book is more likely to chosen as a lead title during its season, securing more of the press’ promotional resources and sheer human attention. Marketing will be more focused on your target readership, reaching niche channels and communities some of the bigger presses may not even know about. Finally, you’ll be dealing with a smaller, potentially more agile team: sales and marketing staff are likely to sit one desk over from your editors rather than in a different part of the building, so decisions on promotional opportunities, book design, and even editorial consideration can be made more quickly and efficiently.”

Tara Mardigan and Kate Weiler signed with Fair Winds Press after being contacted by the publisher and realizing it was a good fit in terms of vision and specific niche market. Their book, Real Fit Kitchen: Fuel Your Body, Improve Energy, and Increase Strength with Every Meal comes out September 1, 2015 and is currently available for preorder on Amazon.

Other mid-sized presses, independent presses and University publishers (another niche!) that clients have recently signed with or published with include Yale University Press, Johns Hopkins Unversity Press, New World Library, New Harbinger and AMACOM (the publishing arm of the American Management Association).

Do your research and you can come up with a list of your own. Make sure the publishers accept queries and proposals without an agent (most do) and check their guidelines to include exactly what they ask for.

When and How to Write a Second Edition: Author Spotlight with Julie Silver, MD

How to Get a Publisher: Should I Pitch Them Directly or Get a Literary Agent?

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