Self-publishing a Book as a Physician
Ever wonder how to self-publish a book as a physician? Discover the process.
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Good evening, and nice to see you in our retrospective introduction this evening, Andrew.
That’s right Keevin. Welcome to the podcast, everybody. And we’re just kind of riffing a little bit here, as we listen back into some of these things we recorded about a week ago and a week is a lifetime these days.
But unfortunately, I was not able to be available for Gerardo, but I very much would have I mean, a he’s a family physician train, which is totally in my wheelhouse. And he is a dot phrase or smart phrase master of electronic health records, which is also one of my feathers in the cap on the local epic guru. Oh, nice. I didn’t know that.
It’s like everybody needs to know what everybody in healthcare is touched by and, you know, little expertise in that is great. Not to misdirect that, but the podcast is about publishing. So he’s actually a dot phrase guru. But really what’s so interesting about him as the kind of the publishing side and something probably everybody thinks about, at some point is publishing a book, he’s just gonna straight up teach you how to do it doesn’t even require a whole lot of know how beyond just sort of the standard googling, and that’s what it sounds like he did, which is pretty cool.
What and the reason I mentioned it at all, which is inspiring is because that was one of his first books was he had accumulated his life experience in EHR, and then that’s what he published. So it was just kind of a neat tie in,
for sure. And the other big time that I caught from this one, this one is so interesting to me is that he is a big Tim Ferriss fan. And I have to say that probably about 10 years ago, Keven introduced me to Tim Ferriss as well.
Yeah, it’s been a very good learning experience. He’s built a network and knows how to talk to people in interview, and I’ve certainly learned a lot from his show and his guests,
For sure, for sure. What’s interesting to me was the sort of this idea of the four hour workweek, which which is something that you wrote is going to talk about sort of incorporating into his own life and his of kind of view on these projects, which is, you know, kind of simplifying it down to the things that have to get done, doing them in a very calculated way, you know, and accomplishing things by, you know, kind of taking off chunks of big projects and treating them like small projects. In the end being a very, very successful published author, while being, you know, very successful physician, so very cool stuff to incorporate that world of like, you know, optimization and efficiency and, you know, the podcasting and all of that into his clinical practice, which is sort of the whole point of our podcast, which is, you know, how do you take those skills that you have or that you want, and turn that into another career, I guess?
Well, it was a great Listen, and we’ll, I’m sure everyone else listening to this will enjoy it as well.
Hi everybody, welcome to the Active Income MD podcast. Today on the podcast. We have Gerardo Guerra Bonilla. Gerardo, he’s a family practice physician. He’s a hospitalist and a nocturnist. But he’s more than that. He’s actually a published author, as well as a variety of other things. But hopefully today he’ll share a little bit with us about publishing. Gerardo, welcome to the podcast.
Hey Andrew. Thank you for having me here. It’s a pleasure.
Yeah. Well, thanks for coming in. So Gerardo, I’d love to get to know just a little bit more about you. Can you tell us your story?
Sure. Well, I went to medical school in Mexico, and then I came here to do my specialty in family medicine. It was quite a journey.
Well, what made you want to come here? What was it about? You know, what did you see, as kind of gaining from coming to the United States with it. Was it a training thing? Was it a need to, you know, sort of expand the things that you knew to take them back to Mexico? Like what was your logic and sort of coming here to practice?
You know, I guess I was influenced by a friend I had in medical school. And, and over there, it’s in Monterrey Mexico is like two hours from from Texas, the border from Texas. So we have a lot of international medical students from the US and also from other parts of Latin America. They wanted to go to US. Somehow, it was embeded in my mind that the US had better training, which in fact, it does. So my goal in medical school was I started there the last few years, I started doing all my reading in English and preparing to hopefully get into… Well, I had no idea what I was going to do. But it all started with an international program in Miami, University of Miami, they have this program where they try to attract doctors from Latin America to practice, or at least a specialice in internal medicine. So that was my first taste there. And you know, In Mexico is completely different than in the US. You go to medical school right after high school, right. So I had no idea what I was getting into. But after, you know, it’s four years of basic science, and then another four years of clinical science. But one year before you finish, you start your internship, during medical school. So a little different than here. And instead of being an intern Hospital in Mexico, I decided to join this program in Miami. And so I was really impressed with the work ethic and professionalism of doctors here in the US. So it was mind blowing. So I really wanted to do more. And then I applied to be a visiting medical student in Harvard. So I got three months there. And then after that, I went to Baylor in Houston, and I did another three months. And I ended up staying there for a little bit over a year doing research with a plastic surgeon. Back then I wanted to be a surgeon. And then I had to return to Mexico. Because here in Mexico, you have to do social service, in order to graduate. So usually you’re like the doctor in a small town, and you’re kind of giving back to the community. But in my case, I found a different pathway. And I stayed in my university in Mexico. And I got involved in developing some research labs because I was doing research so somehow they thought I was an expert. But it was really interesting. It gave me my first taste of kinda the business side of medicine. After that, I got involved in another project, developing a dental clinic. And, you know, it was very rewarding. After completing the clinic and seeing all the people you were helping. So I always wanted that I wanted to do something outside of medicine where I could have more impact. But obviously, my goal was specializing. So I started applying, studying for the boards. I first applied to general surgery and didn’t get in. Then I found another program in UCLA. And the goal of the program is to bring doctors that speak Spanish to, here to California. Because 30% of the population here in California is Hispanic.
Speak Spanish right?
And only 3% speak of the physicians speak Spanish. So they helped me get into family medicine. And I did my residency in Northridge, in LA. And I moved to Northern California, here in the Yolo County. There’s a big Hispanic population. So I practiced in the clinic for the first four years. And now, since the COVID pandemic started, I moved into hospitalst full time.
Sure, yeah. And then you’re a practicing full time hospitalist. Now, what we’re hoping to focus on is sort of all that other stuff. So it sounds like pretty much the entire time you’ve been doing clinical medicine, you’ve always had your eye on these other things. What is it? You know, that brought you in to getting in towards the publishing side of this. Where you said ‘this book needs to be written’? How did you identified this need? Where is it sort of along the way where, you know, you saw that the training was great in the United States, and that you were getting this great training, and you were doing this great service for the community, Latin American communities, but there was still a need, sort of how did you identify there was this need?
So, initially my purpose wasn’t to publish a book. I think, like you, I always was interested in developing some passive income, right? By the way, I love the title of your podcast, Active Income MD, because it’s actually very active endeavor. So I didn’t start with the idea of creating a book. It was out of necessity. When I started residency, I had a newborn at home, and I had to be efficient, right? The first six months of residency we were using paper charts. And back then I made this templates. And then make copies. And then every time I will do an admission, I will use a template. And I’ll use a fountain pen so I could write faster, right. And then EHRs came in and now it slows you down, right? typing, and you could dictate. well back then in residency, we couldn’t dictate. But so I started creating these templates or dot phrases, right? And I started accumulating them for three years during residency. And I started using it when I started practicing. And at some point, I said, Well, we can do something around this. I wanted to create a, an app or a software. But obviously, I didn’t have any technical expertise. So I thought what’s like the basic thing that I can do? First, to share this content with with my colleagues, because it was helping me getting out of the clinic on time with all my note done. So how can I share it with the community? So I thought, well, let’s just publish a book. And you know it’s not expensive, and obviously takes time. But I already had most of the contents, right? So I spent a few months just, really honing the templates and trying to expand the content and perfecting it. And I started putting everything in a Google Docs document and organizing them by specialty, or different categories. And I didn’t know like where to start. But it seemed like Amazon would allow you to publish a book, self authored book, right? So I explored that. And in fact I mean, it’s amazing what you can do in Amazon. So once you you have the content, you can you can create your own content, and then you submit the manuscript as a PDF. And actually, Amazon has their own software where you can start writing, typing the book there and with links and images, and all these things that are more interactive. But I started with the with Google Docs, so it was very basic. And after months of spending a little bit of time, like, creating the content, I published it, and obviously was crickets.
Like most new endeavors? Sure, sure.
So, I had to read a lot of blogs and YouTube videos, websites. And I started to learn, like all the nuances, right? So for example, when I published that I created my own book cover, right? And probably, if you google statnote right now, in images, you’ll see it. It is horrible. But I wanted to do everything right, so I read somewhere, there’s a good websites called Reedsy, if there’s anyone out there who wants a serious about trying to publish something that they have a lot of good tips, and one of the things was obviously having a professional looking book cover. And you know, they say that don’t judge a book by the book cover. But that was from 100 years ago, where all the book covers look the same, so you couldn’t actually judge. So nowadays, you can create something amazing. So I’m a big fan of Tim Ferriss, you probably know.
Sure. Of course
The four hour work week. So one of his advertisements is about 99designs, I don’t know if you recall the name, but they do design and it’s a wonderful platform. You submit your request and then people around the world submit their designs and they compete for the prize. And so you get to work with dozens of designers and you get to choose which one you like and then you start tailoring to what do you like and then end up with a very nice book commerce. So I did that and and obviously it’s it I started getting some sales. Some other things that they recommend is really choosing a good title and keywords. And there are other factors. But basically, once you have that, you’re more likely to get discovered, right? There is obviously, the marketing aspect, which it’s a whole thing. And pricing the book right. For example, you see a lot of books that are $9.99 on Amazon, right? And there’s a reason for that. If you make it more expensive than your royalties decrease. And then obviously, they can print the book and center everywhere in the world, right? So it’s amazing. And then they have the Kindle Unlimited. It’s where users get a membership from Kindle, and they can read 1000s of books. So one of the things you have to decide when you’re going to publish your book is where you want to publish your book. You can polish the ebook in your own website, you can publish it on Amazon, Google, Apple books. So if you do Kindle Unlimited, it restricts your publishing only exclusively to Amazon. And, and that’s has its benefits. and disadvantages. One of the advantages is that they’ll pay you per page that the users we, I mean, it’s like half a cent or something like that per page. But, but I gives a lot of exposure, right? Because the user doesn’t have to buy the book, they can just rent it, or they don’t rent it. The borrowed for a while and read the content, and then you can exchange it for another one. But you get paid for all that. And, and I haven’t tried Google or or Apple. But I mean, you know, from a personal experience, I read all my books on Kindle. So I thought, well, I’m gonna stick with it.
And so it’s another aspect of it is having your web page and the landing page, you know, if you’re going to do some marketing, you might as well know who is clicking on your ads. Amazon has an amazing marketplace by itself without doing any marketing. But I found after trying on, you know, social media, Google ads, and the most effective one is in the actual marketplace in Amazon. And I mean, you don’t have to spend a fortune. And there are two ways to do market. One is by keywords. And the other one is by product. So if you’re interested, for example, if someone is looking for a book on medical documentation, I can say well, I whoever is looking at this, I want to market to this person. And, and that’s a very good way to find leads, right? The other thing that you might do to to increase your revenue, because like the royalties for a book is anywhere from 60 to 70%, depending on if it’s an actual printed book, or just electronic content, and then if you have images, and how heavy the file size is. But the other thing you can do is becoming an Amazon affiliate. So if you got to do some marketing, if they click your link, then you get an extra 4% per per sale, so that it increases a little bit of your profit. But you know, sometimes the main goal of publishing of book might not be to make money, per se, by selling the book, it might be a gateway to something else. Or, I mean, once you publish a book, you’re kind of like the expert on that subject. Right. So that gives you an advantage to do other things. And you probably have seen like a website where they say, Well, if you subscribe to my newsletter, I will give you my ebook, right? So it serves if you give something out of value, you can start growing audience and then sell something else. So in my case, my first question was, well, are people interested in this content? So and the answer was yes. After a few months, it became a bestseller, in the category which is practice management. So that gave me a clue. Well, okay, so let’s go to the next step. So the next step was offering the electronic content on a website. And then from there, it’s what Chartnote is today, which is the web application. But going back to the book, so so it’s not just to publish a book. I mean, it’s it’s a gateway to so many things that you can do with doing that.
Yeah, it’s so interesting. It’s so much stuff. And I do want to throw in there that, you know, I’m also Tim Ferriss fan. So I’ll say so many questions, which is, you know, he says pretty much every episode, but first thing I want to do is throw the name of the book out there, because I realized we didn’t actually say it the first time. So the book StatNote: dot phrases to expedite your medical documentation. So that’s the name of the book. The web application associated with that his Chartnote. So we’re gonna have a ton of show notes with this, basically, everything that you just mentioned come through, because there’s a ton of great content there. So yeah, I mean, Tim Ferriss is somebody who is a master podcaster. As I think, you know, it’s very interesting to me that you got some guidance from Tim, in terms of kind of how to do this. I mean, really, to sort of outsource a lot of these things, I remember reading about the 99designs in that book. And that’s so cool that you use that, you know, and kind of put it up there, because one of the things when we were actually designed the Active Income MD webpage was me saying, I have no idea how to do this, we have to find help. And it turns out, it’s really very easy to find a lot of great sources, a lot of great talent out there. You don’t have to do all of these things yourself. And part of what you have to do in the process is figure out where to ask for help. You know, find the right folks, the right experts. And I think everybody clinically knows, you don’t make all the decisions yourself, you know, what your own limitations are. You call the consultants when you need them. You get called sometimes when you’re needed with that expertise, and I think the same process is true with so many of these other endeavors, and certainly sounds like something you did, you know, starting up with with publishing. I do have a couple questions with that. So you mentioned with, you know, self publishing is what you did through Amazon, it sounds like, you know, creating everything on a Google Doc, Amazon has a platform where you can kind of just upload that they sort of quote unquote, publish it. And then they actually create a paper copy too, is that something you had to do separately? or Amazon just does it all?
No, no… I mean, obviously, you have to follow a certain format, you know, and the index, and the page bleed has – I think that’s how you call it – it has to be a certain measurement. But as long as you follow their guidelines, you submit it, and then they will publish it both versions, electronic and the printed version, which is amazing, because otherwise I mean, if someone wants to publish the book, they have to go to publisher, printers… so I mean, obviously, it’s almost undoable, right?
Well, it sounds like they take care of one of the harder processes for you. Because when you’re when you’re publishing this, you don’t need a publisher, if you don’t have to worry about physical distribution, literally storing paper copies of books in warehouses, because Amazon’s got that covered. So it’s taken out some of the, you know, the more difficult part of the process. So now you can come up with an idea, create the content, then you sort of give it to them, and they probably take a chunk of it, you know, in terms of payment, but it almost sounds like writing a book has never been easier.
Yeah, yeah, definitely.
Very cool. You mentioned another thing, which I thought was cool at the Amazon affiliate Association. Can you talk about that a little bit?
Yeah. So I mean, people can can just become an Amazon affiliate, and promote their products. I mean, you know, they’re this influencers, right, on social media, and they talk about their makeup they’re using and they can make YouTube videos. And so obviously, I’m not an influencer. But these people promote this product and then they say, well click on this link, and you can buy this product. So once you click on the link, and if you buy it, they get a 4% cut. Right. So if you’re doing the your own marketing for your book, I mean, you might as well take advantage of that. And every time someone clicks on that link, that then you get a 4% extra of the sale.
Is that something where you put it on your website that they would go to the book? I mean, how do you set it up? How do you how do you create the process of becoming an Amazon affiliate?
Yes, well you just sign up. I don’t think there’s a lot of science or I mean, you sign up and there are some restrictions. For example, you cannot do a google ads or paid advertisement on social Media with the link. But you can advertise your website and then on your website, they can click on that link and go to Amazon to buy the book. Which I actually it’s better to at least having a landing page, because then you can track all the metrics. Who is clicking on your links. So for example, I discovered that I was selling books not only here in the US, but also in Canada, UK and Australia. And I also discovered that it was not only doctors who were buying the book, it was also nurse practitioners and PAs. So it gives you a lot of advantages. Having a website, I mean, and you don’t have I mean, there right now, there are a lot of services that help you create a website, I mean, if you’re going really get into it, probably WordPress is the one to go. But if you don’t want to get too involved. I mean, for example, MailChimp offers, it’s like kind of an all-in-one, you can have a basic website, a few landing pages, and then obviously, you get the email marketing side of it, because… So one of the things I didn’t tell you is that what I do on my website to create an audience is offering the book for free. So I don’t offer the book for free per se, I offer… So when you’re an affiliate, they they want you to sell Amazon products, right? So what are the products they want to sell is the actual membership for kindle unlimited. So when people go to my website, I tell them, Do you want to subscribe to my newsletter? and they say, Okay, here’s it, well, if you subscribe, I’ll give you the book for free. So they get that actually get a couple months for free of for kindle Unlimited, and then they can get the book. So that way I get a growing audience that then I use to sell my other products. And I usually I don’t just sell the products. I mean, I try to write a blog article every month with interesting content or related content. And so that way that you keep the audience engaged, and they’ll click on the link and go to your website. And then hopefully buy something.
Sure. Yeah. And I mean, it’s interesting, because, you know, for you, it’s, you know, the book is part of a process. The book is part of the thing you’re doing, which is improving documentation, improving clinical care, improving the networks and correspondence and all this other stuff. But the book itself, it sounds like, sort of helped you learn about all of the different ways to incorporate this other stuff into into the entire process you’re doing which is sort of improving your community, community health care and, you know, the the day to day work of doctors and, you know, the process of using EHR and reducing burnout and things like that, you know, it’s it’s all part of that kind of blogger/ podcaster lifestyle, I guess, which is sort of in the in the life online and pulling these things together. So everything benefits, everything else. And optimizing, I guess, is sort of sort of the Tim Ferriss way of doing it. But it’s so interesting to hear about it, because you’ve thought about it so much. And you’ve done so many good things within it’s fascinating and see all the different ways it’s gone off in different directions just from, you know, kind of starting with the publishing very, very interesting. I certainly did not know how easy it was to publish online. I wish I had some things written down to publish.
Yeah, so it’s super interesting and fun. So I told you that I quit clinic and now I’m a hospitalist and I only work four days a week. So I have a day off that I kind of like, do my my side gig. And, and it’s on Mondays. And I’m always super excited for Mondays, right? Because it’s when I get to do my side gig. And medicine it’s very square, right? I mean, you have to do things this way. And here. I mean, I feel like it’s like my creative outlet and I can experiment with things and no one’s telling me how to do things I can do in my own way and learn from mistakes, right. So it’s a lot of fun. I’m sure you’re also having a lot of fun doing your thing
I really am. And and, you know, it’s it’s it’s interesting to hear again, bringing the Tim first thing in where I remember reading those books saying, I mean, not saying I wish I was in medicine, but saying this seems like something that maybe is not as applicable to medicine, something where if I were doing something else, if I were in the business world or technology, there might be some opportunity to use this. And I think you went the other direction, say, I’m going to use this exactly, and figure out how to use these processes that we’re learning the 99designs, and you know, all this other stuff to really market, the content I have inside me in a meaningful way. And that’s awesome to see. And I hope that other people out there in medicine, you know, who have that inside them and say, I have something I want to put out in the world can use some of these tips and tricks and really do it because I think physicians have a lot to say, and a lot to contribute. And I think that, you know, what we, when we’re going through this pipeline where everything is so rigid, you know, you know exactly what you’re doing this year, then the next year, and the year after that, we lose that creativity that I think most of us have. And that was really kind of the, you know, the reason I started doing this podcast was to be able to explore, you know, all of these other options and all the other things that physicians can do, and hopefully it inspires some others to get out there and do it because I think we’ve got a lot. I do want to ask one sort of next question with that, which is when you started this process of really stepping out of clinical medicine, you know, why didn’t you do it earlier? What barriers were there for you?
Well, you know, time is always a big barrier, right? I mean, who has time. I have three kids, and then back then it’s was full time job. So I really had to carve some time to be able to work on this. And the only thing that I could do at the time was waking up earlier and going to bed early. So you know, I had my alarm to go to bed and my alarm to wake up. And I’ll spend one to two hours every morning. Because otherwise, I mean, you start getting time away from the family. And it’s not doable. I mean, I guess the hardest part is starting. After you have something going on kinda like it gets easier and you start getting people involved. And you have a little bit more resources, and you have more credibility with your spouse. Which… I don’t know if this is your case. But I mean, she would say: why are you spending time on this? You’re not getting everything out of it? So but once you start seeing that something good is coming out of it, then I think it’s easier, but definitely, the hardest part is is the start. So if anyone wants to go this route, I think that you just have to start and see what happens.
Yeah, no. And I think we might have heard that a few times on the podcast, that seems to be something that comes up. That being said, you know, if you were thinking of three steps that somebody might take towards publishing a book, what is that first step they need to do?
So I think the first thing they need to do is to start small. So, you know, back then I had the idea of having my own business or doing something to create passive income and, maybe quitting my job and starting something. But you know, I mean, someone who might be less risk averse might go that route. But I realized that, uh, you don’t have to, I mean, I read this book, I think it’s called a 10% entrepreneur. And it gave me a very good insight. Well, I mean, you just have to devote 10% of your time, and slowly build a snowball. Right. And that’s pretty much what I did, right? Just put down in your calendar, when are you going to work on it? And and just start. For example, another big one for me was when I started my blog. I mean, I’m not a writer, right. So I just started with my first article, and I tried to publish one once a month, but you just have to sit down and write the first paragraph, then…
It’s work. It’s not a thing where you always feel like doing it. I mean, you just have to say I’m going to create an article.
I think the hardest part is the first paragraph and then once you run that, then ideas start flowing. All right, okay, we can do this and that. And so I guess the first thing will be start small. The second will be like put it in writing or put in your calendar, when you’re going to devote time to do your project. And the third thing would be…
There two good ones, if you can’t come up with a third on. Get started, and you got to put in the work. That’s the key here. So, you know, what are your next steps with this? And now you’ve got a great website you’re working on, you know, still doing full time clinical. Do you have other plans, other books in you? Or what are you working on next?
So we got the content and I put it on a web application that is Chartnote. So we just started that three months ago, and we have a growing user base, we just hit 500 users last week. And and the goal there is to build a community so that people can contribute their own templates. And you can discover templates from other doctors. And it’s so amazing what we’re getting. Not only doctors, but like I said, physician assistants, nurse practitioners, doctors from Canada, UK, different parts of the world, and I even had a dentist a couple of weeks ago, that joined last week. He was super excited.
I just signed up today just to see what it looks like. And I mean, it looks like you have a variety of specialties in there, too. So it’s not just for internal medicine, Family Medicine. But yeah…
The goal. I mean, obviously, I started with the content. So there were over 1,000 templates that you can choose from. But right now we have more than 3,000 templates, and half of them are private, so the users don’t share that template, but the other half are public. So you can kind of discover other templates. It’s an amazing project. The other thing that I use recently completed is I translated all the templates into Spanish. So in the next few months, I’ll be hopefully publishing a book in Spanish. And what we want to do is get the web application into Latin American Spain, and see what happens.
Awesome stuff. So Gerardo really, really fascinating. Really fantastic. I don’t want to take up too much your time. I know you have to go into work tonight. So you know, is there a place where people can reach you out on the web? I know, we’ll put up the your website in the show notes so that people can, you know, sign up, see what you’re doing, but maybe contact you through that. Do you use any kind of social media any place people can reach out with questions or comments?
Okay. Yeah, but it sounds like you’re receptive. And if anybody has comments or questions, and everybody check it out, great book, great website. tons of great stuff coming out of Gerardo. I’m really looking forward to what we see next.
Yeah, excellent. You know one thing that I want to say is to start with your audience in mind. So for example, everything I do, I it’s like, all the things that I want to tell a resident for example. So it’s, it’s easier for you to create the content because you have in mind who you’re writing for. When you don’t know exactly who your audiences is. It’s it’s harder.
We’ll add that as the third step to take perfect, yeah.
Gerardo, thank you so much for being on the podcast tonight. I really enjoyed it learn so much.
My pleasure Andrew. Have a good night,
Everybody, thanks so much for listening to the Active Income MD podcast. We’ll see you next time.