write to win

Publishers insist writers stick to one genre. But what if they don’t want to be a ‘genre author’?

Marketing wisdom says developing a niche genre is good for positioning. Not every author listens.

Seven years ago, I hit a midlife crisis that took me completely by surprise. Around me I saw much the same going on with friends. After laughing a fair bit about the state of panic we found ourselves in, I sat down and wrote a book about it.

It was my first book, on the face of it, a story about a housewife and two murders but it wasn’t a murder mystery. It was humour, chick lit and social commentary rolled into one. It was a mishmash of genres and at that point I didn’t really care. I was green enough behind the ears not to, and all that mattered was that I had an ink and paper book of my own to rock myself to sleep with every night.

I have learnt since that publishing houses have lists. Bookstores – both brick and mortar and online – have categories. Mysteries. Thrillers. Romance. Chicklit. Mythofiction. Young Adult. Literary Fiction. And more. I, unfortunately, can’t write to fit into lists. Writing my first book was a process of rapidly typing out a story that had to tell itself, done so quickly it is an embarrassment when recalled.

My fourth novel, The Face at the Window, took the better part of four years to get done, a gentler fiction with a ghost and a life lived out with regrets. What genre did it fit in? I didn’t know. When it was written, a kind reviewer stated I had pioneered a new genre, “Himalayan Gothic”. I then went on to write a second chance romance. Then I turned to non-fiction with a collection of true love stories. More books are in process, but again, different genres from what I’ve written earlier.

A single genre game

Well-meaning folk in the publishing world shake their heads disapprovingly. Stick to a single genre, they advise me. You will confuse your readers. Your readers pick up a book by you, expecting a sunny romance with the mandatory happy ending complete with doves and violins in the background, only to get blindsided by a spooky tale. Will they ever trust you again? Dour marketing teams step in, faces so grim one might think they’d spent the morning drowning puppies. Marketing a multi-genre author is difficult, they say, your books can’t be slotted conveniently on one shelf, they get scattered. Readers who might want to read older books might be disappointed when they realise the previous work is nothing like what they’ve just read. You’re dividing your audience. It hurts your “author brand.”

Sticking to one genre is solid advice to someone who is perhaps just starting out and needs to develop a voice and style all their own. It is comfortable and a safe zone to write from. After all, you know the territory, twists and turns, plot points, character arcs, the pace needed. You’ve done it before. “Before” is a safe harbour, for both the writer and the reader. But then, harbours are safe for ships, as a wiser person than me once said, but that’s not what ships are for.

In illustrious company

There have been several authors, fairly popular ones at that, who have jumped genres quite successfully. Ian Fleming wrote the international super spy James Bond series, with all its intrigue, drinking and seduction as well as the classic children’s tale Chitty Chitty Bang Bang, which came about after telling his son a bedtime story about a car that could fly. Roald Dahl wrote for children and for adults, grisly tales with a dark, disturbing undercurrent running through them – layered with frivolity in the children’s writing, sharp and out in the open in the stories for adults. Stephen King wrote the classic horror stories Carrie, The Shining and IT as well as exquisite prison narratives like The Green Mile and Rita Hayworth and Shawshank Redemption.

Among Indian authors, Kiran Nagarkar wrote the darkly internal Seven Sixes are Forty Three, the delightful Ravan and Eddie, a humorous look at living in a Mumbai chawl, followed by the vivid and historical Cuckold and most recently the dystopian Jasoda. Sachin Garg, a bestselling romance author, wrote a hard hitting tale about the Jarawa tribe in We Need A Revolution. Mythological fiction bestselling authors Amish Tripathi and Ashwin Sanghi ventured into non-fiction with Amish’s Immortal and Ashwin’s 13 Steps series. Ravi Subramanian, known for his corporate thrillers, shifted track in his previous book, The Bestseller She Wrote.

To use a pseudonym or not?

The handy pseudonym is widely employed by authors who wish to write in differing genres. Some do it because they don’t want to confuse the reader, others because they want the new writing to be received on its merit and not be weighed down by the expectations that their name brings. Stephen King who wrote his non-horror books under the pseudonym of Richard Bachman said, “I did that because back in the early days of my career there was a feeling in the publishing business that one book a year was all the public would accept.”

JK Rowling wrote her Cormoran Strike series of investigative thrillers under the more masculine name of Robert Galbraith. “Being Robert Galbraith was all about the work, which is my favourite part of being a writer. Now, my cover has been blown, I plan to continue to write as Robert to keep the distinction from other writing and because I rather enjoy having another persona,” she said. Isaac Asimov, the god of science fiction writing, chose Paul French as his pseudonym to write his Lucky Starr series, meant for younger readers. Dean Koontz has written under at least ten different names according to reports because his editors advised him against writing in different genres under the same name. Joyce Carol Oates too published books across genres under her own as well as multiple pseudonyms – Rosamond Smith, Lauren Kelly and Rae Jolene Smith, to name some.

I could have adopted a pseudonym as well. But then, I was far from being well-established in one genre, to be so presumptuous as to adopt a pseudonym for another. And pseudonyms felt like a split personality. For me, writing in different genres was always, like Whitman put it, an expression of “I contain multitudes.”

Why do authors shift genres? Some, like me, have a low boredom threshold and feel compelled to change and reinvent all they know about themselves and their writing ever so often. Others are prosaic and want to straddle different demographic segments and write for potential expanding market.

I enjoy flitting from romance to parenting to horror – after all, romance could turn into horror in the break of a heart, and parenting is a horror all its own. I take heart from stories of these writers. I am not alone in wanting to write in different genres, to play around with different styles, forms and narratives. Is it a risk? Will the reader follow an author across different genres even if they don’t enjoy that particular genre? These are questions I am still searching for the answer to.

What I do try to ensure is that the cover for each book matches the genre expectations, as does the blurb. And I can only hope that my reader recognises that by not sticking to a single genre I am putting myself out on a limb, as someone who will not be contained by the limitations of “genre” writing. I write stories. And I refuse to have them or myself boxed in.

Kiran Manral is the author of eight published books, a TEDx speaker and a columnist.

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What hospitals can do to drive entrepreneurship and enhance patient experience

Hospitals can perform better by partnering with entrepreneurs and encouraging a culture of intrapreneurship focused on customer centricity.

At the Emory University Hospital in Atlanta, visitors don’t have to worry about navigating their way across the complex hospital premises. All they need to do is download wayfinding tools from the installed digital signage onto their smartphone and get step by step directions. Other hospitals have digital signage in surgical waiting rooms that share surgery updates with the anxious families waiting outside, or offer general information to visitors in waiting rooms. Many others use digital registration tools to reduce check-in time or have Smart TVs in patient rooms that serve educational and anxiety alleviating content.

Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.

At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.

Getting the best from collaborations

Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”

Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

  • Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.