Happy last post of 2023!

I hope all my Hospitalogists are having a great holiday with family. Capping off this week’s posts, I’m diving into some thoughts on the growing Hospitalogy ecosystem, including newsletter, community, and more.

Consider it a Hospitalogy ‘State of the Union’ headed into 2024 covering big milestones, what worked well for me from a growth perspective, and everything in between.

Major Hospitalogy Milestones in 2023

2023 was a huge step forward for Hospitalogy, not only in subscriber growth but in monetization and personal growth.

Some quick stats:

About Hospitalogy

For those who might be relatively new to Hospitalogy, I write 2 newsletters a week and have been doing so full time since April 2022 under a media company called Workweek.

  • Tuesday is my ‘news-based’ roundup and analysis, where I cover big headlines that week and drop a host of other links & analysis useful for healthcare folks across strategy/finance/M&A/health tech.
  • Thursdays are for deep dives, which can be a number of things – a commentary or editorial, a financial analysis, strategy breakdown, a guest post, or anything else really.

Based on these weekly outputs, folks from across healthcare (hospitals & health systems, payors, investors, consultants, health tech) have subscribed.

My audience comprises a wide array of incredible people who, simply put, are way smarter than I am. Meeting subscribers is the favorite part of my job. It’s also the hardest part – I feel compelled to respond to each and every one to you because I consider that a privilege to do so! That part was even harder while I left for paternity leave in the back half of the year. I’m still catching up, to be honest.

Moving back to what happened during 2023, here were some of the more interesting trends I noted during the year:

LinkedIn has become my #1 growth platform

Twitter (I’m calling it Twitter) is a lot harder these days, for a number of reasons. Since the algorithm shifted away from threads (for the best, honestly), growing followers has been a lot more ‘grindy’ and less ‘growth hack’ oriented.

Plus, since the algorithm now favors and pays folks for boosting interactions and impressions on platform, big accounts are now incentivized to create and/or reply with inflammatory content.

To be clear, I still love Twitter from a networking and dialogue standpoint for healthcare, but you need to pick your battles and assume positive intent. Otherwise you’re gonna go insane.

For the reasons described above and because there are very few folks posting what I post on LinkedIn, the ‘social media for professionals’ has become one of my biggest sources for organic subscriber growth. My follower count also recently surpassed that of Twitter despite, in my opinion, sinking way more time and energy into Twitter in general. Twitter also really docks your posts for adding external links, which I obviously want to do as a dude promoting a newsletter for a living. But Twitter wants you to incentivize people to stay on Twitter longer, of course.

In 2024 I’m doubling down on LinkedIn, because the vibe of LinkedIn matches healthcare and my audience pretty nicely. It’s much more socially acceptable at workplaces to be browsing LinkedIn than Twitter, ya know? Plus, the algorithm seems to love what I post for the most part – a combination of original thought, analysis, and detailed visuals. Over the past year, impressions on LinkedIn have been orders of magnitude higher than Twitter and I expect that to carry over into 2024.

Open Rates have Hovered around 60%, Consistent Sub Growth since June

Since launching Hospitalogy officially in April 2022 with ~2,000 subscribers and through a combination of organic (naturally acquired) and paid growth, Hospitalogy sits at just under 24,000 subscribers as of this writing.

One of the north star metrics tracked is unique opens – i.e., ‘how many people are actually reading Hospitalogy?’ and to that end, it looks like I’m doing a pretty good job. Although open rates are a bit inflated post-Apple changes, an open rate of ~60% is where I sit today after a June dead subscriber list clean. This something I want to maintain, even with continued growth. I attribute much of this to the enterprise solution we use for sending newsletters, consistency in sending days, and finally, back-office black magic juju from the Workweek growth team.

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Note that the orange ‘open rate’ part of the graph is a range, because it’s hard to pinpoint exact open rates these days, but that range hovers between 55%-65% for most sends. Sorry – I can’t help myself with graphics:

What was Hard in 2023?

My biggest adversary in 2023 was burnout. Being a creator – or producing content – might seem glamorous to some on the outside looking in (follower counts, subscriber counts, idk other vanity metrics) but to pump out 2 newsletters a week at the depth and quality that I want – and know I’m capable of – is a challenge and stressor I face constantly. Not to mention the ever-present imposter syndrome, of course.

Add onto the newsletters internal meetings, writing ad copy, virtual event planning, community coordination and event planning, and education development and there’s a lot of creative bandwidth needed to support all of those functions. Many times I found myself burning the midnight oil to get my newsletter out the next day (or sometimes, even the same day).

This is something that’s unsustainable for me, especially with a newborn. It also leads to mistakes in my writing, inability to coordinate any sort of content calendar with the growth and sales team at Workweek, and just general anxiety around not being prepared. In 2024, I’ll be looking to introduce more structure to my schedule and split more robust deep dives into multiple parts/weeks to take some pressure off the weekly grind and do certain topics more justice.

There were some challenges at Workweek more broadly, too. We weren’t immune to macro conditions, and I was really bummed when we parted ways with Jared, Brett and Healthcare Huddle (along with other brands, many creators who I’d gotten to know well) while I was out on paternity leave. They’re gonna do just fine (and so is Workweek – for the record I’m fully onboard and really appreciate our company’s radical transparency / internal communication), but I miss my healthcare pal, simple as that. It is what it is.

Goals for 2024

Looking forward to 2024, while plenty went right for the ecosystem in 2023, there’s still a ton to jump on entering the new year. Here are some high level goals for Hospitalogy in 2024:

  • Get ahead on content for Hospitalogy (oftentimes I’m writing my newsletter against the clock which hamstrings my ability to do research)
  • Network with and learn from more folks across the healthcare ecosystem – stop coasting by on much of my own existing knowledge and challenge my current beliefs of the industry.
  • Inject more optimism into Hospitalogy by highlighting folks doing real work in healthcare (if that’s you, give me a shout)
  • Continue to add value to the Board Room community by growing the network and adding more perks
  • Double down on LinkedIn posting to maximize organic reach + growth
  • Stretch goal – speak more (podcasts, conferences, panels, etc), something that doesn’t come naturally (in fact a mortal fear) as an introvert. Just ask my wife – I hate the phone. Why do you think I write a newsletter?! Kidding. Sort of.

What I need from you, the Hospitalogists

With all of the above in mind, here are some questions I have for you guys:

  • What type of Hospitalogy content is your favorite? What’s your most memorable deep dive and why?
  • What areas of healthcare do you want me to dive into? What areas should I stop writing about?
  • Is there anything from a formatting perspective you’d change?
  • What sponsors would be a good fit for Hospitalogy in your eyes that could find meaningful ROI by partnering with me?
  • Is there anything I could be doing better generally? What would you change or do differently if you were in my position?


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My Top Performing Essays from 2023

Moving over to the content side of things, the following newsletters were the pieces that you guys read and shared the most (based on internal data):

  1. Breaking Down Amazon’s Emerging Healthcare Strategy
  2. The Vertical Integration Imitation Game
  3. HCA’s Grand Plan: Breaking down the Hospital Giant’s 2023 Investor Day
  4. The Hospital Strikes Back: why Kaiser formed Risant Health
  5. Cano Health’s Slow Demise
  6. CVS, Oak Street Health, and the great Payor Vertical Integration War
  7. The Hospitalogy 1H 2023 in Review

Bonus: even though these didn’t do quite as well, they were still some of my personal favorite essays to write this year:

How to support me and my journey to the fullest extent

I’ve written this before, but if you want to support me to the fullest possible extent, I politely ask that you do the following (with no true obligation, obviously – my incentive is to keep you around and engaged with good content):

  • Open every newsletter I send (unique open rate is my #1 north star metric)
  • Get your IT departments to stop blocking my newsletter!! Hospitalogy is not junk mail, health systems!!
  • Share Hospitalogy with your friends and colleagues (I have a referral program now – look at the bottom of the newsletter!)
  • Meaningfully engage with any advertisements in the newsletter you find relevant (I write almost all of the ad copy for our sponsors and partners)
  • Register and attend every virtual event I host
  • Buy all of my educational products
  • Join my community (for those who are eligible/interested)

Parting Thoughts: Thank you for Supporting & Reading Hospitalogy in 2023

If you’ve been a part of this journey for any amount of time, please know that I do not take your readership for granted. It’s a major privilege to build the Hospitalogy ecosystem and be in the position that I am with a community and one of the larger creator-led healthcare newsletters. To that end, I want to continue to equip healthcare professionals across the industry with knowledge to do their jobs all the while pushing the conversation forward.

For anyone that opens Hospitalogy for the first time, my literal only goal is to get one of the following reactions: “Holy sh* this is a ton of great info, I just learned so much / this will help me do my job better / hmm I never thought of it that way / wow healthcare is actually interesting.”*

I hope I did that in 2023, and I will continue to write the best possible content I can in 2024. Here’s to the New Year, and let’s make healthcare better in 2024.

To you, the Hospitalogists – let’s get after it, baby.


If you enjoyed this, consider subscribing to Hospitalogy, my newsletter breaking down the finance, strategy, innovation, and M&A of healthcare. Join 24,000+ healthcare executives and professionals from leading organizations who read Hospitalogy! (Subscribe Here)

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Blake Madden
Blake Madden
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