A 10 Step Guide by Ilene Brenner, MD, Author of How to Survive a Medical Malpractice Lawsuit

Are you writing or thinking about writing a book? Do you want to get published but have no idea how to go about it? As someone who got my first book published last year, I can tell you it is a confusing and sometimes arduous process, but one that can be navigated with a little direction. This article is going to focus on non-fiction writing. The rules are completely different if you are writing fiction.

I know a lot of people who are writing books and waiting until it is done until they even think about contacting a publisher. While it is counterintuitive, you should not wait. You need to seek publication BEFORE you are finished. Here’s the process

1. Have an Idea for a Book
There are two main types of non-fiction that physicians will produce: Trade and Academic. Trade books are sold to the traditional online and free-standing bookstores. They are for the general public. Academic books, like your textbooks from medical school,  are books specifically designed for students, schools and professionals. Some books seem to fall somewhere in the middle. Here’s an example: A friend of mine has published “The Preemie Primer.” Certainly it could be great for students wanting to learn all about preemies. However, it is designed for parents of preemies, and its general market appeal (even though it is still a niche) makes it a trade book, not an academic book. All of this matters because there is a standardized process for submitting a book for publication, and it differs based on which type of non-fiction you are producing.

2. Research/Samples
After researching this idea, you create an introduction and a few sample chapters.

3. Create a Proposal
A proposal is a detailed document that explains your project, who you are, who the buyers of the book will be, the competition for the book, why this book fills a need, your plan for marketing, an outline with chapter summaries, and a few sample chapters.

Writing a proposal can take time, but it usually helps focus your project and makes your book better in the long run. You can find great information on writing a proposal online, such as on blogs like Another great resource is “How to Sell, then Write, your Non-fiction book.”

4. Trade Book? Find an Agent
If you have a trade book, you should seek out an agent instead of going straight to a publisher. Some publishers do take direct submissions, however, even if they do, it is best to use an agent.

A common question is, “Why should I get an agent when they will take 10-15% of what I earn from the book?”

Answer: Agents earn their money. Agents will negotiate with the publisher for items that you’ll never even know to ask for, or how to ask for it. It is likely that you will get a better contract working with an agent, even accounting for the lost percentage.

The best place to start shopping for an agent is This is the Association of Author’s Representatives, and the website has tons of valuable information. When searching for agents, you want to focus on whether that agent represents non-fiction, and what types in particular they like. Don’t just send out information blindly.

Once you have compiled a list of agents to contact, you will have to create a query letter. This is a simple letter that describes your project in a succinct enticing manner. Most agents now take these by email, which in my opinion is the best way.

However, be careful not to write one letter and include all the agents’ addresses in one mailing. It is a pet peeve of agents to be spammed. Take the time to do an individual query letter to each agent. If you can find anything personal to connect with them based on their website, include that too. However, make these letters short and easy to read. The internet is full of websites that give advice on how to write a good query letter. The Writers Digest website has a lot of helpful information as well.

Don’t be discouraged by rejections. A rule of thumb is after 100 rejections, you need to re-evaluate your project. Otherwise, keep plugging away in batches of twenty-five. You will likely get some constructive criticism and can incorporate that into later batches of queries. If you haven’t had any requests for proposals, it may be as simple as a poorly formatted query letter. However, if you’ve had over 100 rejections, but you believe your project can sell, seek out people who can help you rework your project. There are classes specifically targeted to physicians, and others that target non-fiction writers in general that can be extremely helpful.

5. Academic Book? Contact a Publisher
If you are doing academic textbooks, then you can contact the publisher directly. Which publisher? I simply went to my bookshelf and wrote down the name of every publisher of every book I owned. Then I searched the internet for their submission policy. Some have you send a query email. Some have complicated forms that are essentially a proposal. There has been a lot of consolidation in the industry, so there are less publishers to choose from.

What is most important about making a submission direct to a publisher is finding the right acquisitions editor for your work. The website will list editors and what their specialty is. This is not always an easy task, especially if your book is a crossover subject. Most editors will not send your project to the “right” editor if you pick the wrong person. If you don’t hear something back in one month, find another editor and resend.

6. Upon Request, Submit Your Proposal

7. The Contract
If accepted, a contract will be offered to you, and if you have an agent, they will negotiate for you. If you don’t have an agent, I highly advise hiring a literary attorney. The $400/hour for their services always pays for itself.

8. Deliver the Goods
Deliver your book according to the terms of the contract—usually eighteen months. It could be shorter if the book is completed.

9. Wait!
Wait a year or two until your publication date! On rare occasions, if your book is complete, and a timely topic, it will be rushed. However, publishers like lead time to prepare the marketing, and like everything else in the publishing industry, things move slowly.

10. A Note About Timing
If you search for an agent, that process can take a year or two. Some agents will immediately reject you. Some will take months to reject you. An occasional one will ask for  a proposal, which will take months (even up to six or more) to get evaluated. Once you are lucky enough to get an agent, only then will the search for a publisher begin. Which is why, before you even write your book, you need to begin the process of getting published right now.


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