Self-Publishing vs Traditional Publishing: How to Decide the Right Path for Your Book
- Nisha Mehta, MD
- Oct 12
- 8 min read
Writing a book can be a great way to help educate the masses, build a following for other side gig opportunities, and/or to create a future passive income stream. When publishing a book, there are two primary paths: a do-it-yourself approach with self-publishing or the traditional publishing route through a publishing house. Many members of our physician communities who decide to write a book ask which pathway is better. Choosing how you want to publish your book is one of the biggest decisions you’ll make as an author (also noting that it may not always be easy or possible to find a traditional publishing house willing to publish your book idea). Both paths have advantages and potential downsides, so it’s important to understand the differences between self-publishing vs traditional publishing to help you choose the model that works best for your goals, schedule, and expectations.
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Self-publishing vs traditional publishing: what’s the difference?
There are quite a few differences between self-publishing and traditional publishing.
In traditional publishing, you enter into an agreement with a publishing house for the rights to distribute your book in exchange for assistance with editing, printing, distributing, and marketing your book.
Self-publishing, as the name suggests, is where you have control of this entire process and handle all the logistics that go into launching a book into the world once you’ve finished writing it.
Depending on your particular expertise, brand, and writing background, traditional publishing may not always be an option if you encounter difficulty finding a publishing house to take on your project. Self publishing offers a pathway to authors who may not have access to traditional publishing methods, and has really opened up the possibilities for non-traditional authors to publish a book.
Below, we break down the major differences by key categories and considerations to aid you in the decision making process.
Who controls the publishing process
Traditional publishing offers a professional support team, but limits control, while self-publishing allows you to retain full control but carries all the associated responsibilities.
Traditional publishing: A publishing house acquires the rights to your manuscript (typically through an agent) and manages the entire process. This includes, but isn’t limited to, editing, design, distribution, and marketing. This even includes the book’s title, cover image/jacket design, selling price, and publication date. While you may have a say in this process, the publisher typically dictates the process and ultimate decision.
Self-publishing: You are the publisher and thus retain full control and responsibility. You are in charge of hiring an editor and designer, formatting your book, setting your price, distributing it, and developing a comprehensive marketing plan.
Timeline to publication of your book
Traditional publishing is notoriously slow, while you can self-publish as quickly as you can put a plan in place.
Traditional publishing: The runway when working with a publishing house can take 12-24 months from contracting to release. This doesn’t include the amount of time you take querying literary agents to find representation and then going on submission to get an editor and deal with the publisher. Traditionally publishing a book, especially your first one, can easily become a multi-year process.
Self-publishing: If you have an efficient publishing process, you can publish your book in as little as a month or two once you’ve found contractors to help with editing and design and have it formatted and ready to distribute. Your pre-sale campaign and printing timeline (if doing physical copies) can impact your timeline, but self-publishing is a much quicker process overall.
How books are distributed for purchasing
The publishing path you choose can depend on your goals for distribution. Major publishing houses offer the opportunity to distribute to bookstores and libraries, while self-publishing often favors those who are focusing on digitally distributing eBooks or print-on-demand services.
Traditional publishing: Publishers can offer a broader distribution with a dedicated sales and distribution team that can get your book on shelves in major retailers like Barnes & Noble and Target, as well as in independent bookstores and national wholesalers.
Self-publishing: Self-published authors typically use print-on-demand (POD) services to help lower upfront publishing costs for print books and to reduce the risk of having unsold stock. Some of the services may also provide the opportunity to list your print book with Amazon and other online retailers, though it’s more difficult to get your book stocked on shelves in stores. eBooks can be sold through platforms such as Amazon Kindle Direct Publishing (KDP), and you even have the flexibility to sell directly to your audience through your website.
Financial structures in publishing
While traditional publishing comes with the support of a professional team, this help isn’t free. Traditional publishing offers lower royalties without upfront expenses, while self-publishing can offer higher potential profits but at a greater upfront cost.
Traditional publishing: Publishing houses typically pay an author an advance, which is a pre-payment against future royalties earned. This may be done in one upfront lump sum, or broken up into multiple payments (which may even occur after your publication date, making the term a bit of a misnomer). Royalties can vary, but are typically around 10% of the book’s retail price. Your literary agent will likely take a commission of your advances/royalties, further reducing your net profit from your sales. While the publisher + agent is a hefty percentage of the total, the publisher covers all costs of production, printing and distribution, and the agent only gets paid if they land you a book deal. In addition, publishing houses may be able to sell more copies and at a higher listing price than what you might be able to find a market for in self-publishing.
Self-publishing: In self-publishing, you control many of the financial aspects. Self-published authors pay expenses out-of-pocket including professional editing, cover design, and marketing fees. While this requires an upfront investment, self-publishing can offer higher royalties in exchange by cutting out over middlemen. While platforms such as Amazon KDP still charge fees, self-publishing royalties are typically closer to 60%-70% of sales versus 10% of list price.
Marketing and platform expectations
While one of the benefits of traditional publishing has always been marketing support, publishing houses are relying more and more on authors to build their own platform to market their books.
Traditional publishing: While publishing houses have marketing budgets to put behind authors, the majority of their marketing efforts go to their A-list authors. Authors, especially debut authors and nonfiction authors, are expected to maintain and grow a platform, often through social media, speaking engagements, etc. The publisher may put together a book tour around the book’s publication to help raise awareness and give readers a chance to interact with you, but there is still a lift required to digitally market your book.
Self-publishing: Marketing is entirely your responsibility, which gives you full control over your strategy. Many self-published authors say a strong social media presence is required to build a following, while others grow their audience more naturally through their brand and their backlist of published works. A newsletter is often a great marketing tool, but you have the freedom to get creative and see what fits naturally to your brand and your book(s).
Credibility and perception in the marketplace
Traditional publishing offers external validation and can lend more credibility, while self-publishing requires more effort to provide a professional perception and to build credibility for your work.
Traditional publishing: To become traditionally published, you typically have to secure a literary agent who believes they can sell your book. The literary agent then has to pitch your book to publishers to secure a book deal. Given the highly competitive selection process, publishing through one of the main publishing houses can carry a certain prestige, as only a small percentage of books pitched get offered publishing deals.
Self-publishing: While self-publishing removes the gatekeepers, it also removes the names and reputations behind these literary agents and publishers. Self-publishing used to carry a stigma to it, but that has changed dramatically in recent years. Several traditionally published authors have started their careers self-publishing, and some agents and editors focus primarily on bringing in new talent that has found success in self-publishing.
If you’ve already built credibility through a brand, such as coaching or speaking, you may not need the additional credibility a publishing house can bring.
Self-publishing vs traditional publishing: which is a better fit for my book?
Traditional publishing and self-publishing both have advantages. Which is a better fit can often depend on your overall goals for the book and for your writing career.
Traditional publishing can be a better option for physicians who wish to:
Build academic credibility or credibility in their industry (this doesn’t have to be healthcare if your writing side gig focuses on something else, such as fiction writing or self-help)
Have the guidance of an agent and the assistance of a professional editor, as well as other in-house teams for design and marketing, etc.
Avoid the upfront costs associated with self-publishing
Physicians should consider self-publishing if they want to:
Quickly reach their target audience that they’ve already built through their platform
Retain full ownership and control over their content and rights to their material
Maximize their potential royalties (note this doesn’t necessarily mean higher profits, as listing prices and sales volume may differ for traditional vs self publishing)
Hybrid publishing: an additional approach for physicians to consider
If your goals give you conflicting advice for the best pathway above, hybrid publishing is another model physicians can consider. Hybrid publishing has grown in popularity in recent years and provides a middle ground.
In hybrid publishing, authors pay for the production costs and thus carry the financial risks, similar to self-publishing. In exchange, the publishing house provides the professionals (editors, designers, distributors, etc.) to help take the book from a manuscript to a final sellable product, similar to traditional publishing. In a simplified form, hybrid publishing is like hiring an independent contractor to help publish your book.
Though this requires an upfront investment, in hybrid publishing, you retain more control over the creative process, timing, rights, and outcome. Authors who use the hybrid model typically earn higher royalties than through the traditional publishing path.
Conclusion
A few decades ago, traditional publishing was the primary publishing path. With the growth of digital publishing and eBooks, however, self publishing has found a solid footing in the industry, and is a great option for physicians to consider as well.
The “right” publishing model ultimately depends on your goals (and a traditional publisher’s willingness to publish your book), though your bandwidth and financial situation also factor into the decision as different publishing paths require different time and financial commitments.
Regardless of which path you choose, if you approach it with intentionality, you have the opportunity to share your knowledge and your voice with the world. The publishing path you choose simply determines how (and how quickly) you’re able to share your voice with your audience.
Additional writing resources for physicians
Related PSG resources:
You can also explore medical writing side gig opportunities.