Creatviity versus Productivity-Medical fiction- royalty versus self-publishing

What happens when one has to depend on their writing to financially support themselves. If you don't produce you can't pay the electric bill or put food on the table. Then the creativity becomes the same as the productivity.
Does that change the creative process? Does it sharpen or undermine it?
If we speak of medical fiction, I suppose you can artificially classify writers into those whom have worked professionally in the field and those that have not.
We like to think of clinically accuracy in medical fiction, (see previous posts), so therefore someone that has not worked in the field would have to do some research, or there is also those whom have had experience as a patient, or what we sadly refer to now as a CONSUMER of health care.
So then we have the medical professional who pays the bills via their day job. They write because they need or want to write. Complete creativity, or maybe obsessive need to be heard or tell the story.
Then there are the writers who pay their bills via writing and they happen to have a medical degree of some sort. Some of them worked in the field for years, some have a degree and residency training but never did much work in the field. Most don't see patients too often anymore, receive advances and are compensated by big royalty publishing houses. They are under contract to produce. Many of the other medical fiction writers dream of this. But on the other hand they can create from the heart, they don't have to produce work that must sell in mass market. That pressure is not there. There are more medical people writing than ever, especially with the proliferation of kindle and nook etc as well as the mainstreaming of small presses and real self-publishing.
All the self-publishing options give free will and avoid any "suck-up sell out" mentality of the author for the work, of course that leads to a lot of self-published literary garbage. (don't quit your day job kind of stuff) On the other hand if the writing is "good enough"  which means marketable to be picked up by royalty publisher and agent etc, the author may have to submit to lots of changes to make the book even "more marketable".
I suppose the few medical fiction writers achieving "celebrity" status have the best of all worlds, although I am  not sure they don't struggle with the issue of being true to thyself, in other words do they write from the heart or do they just "create" what the editor demands?

Technical Aspects of Medical Ficiton-Getting it Right....

I recently read a work of medical fiction by a New York Times Best Selling Author. I am a specialist in psychiatry. This book involved a character with a major psychiatric issue. The Best Selling Author is a physician but not a psychiatrist.
In my opinion the technica and l clinical aspects of the psychiatric problem were way off and not accurate.  I looked at the credits and acknowledgements in the book and I saw a mental health person or two, -no physicians.
Now with all that said, does anyone really care? If the general public would not notice, does it really matter? What if you are in the general ballpark of accuracy, it is just fiction right. No one says the technical clinical aspects have to be accurate. Certainly for a NYT Bestseller, it does not matter, if only a specialist in the field would notice.
It bothered me a bit because I think the fiction works with inaccuracies in mental health might not do much to dispel myths and ignorance around mental health issues. Of course with that said , these are works of fiction and the writer has no ethical, moral, or literary obligation to get technical aspects correct, even when the fiction is a real life story and not fantasy or sci-fi or supernatural.
Basically in fiction the writer can do what he or she wants. If it sells, does that mean its good? What do you think?

Medical Story Writing: Character or Setting ?

Do you pick your setting first. The action packed stereotypical Emergency room with all the fast- paced adrenalin pumping action. Or the Operating room, with lots of life and death action and drama.
Do you build your characters around that setting?
Do you have an idea in mind for the character first? That misunderstood, misinterpreted and determined Doctor or Nurse or God forbid Hospital Administrator. Do you develop that character through dialogue? Too much or not enough Dialogue? Too much or too little descriptive setting?
Do you follow all the "RULES" for general fiction writing.
Does every medical professional have a novel or two or three in them? Do they ever get to share, or like a war veteran do they repress, suppress and suck it up all day and go on to the next day?

Where Has The Literary Romance of Medicine Gone?

Lots of stereotypes about doctors and medicine. At one time we had the ideals of Dr. Kildare and Ben Casey, and of course Marcus Welby and even Chad Everett in Medical Center. TV really helped galvanize our romance with the praticioner of medicine.  Then of course Came ER and the romantic blood and guts of Dr Green. They were all so popular in the conscious mind of Americans. We had so pretty cool doctor writers too through time from around the world/, way back too way back to Anton Chekhov, A.J Cronin, Robin Cook.
Of course we had the romantic view of the physician destroyed by outside forces over the last 40 years. So many loved to hate doctors that they cheer and applaud the destruction of the oh so unrealistic ideal of the doctor.
I suppose Arrowsmith, written almost 100 years ago was not too romantic of a view of a physician, of course Sinclair Lewis sure was not a physician but his Dad sure was. Think about it.
We have a lots of blood and guts medical literary works now. It seems that in this day and age most are in the mystery and crime and suspense realm. who would read a novel with a Marcus Welby character anyway?

Shout out to Independent Author Network

A really excellent site that is a wonderful resource for Indie Authors is the
Independent Author Network . There are many sites  for small presses and Indie Authors out there, I find this one kind of nice, in that it is diverse, and seems to genuinely be frequented by some truly nice people- authors.
Writing like any art form is a very solitary activity. We get isolated in our thoughts and imaginations. We often loose ourselves in our characters. Sometimes it is hard to find of even recognize the support and connection of our fellow humans when engrossed in the craft. In fact sometimes we don't even want the connection, but we all still need it sometimes. This little site is one link in that network of support. See what you think.

Greetings

The medical setting remains one of the most routinely dramatic and intense environs in our modern society. It is fraught with life and death, pain, tragedy, love, hate, and a level of emotional power that is unparalleled in the literary world. I know so many doctors and nurses paramedics  and other  health care workers that live these emotions on an everyday basis. They don't often get to talk about it, and unfortunately many don't get to write about it, but they all have stories. Wonderful, turbulent, intense stories. A few are lucky enough to find the time and the fortitude to write about it. To take their experiences and turn them into a class act fiction essay or even better a novel. Still others have never worked in the field but know someone who has or they are related to somone who does, or thery have been a patient in that world. So many stories, so little time.  So much fiction writing in the world of medicine. Have you written a book or a short story in this area? Do you want to? What is stopping you? Now is the time. I bet you have so many stories, I know I do, so many blend and run together, thousands of human interest stories every day.