The following essay is one of a collection of 39 essays by distinguished editors about the practical and theoretical aspects of publishing that appear in Editors on Editing:  What Writers Need to Know About What Editors Do, edited by Jerry Gross, Grove/Atlantic, 1993.  It is reprinted with permission of the author.

When should a writer consult a free-lance editor or book doctor? What can a book doctor really do for an ailing manuscript? Why has the book doctor become an increasingly important editor for author, agent, and publisher? When would a publisher’s editor assign a manuscript to be edited by a free-lance editor or critiques by a book doctor? How can a writer choose and work effectively with a reputable book doctor? Mr. Gross provides practical, realistic answers to these important questions in this comprehensive look at today’s new breed of editor–the book doctor–whose skills could help you improve your manuscript and possibly save your career.

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Working with a first-rate book doctor can be a creative and rewarding career experience. A talented book doctor can stir and free your imagina­tion, enabling you to look at your manuscript in a fresh and original way. Following a book doctor’s advice on structure, characterization, dialogue, plotting, and organization of material can increase your mastery of fiction and nonfiction techniques, not only for the project you’re currently working on, but for other works to come. But, as with choosing a physician, it’s important to find and select a reputable, experienced one and to establish a good rapport in your working, professional relationship. It’s essential to understand that the editor-author relationship should be collegial, not ad­versarial, symbiotic, not parasitic. Writer and editor must respect each other’s talents, values, and goals.

 Book doctors are free-lance editors highly skilled in analyzing the problems presented by a manuscript or a proposal and offering solutions to those problems. These solutions are usually presented in a lengthy, in-depth report to the client (author, agent, or publisher’s editor) that should also serve as a guide to rethinking and revising the manuscript. These critiques often run from ten to thirty pages or more in length, depending on the size of the manuscript, the number of problems in the manuscript, and the insight and skill of the book doctor in solving those problems. Many book doctors also critique a manuscript line by line and make recommendations for revision in terms of adding or deleting sections; improving pacing, plotting, ambiance, characterizations, motivations, and dialogue; supplying line editing, etc., etc.

Some book doctors, however, begin the editor-client relationship by first skimming the manuscript to get a sense of it and whatever problems it might pose, and then calling the client or writing a short note outlining what the editor believes has to be done to the manuscript to make it more effective. After the client responds to the editor’s recommendations in a follow-up phone call or note, the book doctor begins the detailed critiquing of the manuscript. My own feeling is that both book doctor and client are best served by the former approach — the editor beginning the author-editor relationship by writing a detailed report. The latter approach, a more cursory preliminary reading of the manuscript, risks the possibility of mis­understandings developing between editor and client as to how the manu­script should be revised or edited. The editor could critique the entire manuscript only to discover that the client didn’t like his or her approach. This kind of situation often results in the client not paying the editor because of dissatisfaction with the editor’s work, and the editor having to take the client to court to be paid his fee.

Many book doctors — myself included — do not do any line editing until the client receives the detailed critique of the manuscript (containing, as I have said, suggestions for line editing) and approves the editorial approach the book doctor wants to take with the manuscript. In point of fact, the suggestions for line editing in a comprehensive, well-written and -organized critique are often so clear that the author can do the line editing, or effect any other of the editor’s recommendations, without the book doctor’s help. In any case, line editing a manuscript should always come after the develop­mental editing (the heart of the critique) is completed and approved by the client. (The actual line editing, revising, restructuring, etc., by the way, are separate editorial services and are not covered by the fee paid by the client to the book doctor to critique the manuscript.) In some situations, book doctors work from a detailed critique written by the client that instructs the editor to do exactly what the client wants done. The editor is not asked for any suggestions or recommendations; he or she is paid only to follow the client’s instructions. In this arrangement, clearly the client loses the benefit of the editor’s expertise by not soliciting the book doctor’s help. And the book doctor’s creative talents are frustrated and wasted. The editor can and should be much more than a red or blue pencil for hire, but sometimes that’s all that’s wanted or needed by the client. Both parties are shortchanged in this kind of arrangement.

Further services a book doctor may offer might include collaborating and even ghostwriting. But if you hire a book doctor for these services, make sure that the editor is also a writer: not every editor is. Editing is very creative, but not in the same way that writing is. The editor’s creativity comes from exercising his or her critical faculties. The writer’s creativity comes from the exercise of his or her imagination. The two don’t always function with equal effectiveness in the same person.

It is important that client and book doctor know what is expected of each other before the actual editing begins

Most book doctors work on all types of fiction and nonfiction but some edit only fiction, others only nonfiction. Others specialize in specific genres: mystery, self-help, romance, science fiction, espionage, etc. Learn your book doctor’s areas of expertise before you hire him or her to critique and/ or edit your manuscript.

You may want to hire a book doctor for any number of reasons and at various stages of the manuscript-from working on the theme of the project, through the creation, development, and critiquing of a proposal to present to an editor or agent, through completion of the manuscript and even, in some instances, after it has been accepted by a publisher’s editor.

If you’re a nonfiction writer, a book doctor could help you create your proposal, or critique it before you send it to an editor or agent. A proposal is really an “interview” with a prospective editor or agent and so you want to make sure that what you have to sell is in the best possible shape in terms of readability, organization of material, clarity, effectiveness, targeting of the potential audience, and salability. If you’ve already submitted your proposal to an agent or an editor, he or she might suggest consulting a book doctor to improve it before either taking it on or presenting it at the editorial meeting.

If you’re a fiction writer, a book doctor’s critique of your novel can offer you a new way of looking at your work. In this way, you can rethink, revise, and rewrite it to put it in the best possible shape before your try to get an agent to represent you or an editor to bring it before the editorial board of the publishing house. If there are specific areas you feel unsure about dialogue, or pacing, or characterization, or plotting-be sure to ask the book doctor to give special emphasis to these aspects of the novel in the critique.

An agent interested in your work might advise you to work with a book doctor before the manuscript is sent out to potential acquiring editors. The agent makes the referral; you make your own financial arrangement with the book doctor. The agent also realizes that the manuscript is an interview, and that the first impression it makes can be the difference between the editor wanting to take the book and rejecting it. Realizing how pressured for time the editor is, the agent wants to present the editor with a manuscript that requires little or no editing. If an editor perceives your manuscript to be riddled with problems that will take a great deal of editorial time to solve, it will be difficult for the agent to make the sale. As a result, book doctors have become pre-editors, working on the manuscript to make it as effective as possible even before it is seen by the first acquisition editor.

A book doctor can be valuable if you or your agent finds that the manuscript keeps being rejected but that there’s no consistency in the reasons for the rejections: some editors loved the plot but hated the characters; others hated the plot but loved the characters. Some thought the style mannered and overripe; however, several thought the style was too minimalist, too spare. Most editors don’t go into much detail about why they reject a book or offer suggestions about how to improve it: they just don’t have the time to do so. Also, editors must be very aware of the types of books their house can or cannot sell. Not every publisher can sell every type of fiction and nonfiction book. Accordingly, an editor will often decline work saying that it’s not right for _ (fill in the name of the publisher for whom the editor works). What the book doctor provides is constructive, objective editorial advice from a skilled editor who will take the time to offer a specific “cure” for the ailing manuscript. Being a free­lancer, concerned only with critiquing the manuscript at hand, the book doctor does not have to worry about whether a particular publisher could or could not sell it. It’s like having the uninterrupted attention of a private doctor as opposed to taking your chances with whatever doctor is available to treat you at a clinic.

Sometimes, too, your book keeps getting rejected for the same reason but you’re too close to the manuscript to know how to fix it. A book doctor will have the objectivity to evaluate the book with a fresh perspective and be able to advise you on how to rewrite to eliminate the features of the book that the editors found unacceptable.

Frequently an agent or editor will tell you that your manuscript needs to be cut or line edited or restructured and you don’t want to do it or can’t do it. Here again the book doctor can do the work that, psychologically or emotionally, you are not able to handle yourself. Many authors don’t have a realistic perspective on their manuscript once they’ve completed it: the process has been too demanding and/ or draining. And it can be almost physically painful — in addition to being intellectually and aesthetically impossible — to cut one’s manuscript or undertake a radical revision and restructuring of its contents.

Even when a manuscript has been accepted by an editor, authors hire book doctors for a number of reasons. Many editors are mandated just to acquire books; they have an acquisition quota to meet. They just don’t have the time to work with the author-either in the developmental or, later on, in the line-editing stage. Sometimes they don’t have the experience either: they haven’t been trained in the arts of developmental and/ or line editing. They are skilled in going after authors, coming up with ideas for books, and intuiting what will sell to what audience and what the size of that audience is, but they don’t know how to work with the author to shape the book and line edit it when it comes in. Instead, the manuscript often goes directly to the copy editor, who is an extremely valuable, important, and skilled editor in his or her own right but is not trained to shape and line edit a manuscript.

As a result, authors sometimes don’t get the editorial care and attention from editors that they feel they need and deserve. In such a situation, a free-lance editor, a book doctor, is called in by an author who wants to make sure that his or her manuscript is sent to the copy editor in the best shape possible. Good (or bad) editing can affect the critical reception and sales of the book.

Under certain situations, even a highly skilled editor will call in a book doctor. Sometimes, because of contractual stipulations, a manuscript must be published by a certain time. But if the editor cannot meet the deadline, a free-lance editor is hired to prevent the publisher from being in default of contract and thereby open to legal action instituted by the author. Sometimes, too, an in-house editor, who often works on as many as twenty books a year, is just plain overwhelmed by several manuscripts coming in at once and hires a free-lance editor to ease the burden.

A publisher’s editor might hire a book doctor when he or she is not happy with a manuscript that has been turned in. The book doctor might be hired to work with the author to improve the manuscript so that the editor will accept it for publication. Sometimes the book doctor’s fee is paid all or in part by the publisher; sometimes the fee is taken out of the second half of the advance, which is owed the author upon acceptance of the manuscript. The alternative is drastic: the editor rejects the manuscript and the author not only does not get the second half of the advance but has to pay back the first half. In such a situation, it’s clear that all parties-editor, agent, and author-will want an outside editor to save the manuscript from being rejected. After all, everyone wants the book to be published: the author so that the rest of the advance is paid, the agent so that the commission is received, and the editor so that the book gets on the list to fulfill his commitment to author and publisher and create a revenue-generating project for all concerned. Sometimes, though, it takes an outsider-the book doctor-to make it all happen because everyone concerned is too close to the project and relations among all parties may have soured to the point of damaging feelings, reputations, future relationships and, last but certainly not least, the project itself. Indeed, sometimes a book doctor is hired because tensions and hostilities are so great that agent, editor, and author are not returning each other’s calls and the project is at a total impasse. The book doctor comes in and takes over the project, under the supervision of the editor, and works with the author and the agent until the manuscript has been revised and edited to everyone’s satisfaction.

Finally, a publisher’s editor sometimes reads a manuscript once too often. It loses its freshness, its purpose on the list. The editor wonders why it was bought in the first place, and for what audience, but knows it needs work: perhaps a new opening or a new ending or a reorganization of the material or a deletion of maybe fifty or sixty pages (but where?!). The editor also knows that he or she has become jaded with the manuscript and doesn’t know how to regain enthusiasm for it. Or what’s lost is a clear idea of how to fix what’s wrong or even of what needs fixing. And so the editor turns to a skilled outside editor-a book doctor-to critique the manuscript and come up with a fresh perspective on the book, ideas on what the editor could and should do to make it effective and salable.

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Now that you know what a book doctor does, how do you find, choose, and work with one once you decide you need that kind of editorial help?

To find a book doctor, solicit the opinions of any authors, friends in publishing, or agents or editors you might know. Talk to people you meet in writing classes or at writers’ conferences. Write to the National Writers Union or the Editorial Freelancers Association. They publish directories of their members, listing their specific skills. You’ll find the addresses of these organizations in Literary Market Place (LMP), which can be found at the reference desk of most libraries in the United States. Literary Market Place also lists the names and addresses and services of editorial consultants throughout the country.

Before you hire a book doctor, ask to see one or more of the editor’s critiques of a work in a genre or on a theme as close to what you have written as possible. These reports should be comprehensive and should not only point out what’s wrong with the manuscript but offer solutions to right those wrongs. You may not agree with the book doctor’s approach in these critiques, but you will at least get a sense of the quality of the critique and whether it is the kind of critique that you will find valuable in improving your own work.

Ask for a resume of the editor’s career history, the names of books acquired and edited that are close to your own in theme, and a list of colleagues and authors the editor has worked with to serve as references. By all means, check those references: talk to the book doctor’s previous clients to learn if he or she is diligent, creative, qualified, and easy to work with.

If you want a book doctor to line edit, cut, revise, or rewrite, commission a report that will show how the editor would perform these services. The two of you should agree on the thrust of the editing and the content of the final, edited manuscript before the editor begins work. So wait until you have read and discussed the report before you hire the editor to actually work on the manuscript. You probably won’t agree with every one of the editor’s recommendations, but you should feel comfortable with most of what he suggests needs doing; otherwise, don’t go ahead and ask that the work be done. Naturally you are obliged to pay the editor for the report whether or not you hire him or her to do the work: after all, time has been spent in reading the manuscript and writing the report.

Before any editorial work is begun on the manuscript, there should be a fully executed letter of agreement between you and your book doctor itemizing what services the book doctor will provide, the delivery date of the services, and how the fee will be paid. The usual method of payment is one-half of the agreed-upon fee on signing the agreement and one-half when the critique is completed and sent to you, along with the manuscript. Do not ask a book doctor to work on spec, agreeing to pay for the report only if the manuscript is taken by a publisher. (Would you ask your medical doctor to treat you on spec, expecting payment for care only if he or she makes you healthy again?)

Book doctors should not reveal the names of their clients unless they have given permission for their names to be used. Generally speaking, if you receive a sample critique, the name of the author should be inked out so that it is unreadable. Book doctor-author confidentiality and privacy should be adhered to as strictly as is confidentiality between medical doctor and patient.

Determine in advance if the editorial work you are contracting for will be done by the highly experienced editor you contacted and who signed the letter of agreement, or whether it will be turned over to an editor with less experience who works with or for the more experienced editor. If it is understood that the manuscript will be turned over to a less experienced editor, the fee should be less than that paid to the senior person.

Beware a book doctor who guarantees that if you work with him or her, an agent will take you on as a client and an editor will buy your manuscript. No free-lance editor can make that promise-not even the most successful book doctors in the country. No agent will take on a writer on the book doctor’s say-so, and no publisher’s editor will buy a manuscript because the free-lance editor tells him to. These grandiose promises are as unethical as a medical doctor’s guarantee that he will cure you of whatever is making you sick. So if you get this kind of pitch from a book doctor, don’t fall for it. Just look elsewhere for some honest, ethical editorial help.

Naturally, anyone who has read this far wants to know what it costs to hire a book doctor. Well, as in everything else in life, you get what you pay for. Consulting with a young doctor just out of medical school won’t cost anywhere near as much as seeing a brilliant physician of mature years, great prestige, and accomplishment. Accordingly, the fee charged by a relatively young editor is far less than the fee charged by a book doctor with many years of experience and expertise.

Broadly speaking, though, the cost of an in-depth critique of double-spaced manuscript can range from as little five dollars to fifteen dollars per page, thus a critique of a 400-page manuscript could be between $2,000 to $6,000, depending on the amount of experience the freelance editor/book doctor can offer the writer.  Instead of a page rate, some book doctors charge an hourly rate for their critiques t hat can range from $35 to $150 per hour, or even more if the book doctor is an expert in a particular area of fiction and nonfiction. The same rates apply to line editing. Some book doctors take less of a fee up front for their critiquing and editorial services but take a percentage of the book’s advance and royalties when and if it is sold. Fees and percentages should be discussed in great detail, and be clearly understood by both parties, before the letter of agree­ment is sent to the client. A void phrases like “fee to be mutually agreed upon.” Work on the manuscript should not begin until that letter of agree­ment is signed by both parties-author and editor-and at least a portion of the critiquing fee is paid to the editor.

Fees for the creation and development of a book proposal vary according to the extent of the book doctor’s participation: How much of the idea for the book came from the book doctor? How much of the writing and organization of material will be done by the author and how much by the editor? Will the book doctor be critiquing an already written proposal or creating one from conversations with the author and some rough notes?

Hiring a free-lance editor as a collaborator or ghostwriter involves not only a fee for the editor’s services but also agreeing on the percentage of the advance and royalties the editor will receive if the book is sold. Depending on the extent of the editor’s participation in the project, the percentage received by the book doctor could vary anywhere from 25 to 50 percent of the advance and royalties earned by the book.

A final caveat: A talented, creative book doctor can help your work achieve critical and commercial success. An ineffective, unimaginative book doctor can be hazardous to your creativity. Take as much care in choosing a doctor for your manuscript as you would a doctor for your body. The life of your career may be at stake!

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Click here to email Jerry Gross

Other articles by Jerry Gross:

What a Good Editor Will Do For You, Writer’s Digest Magazine,

The Most Common Mistakes I See in Fiction Manuscripts–And What to Do About Them, Webdreamer

How to Prepare Your Manuscript for an Agent or Editor, The Writer Magazine

Rx for your writing by Charles R. Davis, The Writer Magazine, round robin on editing with Jerry Gross