Category Close-Ups

Of Aging and Ailments, Boomers and Bodyfat, Calories and Carbs
-- 11/27/00
- continued -

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PW : In this category filled with "stars" and well-established authors, can a knowledgeable, credentialed author make a breakthrough? How?
Gold: It is the knowledgeable, credentialed author that d s make the breakthrough! They become stars later. As for the "stars," some of them actually become knowledgeable, credentialed authors.

Post: If an author has authentic new information and practical advice for readers, editors at publishing houses will pay attention. Prospective authors need to remember that consumers like lists, bulleted points and information that can be quickly digested. Also, authors need to remember that they are competing with the Web, popular magazines and newspaper health columns. There's an abundance of information available, so it needs to be conveyed in standout ways.

G hring: New authors are able to break through, even if they are not stars, by creating something that hasn't been done before. For example, Dr. Glade Curtis, author of several Fisher Books titles, has developed a very successful publishing profile, selling more than a million copies of Your Pregnancy Week by Week by providing mothers and mothers-to-be with unparalleled information and advice about pregnancy and child health that has not previously been available and in a format that consumers find most beneficial.

Moran: It's not easy, but most consumers today are looking for expertise. When the latest fad diet or exercise fails, they will find those good solid midlist books by certified trainers and dieticians that work.

Jorgensen: It helps if the author is the friend of someone who has already made it big. Blurbs can't be underestimated. A lot has to do with connections. If the author can get on Oprah or get coverage in a magazine, it helps get the word of mouth started.

Raymond: The key is publicity. It's not enough to just have good distribution at retail. We work very hard to get the highest visibility publicity outlets for our diet and health authors and that--promotion through radio, TV and print--is the key to making the breakthrough.

Silverman: Absolutely, they just need--pardon this old publishing saw--a fresh hook or topic that hasn't been published to death, one that has resonance in the everyday lives of people.
Wells: Many of the
infomercial people have
had their day as authors.
Wells: For a new author to break through, they need a really smart program that's easy for readers to do as well as a great platform such as a good Web site, good media experience or being connected with a well-respected hospital or medical center.

PW: In these very crowded fields, what d s it take to make a book stand out? How important is a book's packaging?

Bollh fer: Graphics don't hurt. DK's new book [Complete Home Medical Guide by the American College of Physicians] has many good graphics. It's helpful to have a cover that's clear to read. Darker covers don't do as well when they're hard to see.

Post: Author promotion is so important. Radio and TV interviews help a lot, because consumers get to experience the author's sense of compassion and knowledge. A book's title needs to be very clear to the consumer; otherwise, they'll keep scanning for the title that addresses his or her particular need. Remember, these types of consumers have a health problem; they may even be in crisis.

Meredith: The packaging is extremely important. It needs to be attention-getting and enticing. The title needs to be terrific. I think we have a fantastic title coming up next April called Sugars That Heal. It's counterintuitive, it's intriguing, it makes a promise and it can help establish a look and brand for a new expert. It's crucially important.

Baroni: I'd have to say that a great title is more important than the book's packaging. A title can form an immediate connection between a consumer and a book--I think it was partly responsible for certain successes we've had on our list, like Live Now, Age Later and What Your Doctor May Not Tell You About Fibromyalgia.

G hring: A health book, like any book, needs to be distinctive in some way in order to stand out. A brand-name author can provide that distinctiveness, or a new approach or philosophy can provide it. Consumers today are constantly being bombarded with media messages and sales pitches and they develop a resistance to the bland. So books need to be visually striking in order to stand out from the crowd. Publishing a book in the proper format is also critical to a book's success. Perseus published a book called Living Well, geared to seniors, many years ago. But that book has never been available in a large-print edition--until now. We are planning to release a revised bona fide large-print edition of the book this winter to accommodate the book's readership.

Raymond: Packaging is key--you have about three seconds of a consumer's time in a bookstore to get across your message. The jacket--particularly for diet and health titles--needs to be very hardworking. You often have a lot of key benefits to communicate in a very short amount of time in order to capture a consumer's attention. We keep them short, bold and try to use a lot of color.
Dinas: A book, as
opposed to the Web,
gives a certain authority.
Dinas: The traditional all-type approach seems to be going by the wayside, with a play of some type of organic image in addition to the type. Quotes are important, of course, from doctors. We've been told a medical professional (i.e., an M.D.) affiliated even with alternative product will really put it over the top. People are still looking for that kind of validation. Trade paperback seems to be the format of preference, although we're finding a lot more play in mass market now. Because as alternative health is growing by leaps and bounds, traditional mass market outlets like drugstores and supermarkets are supporting it more and more and they can support mass market in their system much more than trade paperback.

PW: Has the state of health care these days changed what type of books you are acquiring?

Post: We seem to have more flexibility in what our readers are interested in reading; people are looking everywhere for health-care information. They don't seem as reliant on traditional Western medicine.

Meredith: No, but I think it absolutely has contributed to the popularity of health books because readers understand they have to know more about their bodies to help their health-care professional give them the best care. So I think there is much more of a search for wellness advice, for information that people really need since they don't have the friendly family physician anymore.

G hring: Consumers now know that they need to take responsibility for their own health and as a result they look to books for help in managing that responsibility. This fact has led to our enormous long-term success with Take Care of Yourself and Taking Care of Your Child, two of the all-time bestselling health-care books.

L wenthal: It is hard to say how much of what sells is due to the state of health care. I can't say that it has had a dramatic or direct impact on what we buy. I do think people are turning more and more to books and the Internet rather than to doctors, who are largely unavailable to them.

Raymond: Consumers are now in a position--more than ever--to be responsible for making crucial decisions about their own health care, and they need accurate, comprehensive and understandable sources of information in order to make their decisions. Books that help consumers ask better questions and work more closely with their doctors in managing their care are essential.

Shepherd: I think the statistic is that more than 60% of Americans now use some sort of alternative therapy, and I'd say this is in direct response to our dissatisfaction with the current health-care system. People are tired of simply treating the symptoms. They want to cure themselves and improve and extend their overall quality of life.

Dinas: Absolutely. That's one of the reasons for the boom in alternative publishing. No one trusts their doctors, no one trusts their HMOs, they can't get the kind of information or care that they're used to getting so they're flipping over to the self-help mode. They're becoming educated consumers. And a lot of the books on traditional and alternative medicine are turning into consumer awareness books. It's really an empowerment issue for the consumer as a result of the disarray of the medical establishment right now.
Miller: Most of
today's health-book
buyers are baby boomers.
Miller: With the preponderance of HMOs and the aging of the highly educated baby boomers, more consumers are educating themselves about their own health rather than relying on their doctors to dictate health-care measures. Health care is now more of a dialogue between two educated people, and it's more about prevention and maintaining health rather than about treating diseases.
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PW: How has managed care changed what consumers are buying?

Baroni: In my opinion, the state of the health system has actually helped the health book market. Doctors, for the most part, don't have the time to answer all the questions their patients have about their health issues. Consumers don't feel they have the full attention of their doctors or that they are being offered information about all the treatment options available. For answers to all their questions, as well as for peace of mind, people are turning to books (and the Internet).

Dinas: The irony is that managed care is falling down in traditional areas, but is more and more focusing on preventative and alternative support. For example, you can get chiropractic through an HMO. You can get different kinds of manipulative therapies in part supported by HMOs that never were before because it's becoming so much part of the mainstream. They're finally connecting with the fact that rather than waiting until you have a chronic disease, why not try to prevent the disease? That's a very big area we're finding and that's helping drive the alternative publishing area.

Moran: It's certainly changed the way we publish health titles. If your doctor is not giving you answers because he or she is pressed for time, you'll turn to books. If your book is not up-to-date or comprehensive, they just won't buy it. Our bestselling health book is Living with Hepatitis C: A Survivor's Guide [by Gregory T. Everson, M.D.]. In the past, we might have revised it every five years. Now we have it on a two-year revision cycle just to keep ahead of the competition.
Jorgensen: Today's
health-book customer
wants to be more proactive.
Jorgensen: People are now buying five books on a single topic. They want to make sure they have all the information they need. For diabetes, they'll want a cookbook and an exercise book. They want a book by a doctor on the aspects of treatment and memoirs telling how other people have coped with giving themselves injections every day.
Miller: There's more emphasis on self-care than before; self-care books are the tool consumers can use to know how to help manage their own health.

Jones: With today's managed care, patients want to become better informed about what's going on. Now they're getting only 10 or 15 minutes with a doctor. That's not a lot of time. So basic books about drugs are becoming necessary. If patients don't inform themselves about drugs' side effects and drug interactions, nobody will. Patients want to know their rights. It's good for books to have lists of questions to ask doctors. They help patients empower themselves.
Raymond: The quest
now is how to build up
your body to live longer.
Raymond: Consumers are now in a position--more than ever--to be responsible for making crucial decisions about their own health care and they need accurate, comprehensive and understandable sources of information in order to make their decisions. Books that help consumers ask better questions and work more closely with their doctors in managing their care are essential.
Perez: Consumers realize they need to take more control of their health and health care. Therefore, a patient may turn to books to get more information when her 10-minute appointment with her HMO doctor d sn't answer all her questions.

PW: Is it better to publish new diet/health books in hardcover or trade paper? Why?

Jones: A hardback is harder to sell because of the price difference. People don't care whether a book is a hardback or a softcover. It's the information that's important, not the format. On the other hand, there's a gorgeous herb book by Penelope Ody from DK [The Complete Medicinal Herbal, new revised edition due in December]. Everybody loves it and they don't mind if it's a $29.95 hardback. In that case, the format enhances the information being given.

Meredith: It depends on the subject. Generally, we have been publishing first in hardcover to establish the book, establish the author's expertise, get the reviews, but virtually always the trade will outsell the hardcover because of price and the work we've done to establish the book in hardcover.

G hring: The format needs to be appropriate to the subject and to the market. For example, a major health reference work might be appropriate in hardcover whereas a single-subject health book might be better published in paperback.

L wenthal: It really d s depend on the book. It is important to launch a major new program or author in hardcover, as it is with many other categories. And certainly the sales are there for this category in hardcover. But more often than not a book will find its major sales in paperback.

Shepherd: I think if the book is personality driven, hardcover is still the best format, especially weight-loss titles. But I love trade paperback originals because it allows me to publish some smaller but very important books. Disease-specific books, such as titles for diabetics or people with allergies, just seem to work better in trade paper. This is what the market seems to want--more affordable books.

Bollh fer: Trade paperbacks are preferable, and as people get older, trade paperbacks are easier for them to read than mass market editions. When the price of a book gets to be $18 or $20, people start weighing the cost.

Post: Softcover, in general, is more approachable for consumers who may not even be normal book buyers. Because they have a health interest that requires them to educate themselves, I think the book's price point should not be a hindrance in whether they buy the book or not; in hardcover, prices can be a deterrent. Our authors tend to be biased toward softcover as well.

Model: I think what's nice about a trade paperback is that not only is it accessible in terms of what it looks like and how easy it is to use but also in terms of the price point. But it depends on what the type of book is; there are certain books that people are going to want to hang on to forever and it's important to them to have a hardcover.

PW: What are you looking for when you sign up a diet book?

Silverman: Good information, a fresh take on the subject, terrific author credentials and a strong promotional platform from the author.

Massey: We look for a unique message from a well-credentialed person who's very promotable.

Miller: A new hook and a strong, mediagenic author. Media experience and media skills are especially important for diet book authors.

Model: Not only that it's different but that it's something that's easy to follow, that there's a specific program, that there's sound advice, that the author is credentialed and that they can walk and talk.

Dinas: We're looking for something different. We're looking for personal stories that show it has worked not only for the author but for many, many types of people. We're looking for some sort of validation medically. We're looking for some sort of science behind it. Fad diets are fine for a quick hit, in and out, but they require so much marketing to really get it over the top that we tend to err on the side of looking at something that's much more concrete and long-lasting.

G hring: Credentials and distinctiveness. We look for the marriage of those two characteristics--a strong author and a strong concept. For example, Perseus is about to publish The Children's Hospital Guide to Your Child's Health and Development with the Children's Hospital of Boston. It's a massive project, years in the making, that will stand as the definitive reference book for the child health market. What makes the project so exciting, and what attracted us when we first heard about it, is that it is from the world's preeminent pediatric research hospital.

PW: Is alternative health still thriving?

G hring: Yes. Recently President Clinton appointed Dr. James Gordon to chair the White House Commission on Complementary and Alternative Medicine Policy, signaling the growing importance of alternative health. Perseus published Dr. James Gordon's Comprehensive Cancer Care, which offers complete information about cancer treatments, integrating traditional as well as more nontraditional methods of treatment.

Gold: The field of alternative and complementary medicine is growing. In other countries and in other cultures there is much less distinction between these subjects. The person is treated as an integrated being--including arenas that only we see as "alternative"--acupuncture, nutrition counseling, chiropractors, etc. Ancient schools of medicine rarely distinguished between food and medicine, and the scientific community today is just beginning to validate what older societies have always known: food is our first medicine.

Bollh fer: Sales haven't increased in alternative health books, but like the recovery section of eight or 10 years ago, it stays consistent. I think publishers have pared down the glut.

Miller: Yes, alternative health books are still thriving, but there is so much competition now--some of it rather generic and mediocre--that it is more important than before for an author to have very strong credentials, for the book to have a unique hook and for the content to be of high quality. Readers know the difference.

Jorgensen: Americans spend more on alternative medicines than on conventional treatments, and books about alternative methods still sell well. That's why we've seen Penguin buy Avery, Wiley buy Chronimed, NTC buy Keats. And of course there's the ongoing success of Rodale and North Atlantic Books.

Dinas: Still thriving, although very cluttered. It's like every other category in this business: you create a bandwagon and every publisher jumps on and breaks it. We hear from the book trade all the time, How many new books on breast cancer can be published each year? How many on herbs? Everybody's looking for a piece of a diminishing pie. So we try to focus on something that's cutting-edge, different. Something that nobody really knows about or someone is just about to know about.

Wells: I think "alternative" health has really become mainstream. The Web has made so much health information and complementary medicine available--and also a lot of misinformation, unfortunately--that people are very hip to herbs, acupuncture, etc.

Perez: Yes. As conventional medicine d sn't always answer all the questions, particularly for chronic conditions or deadly diseases, people have been more open to alternative health and are turning to it more frequently. Some titles turn into real classics, like Women's Bodies, Women's Wisdom by Christiane Northrup, M.D., and Hands of Light: A Guide to Healing Through the Human Energy Field by Barbara Ann Brennan.

PW: With the growing statistics about how many people search for health information on the Web, will health books lose any of their value in the future? Will the way they are published change? How?

Post: The Web is a great resource, but people still enjoy the experience of learning from a book. Also, a printed book can also be a comfort object, and people with illness need these objects.

Meredith: No, the books won't lose their value, because you can't tell on the Web usually how correct or valid the information is. And there's still a very clear role for a publisher to have in presenting the best of what we can see are true experts' works.

Dinas: There's so much information available on the Web. You can go to 800 Web sites on osteoporosis, so the value of those books--the more general reference books, like "everything you want to know about osteoporosis"--is a bit diminished. However, the argument on the other side is, How many people really have the time to cruise the Web and decide what the best information is? A book still gives you the authority of the information, especially if a doctor is writing it instead of a dot-com journalist as just a compiler of information.

Model: We have to be more careful that we're not buying books that could just be a magazine article. If we're purchasing books that we want to get out to the public, it has to something that's has a large enough program and enough information in the different chapters so that people would want to have the whole book on their shelf so they can reference it any time.

Jones: Yes and no. I think people find that the Web can be an overwhelming place. There's just so much information, some that's good and some that's bad. People recognize that. However, if there's a book that's very focused, very specific, it will sell well. It's much easier to flip to a page in a book than to wade through millions of Web sites.

Jorgensen: There's a lot of junk on the Web, and some of the health Web sites are going under. The writing on the Web isn't as comforting in tone as you'll find in a book. It d sn't have that I've-been-through-that warmth. There's something about a book that seems more trustworthy, and books are better than having printouts all over the place.

Massey: People are turning to the Web and have been for a couple of years now. I think, though, that's there's been some disillusionment with it. People can find a million Web pages and they may explore hundreds of them before finding one they can trust. Books still come from a reliable source. I'm not saying there'll be a backlash against the Web, but people are becoming more educated about it.

Bollh fer: Sales of the PDR [Physician's Desk Reference, Medical Economics Data] dropped last season, and that was perhaps affected by the Internet. I do think people may be getting more information about cancer or chronic illnesses over the Internet. I also think that people get information on the Internet and then come in and look at a book.

Perez: While the Web is a wonderful resource tool, sometimes the information there can seem a bit daunting or contradictory. I don't feel health books will lose their value as they provide a singular source of accurate information by a medical expert.

Silverman: I think it will be tougher and tougher to publish traditional reference books in any paper/cloth format as online information gets more reliable (it's not now). I think the Internet will vastly affect the type of health books published in the future--only those that create new theories on healing and/or synthesize information in a fresh and cogent way will survive and thrive. Pill books, omnibus-type health encyclopedias and simple informational books on single subjects (ailment or disease-specific titles) will take the hardest hit, I believe.
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