Over the past several months, I’ve’ been busy assembling various essays into a book—essays I’ve written and published here on KevinMD and elsewhere. The manuscript is now complete. Here’s a brief pitch I’ve given to about two dozen publishers (I do not have an agent):

Dear Acquisitions Editor:

I am writing to ascertain your interest in publishing my manuscript tentatively titled Narrative Rx: A Quick Guide to Narrative Medicine for Students, Residents, and Attendings. The book presents a thoughtfully curated selection of my finest literary insights alongside essays crafted to engage and educate medical trainees and practitioners alike. I am providing you with my CV and a sample of the manuscript. In all, the book contains 60 narratives divided into two sections:

Section 1: Writing and reflection

This section features 28 insightful essays that act as an instructional primer for medical students, residents, and practicing physicians. Readers are reminded of the healing benefits of storytelling and creative writing, as well as the empowering effect of integrating patient and personal narratives into daily practice.

Section 2: Five-minute narratives

In this section, 32 succinct essays highlight themes central to modern medicine, from mental health and artificial intelligence to identity politics, ageism, administrative burdens, and the erosion of health systems and patient-centered care. Each narrative offers a quick yet incisive glimpse into the complex realities of today’s health care landscape.

Within these pages, you’ll discover a rich compilation of perspectives and stories designed to inspire empathy, compassion, and critical thinking. More than a guide to navigating and shaping the future of medicine, this book equips readers with the tools to expertly and intelligently write about their experiences, insights, and reflections, ensuring that their voices—and their patients’ voices—contribute meaningfully to the ongoing conversation in health care.”

I’m beginning to receive rejections, which is not unexpected based on my previous publishing experience. However, one rejection letter, in particular, really ticked me off. The publisher wrote: “Thank you for your email. I’m afraid that your book, while interesting, is not one that we would be able to publish. We are increasingly finding that the only books we can sell to medical students are those that help them through an exam—there just isn’t the interest in reading around the subject [of narrative medicine] that there used to be.”

The publisher’s response suggests that they find my manuscript attractive but do not see a strong market for it within their current publishing strategy. They indicate that their focus is on books that directly help medical students with exams, as this is where they see demand. This feedback reflects a broader trend in educational publishing where practical, exam-oriented materials are prioritized over more exploratory or supplementary content. And that’s why I’m miffed—not because I was rejected, but because publishers—and medical educators—fail to realize how narrative medicine can enhance clinical skills and patient care, potentially making it a valuable resource beyond exam preparation.

Despite teaching narrative medicine in some form in many medical schools, the emphasis remains clearly on exam-focused materials in medical education that overshadow the broader educational value that subjects like narrative nonfiction provide. Narrative medicine is crucial in cultivating empathy, improving communication skills, and enhancing the patient-physician relationship—skills that are essential in practice but not always captured in traditional exam-focused education.

The publisher’s response highlights a challenge in the current medical education landscape, where the commercial viability of educational materials often takes precedence over the holistic development of medical professionals. This situation underscores the importance of advocating for a more balanced approach that values the humanities alongside scientific training.

One publisher suggested that in future pitches or discussions, I might emphasize how narrative medicine contributes to developing well-rounded physicians who are better equipped to handle the complexities of patient care could resonate with publishers or educational institutions that value comprehensive medical education. Additionally, they said, exploring partnerships with organizations or educational bodies that prioritize humanistic approaches in medicine might provide alternative avenues to disseminate my work.

However, I’m not completely sold on these ideas. That’s why I’ve self-published my previous books: there’s no arm-twisting, and it’s delivered quickly to the market. Self-publishing also allows me to retain control over my work, which is important for niche topics like narrative medicine that may not fit into traditional publishing models. Self-publishing allows me to directly reach my target audience without having to compromise on my vision or wait through lengthy publishing processes.

However, in my experience, self-publishing definitely requires strategies to maximize a book’s impact and sales. Here are a few suggestions that might help authors of works that have educational value:

1. Leverage professional networks: Use your connections within the medical and academic communities to spread the word about your book. Consider offering workshops or seminars on your book’s topic to showcase the value of your work.

2. Engage with online platforms: Utilize platforms like LinkedIn, medical forums, and social media to engage with a community interested in your subject matter. Sharing insights or excerpts from your book—for example, in a podcast—could attract interest.

3. Collaborate with educational institutions: Reach out to medical schools, residency programs, and professional organizations that might be interested in incorporating ideas from your book into their curricula or professional development programs.

4. Offer additional resources: Consider creating supplementary materials, such as guides, worksheets, or online courses, that provide practical applications of your book, making it more appealing to educators and practitioners. Audiobooks are especially useful.

5. Gather testimonials and reviews: Encourage colleagues, educators, and readers to review your book and share their experiences, which can help build credibility and interest. Consider asking a thought leader to write a foreword for your book.

By focusing on these strategies, you can effectively promote your book and its important message, helping to integrate it into the broader conversation about medical education and practice.

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. He is the author of several books on narrative medicine, including Medicine on Fire: A Narrative Travelogue and Story Treasures: Medical Essays and Insights in the Narrative Tradition.