To Blog or Not to Blog?

Victoria Dunckley, MD first started blogging on her own website to share information with patients and parents. When she moved her integrative psychiatry practice and opened a new office in Los Angeles, the blog helped her grow the practice. The blog also brought in consultation work with patients from all over the country, and has led to expert witness work, as well.

The posts on her blog eventually evolved into ideas for a book. When I first met Dr. Dunckley and began working with her, I suggested she pitch a blog column to Psychology Today as a way to increase her reach and national impact and meet her goal of "increasing awareness about the ill effects of screen-time."

It would also help make her book proposal for her book, Reboot Your Child's Brain, more attractive to agents and publishers. She did so and the result is her Mental Wealth Column on PsychologyToday.com.

At first, she blogged tangentially about her book topic with posts on topics such as misdiagnosed bipolar disorder,  how electronic screens can contribute to tics and 10 rules for safer cell phone use, so as not to give away all the information in her upcoming book. However, over time, she began to blog more specifically about electronic screens and their effects on children's brains and mental health--including what she has termed "electronic screen syndrome."

Indeed, her high profile blog posts contributed to landing a top agent and a book deal with New World Library for Reboot Your Child's Brain. Even before that book comes out, though, her blog has already helped her have a powerful impact. Dr. Dunckley reports, "I've received emails from people all over the world telling me how a particular article has helped them. Those emails make all the effort worth it! Blogging has also helped sharpen my writing skills and has led to supportive connections with like-minded individuals."

So, should you be blogging? Here are some reasons to blog and a few reasons not to:

Reasons to blog:

1. Blogging can help you reach a large group of people with your ideas and make an impact.

2. Blogging can help hone your writing skills.

3. By inviting comments you can find out more about how your audience/readers think and what they want to read about.

4. Comments and other responses to your blog can help you clarify your own ideas, explore new avenues or see things differently.

5. Your blog can attract a large audience of fans who are then interested in buying your books, attending your seminars or hiring you as a consultant.

6. Your blog can attract media attention: more and more the media are finding experts for radio and TV shows through searching the web. Your blog helps them find you as search engines like Google love CONTENT and your blog is full of relevant content.

7. Your blog can attract patients or clients to your medical practice or business. Again, search engines like Google are looking for websites with lots of relevant content. Websites with extensive blogs and tagged with appropriate "keywords" win out on Google.

8. Publishers LOVE authors who blog, especially if you are reaching a large audience.

9. Blog posts can be short--less time cnosuming than writing a magazine article, for instance.

10. Blogging is a great way to be viewed as a thought leader--and rightly so.

So, why wouldn't you blog?

a. Blogging takes some time. You will need to figure out where that time will come from and schedule it in for blogging to work.

b. You don't get paid. Sure, some people have ads on their blogs, but that can detract. In general, you don't get paid directly for blogging.

c. You may need to learn a few new skills--beyond writing, you'll need to learn wordpress and get some sense of how search engines work so you can make your posts "discoverable" on search engines like Google.

d. You'll want to blog with some consistency or it's harder to develop a consistent following of readers.

I hope none of these reasons deter you. Basic blogging skills can be learned in a day and the benefits are many--to your medical practice, your business and your own personal satisfaction.

If you want to learn more about blogging and other forms of reaching the public with your medical knowledge, join me at Harvard Medical School's CME course on writing and publishing: Achieving Healthcare Leadership and Outcomes through Writing and Publishing March 31-April 2 atthe Fairmont Copley Hotel in Boston, MA.

There, doctors who are also bloggers and published authors, as well as agents, acquisitions editors and other experts in the publishing industry, will guide you in the many writing opportunities available to doctors and others in the health professions. You'll also have many opportunities to share your ideas with us one-on-one and receive guidance for navigating this exciting arena.

Go the F**k to Sleep: A Bestselling Book

If you read the June 20, 2011 issue of Publisher's Weekly, you'd have seen that the #1 hardcover nonfiction bestseller is a book titled Go the F**k to Sleep.  Why is that?

Well, there are a lot of things that create a bestselling book.  The author's connections and media presence (this is called "platform"), the book's content, key opportunities for exposure and sometimes dumb luck. 

Another thing that makes a book a bestseller is that it "resonates" with people.  This is probably a key factor in Go the F**k to Sleep's success.  The book is about what some parents refer to as "the witching hour."  That time of night when you are exhausted and so are your kids.  But, instead of calmly ending the evening on a peaceful note, chaos ensues.  Night after night.  Until, at some point, your kids grow up...or at least grow mature enough to enjoy a peaceful end to the day. 

Time magazine's review of Go the F**k to Sleep reported that the "deliciously vulgar treatment of the dreaded bedtime hour went viral".

What I think is important about the success of this book is not the content, but the fact that it has touched on a topic that really resonates with people.  Books that do this--regardless of whether they are a memoir, self-help guide, or any other genre--have the potential to break out and become a bestseller.

Do You Listen When You Write?

Every time you write a blog, speech, article, pitch or anything else, do you listen to your audience? 

What I mean by this is: Do you put yourself in the position of being the listener, rather than the writer?  This is one "trick" that helps tremendously when you want people to read something.  Here's why.

Many people turn to writing as a form of communication, because they have a message that they want to convey.  So, they say it in written form.  If this was done orally, it would translate into "speaking" rather than "listening", of course.  But, as a writer, you want to be thinking about your listeners (or readers).  If you were speaking, then you'd guage their response by watching attentive facial expressions (or signs of boredom). 

As a writer, you don't get this kind of feedback, so before you finish writing your piece, it's a really good idea to "listen" to it the way that a reader would.  Does it sound the way that you intend?  Does it hold your attention?  Is it the right length, the proper tone, and so on?

Some writers write and some both write and listen.  The ones that do the latter, tend to reach their intended audience better.

How Truthful Does Your Memoir Have to Be?

The thin line between fact and fiction.

When James Frey published his memoir, A Million Little Pieces, he was all the rage. Oprah chose this for her book club, and it sold nearly 2 million copies in 2005.  Then, Frey was "outed." His book became known as A Million Little Lies. What happened?

Frey made the critical mistake of writing things that weren't true AND could be documented as lies.  Don't all memoirs contain some "untruths"?  Probably.  A memoir is a snapshot of someone's life.  A period of time that they document from memory.  Since we all have imperfect memories, it stands to reason that any book written purely from memory would contain some erroneous information. 

That's expected and appropriate, if it's not intentional and documentable.  If you say you've been in the military, but the military has no record of this and no one recalls your having been a soldier, then you're in trouble. If you say that your family drove across the United States in a blue car, but it was really tan, well, that's a reasonable mistake. It would be pretty hard to "forget" that you weren't in the military and fairly easy to document this  On the other hand, it's much easier to forget the color of a car that you took a trip in many years ago, and that would be harder to document.  Readers would expect and forgive an inaccuracy such as the latter one. 

However, as Frey and many others have found out, they don't forgive it when authors lie.  The Smoking Gun investigated and found many documentable inaccuracies in Frey's book--related to police reports, court records and interviews with law enforcement officials.  Frey lied.  He lied to his readers--among them, Oprah.  Oprah never forgave Frey. 

Perhaps unsurprisingly, Frey now writes fiction. 

So, how truthful does your memoir have to be? As truthful as you can make it when you write from memory.  But, keep in mind one thing: if a reporter can check something out and document it, you'd better do that yourself before you ever commit it to paper and call it nonfiction. 

The ExpedMed Textbook: Expedition & Wilderness Medicine

For those of you who are interested in learning more about Expedition Medicine or Wilderness Medicine, I'd like to mention our textbook, Expedition & Wilderness Medicine, that was recently published by Cambridge University Press.

This textbook is used as the syllabus for our Expedition Medicine National Conference and also as a teaching tool for many other courses and organizations around the globe.

The textbook is a hardcover text over 700 pages in length, with full-color photos and diagrams.  We recruited more than sixty experts from around the world who contributed content for this project.  Contributors include many notable individuals such as 

Richard Carmona, MD, MPH, FACS: 17th Surgeon General of the United States

Luanne Freer, MD, FACEP, FAWM: past president of the Wilderness Medical Society and founder and director of Everest ER

Ken Kamler, MD: Vice President of The Explorers Club and author of Doctor on Everest

Richard Williams, MD, FACS: Chief Health and Medical Officer for NASA

Peter Hackett, MD: Director, Institute of Altitude Medicine

We have been pleased to read many favorable reviews of our book in multiple journals including the New England Journal of Medicine and JAMA. Here's an excerpt from the JAMA review:

Expedition&Wilderness Medicine, edited by Bledsoe, Manyak, and Townes, is a comprehensive guide to the multitude of issues facing the expedition physician. The book is organized into 3 sections covering expedition planning, specific and unique environments, and specific wilderness illnesses and injuries. The comprehensive and often humorous chapters have been edited in a style that allows for easy reading, and they include numerous excellent illustrations.

Several of the chapters are written by some of the world’s authorities on the topic. Not only have many of the authors published widely on their areas of expertise, they have spent considerable time in the field. The authors have diverse experience ranging from serving as the expedition physician on a climb of an 8000-m peak in the Himalayas to providing medical care to a patient injured thousands of feet underground in a Mexican cave. This experience—and the willingness of many of the authors to illustrate ways to avoid future problems by describing their own misadventures in the field—contribute to the strength of this text.

Expedition & Wilderness Medicine is a must-read before any expedition. It carefully details what an expedition medical kit should contain, along with details on what to consider taking along for toxicological and dental emergencies. Although this book is aimed at the expedition and wilderness medicine physician, many of the chapters are superb summaries of core emergency medicine knowledge that are better distilled and presented than chapters in some more traditional textbooks of emergency medicine. We recommend this text to all who practice acute care medicine and all physicians who hike, climb, or vacation outside the city or who might encounter anyone else who does.

Jones ID, and CM Slovis. JAMA. 2009;302(4):442-44

We'll be writing more about opportunities in Wilderness Medicine and Expedition Medicine here on Freelance MD, but for those of you who need something to begin your journey, pick up a copy of our textbook online or attend our Expedition Medicine National Conference and receive the book for free.

Physician Writing: Emotional Responses To Breast Cancer

By S David Nathanson MD

Ordinary Miracles: Learning from Breast Cancer Survivors.

Directing a Multidisciplinary Breast Cancer Clinic gave me the opportunity to interact every Thursday morning with newly diagnosed patients, their families and friends, and with my colleagues in Medical Oncology, Radiation Oncology, Nursing, Radiology, Pathology, Genetics, Plastic Surgery, and Psychiatry. I met and observed six new patients every week for years. I noticed that patients, while grateful for the purely technical and medical information, seemed quite interested in the other patients. Patients struggling with their fears of death and the uncertainty of an impending barrage of treatments want to determine how other newly diagnosed patients feel. I wanted to understand these uncertainties, emotions and feelings in order to better manage my patients and to help them cope with their disease. I asked eight hundred of my patients to write about their experiences. I encouraged them to remember the feelings when they were told there was a suspicious lesion in the breast, when they were given the diagnosis in the surgeon’s office, when they faced surgery, chemotherapy, targeted therapy, radiation and follow-up visits. About ten percent of the patients responded to my request, some with brief paragraphs, others with many pages.

A number of common themes emerged from the patients’ stories. There is an emotional value in knowledge gained from professional explanations. Knowledge enabled an understanding of the choices, helped overcome myths, guided decisions, provided hope and diminished fear. All the patients showed an innate wisdom and determination to survive. In taking control of their own treatment decisions and choices they helped unmask the feeling that the disruption to their lives would eventually be overcome, that ‘time would heal the issues.’ During the disrupting events of each of the treatment modalities they found the strength to immerse themselves in ‘normal activities’ which helped them avoid focusing every moment on the cancer. The support provided by family, friends, health care workers, cancer support networks, one’s boss and co-workers were very valuable. Faith in the health team and in ‘a higher power’ played a big role in emotional support although professional psychological help was sometimes necessary. The biggest fears were: loss of control, loss of dignity, pain, loss of a job, and progressive encroachment on personal freedom.

I learned important lessons that enhanced my own ability to manage patients and I was enchanted by stories of great courage, bravery, inner strength and tenacity. I thought that the stories would help many new breast cancer patients, and also their care givers and perhaps many other patients with life-threatening diseases. Organizing the stories into a book was time consuming and filled with joy and it took some time to come up with the title: ‘Ordinary Miracles: Learning from Breast Cancer Survivors.’ Miracles abound in the modern day management of breast cancer and many are related to the creativity of modern scientific discovery, leading to a twenty percent improvement in the overall cure rate of stage one disease over the past thirty years. But the miracle in my title refers to the triumph of the human spirit. Faced with despair and death, the human soul chooses life and hope. No matter how devastated the patient feels when first confronted with the diagnosis, she displays a miraculous and triumphant change within a few weeks while she goes though the necessary treatments. This is an ‘ordinary’ miracle because it is accomplished by almost everyone, old and young, highly educated and less educated, of all social, economic and ethnic classes, and therefore not ‘extra-ordinary.’

Serendipity accounts for the rapid publication of my book. The day after I completed the last page, while wondering how to get it published, I received an email advertisement about a workshop in Boston that offered to address this exact question. I brought the manuscript with me to the workshop, found an editor who liked the work and offered to take it with her to her company in Connecticut. Six weeks later I signed my first book contract. There followed a whirlwind few months of editing, finding a publicist and obtaining endorsements from prominent oncologists, a patient, a theologian, a psychiatrist and a psychotherapist. Soon after the first printing, and while working full-time in my academic position, I was exposed to a number of media interviews including major newspapers, magazines, television and radio. I found myself signing copies of the book at Borders, cancer survivor luncheons and in my office. The most rewarding part of all the frenetic activity associated with the writing and publication was to hear from patients and from nurses that newly diagnosed breast cancer patients felt quite comforted to recognize that they were not alone in their fears. Knowing that someone else had experienced the same feelings and emotions and had survived the treatments was extremely comforting. The learning experience for me and for my patients continues.

About: S. David Nathanson MD, surgical oncologist and Professor of Surgery at Wayne State University Medical School in Detroit is a breast surgeon at Henry Ford Health System in Michigan. He directs A Multidisciplinary Breast Diagnostic Center at West Bloomfield Hospital and the Multidisciplinary Breast Cancer Clinic at the Detroit Campus of Henry Ford Hospital and can be found at www.facebook.com/henryfordpinkyswear and www.youtube.com/user/HenryFordTV.

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If A Surgeon Can Write A Book or Two, So Can You

If I had only one word, I would use “pinball” to describe my transition from academic surgery as an Associate Professor at Dartmouth to what I do now, combining locum tenens general surgery with being a thought leader in physician engagement and optimizing physician-hospital collaboration.

Yet, writing appears to be the common thread in my iterative life journey.  I learned that the words “author” and “authority” have a common root, auctor, (http://dictionary.reference.com/browse/authority)  meaning writer, progenitor, accepted source of information, power, and mastery.

I had a fortunate break that helped me write my first book, Better Communication for Better Care.  In 2003, the head of the California Hospital Association who heard me present results of a consulting project, remarked, “This is the best work in any California community hospital, bar none,” and told the President of the American College of Healthcare Executives (ACHE) to ask me to teach a seminar there.  As a result of the seminar, the acquisition editor of Health Administration Press, the publishing arm of the ACHE, told me that she had a series of 80-page Executive Essentials books and asked me if my seminar material would fit.

When I said yes, she said, “Just because you have published over 40 articles, don’t think of this project as an extended article.  Writing a book is different.”  What I learned from the process is that:

• Writing a book with a publisher requires others’ assistance: people who cannot abide by others advising them re: title, cover design, length, and word-smithing are better off self-publishing
• The focus is on the needs of the target market: unlike a review article, which is a scholarly product, a book published by Health Administration Press must reflect the unmet needs of senior healthcare leaders, guiding them on what strategies and tactics work with physicians, not telling them how ignorant they are because they did not attend medical school
• Once the book is published, the author’s job begins: at Health Administration Press, a marketing department of two oversees the launch of about 100 books in the catalog; it becomes the author’s responsibility to take an active role in marketing the book if s/he wants to publish another book in the future

So, how do you market your book?

• The Internet is a great equalizer: you can build buzz for your book even before it is published through blogging; I use WordPress because it combines seamlessly with my website (http://healthcarecollaboration.com/blog/)
• LinkedIn (http://www.linkedin.com/in/kencohn) is a great way to connect with fellow healthcare professionals; it also can provide links to your latest blog posts
• I maintain a Facebook page for each of my books, (http://www.facebook.com/pages/Better-Communication-for-Better-Care/98165231327), (http://www.facebook.com/pages/Collaborate-for-Success/114669573209)
• I customize my email signature; my Hotmail account, which has my widest distribution, displays: Author of Better Communication for Better Care: Mastering Physician-Administrator Collaboration (2005) and Collaborate for Success! Breakthrough Strategies for Engaging Physicians, Nurses, and Hospital Executives (2006) http://healthcarecollaboration.com/books

My mentor Sam Horn, taught me, “Ink it when you think it.”  I keep a pad of paper and a pen in my pocket, and on my bedroom nightstand for those moments when a thought comes to me.  Others use the record button of their smart phones to capture ideas.  For me, writing has been a wonderful journey that has expanded my knowledge base and circle of friends and colleagues and that has led to speaking and consulting invitations in 40 states, England, Sweden, Italy, and China.

I hope that your writing journey is equally rewarding and that you will keep me posted on your progress by writing me at ken.cohn@healthcarecollaboration.com