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Merry Christmas Hospitalogists!

I hope you’re finding this break relaxing and restorative before the new year gauntlet begins. But never fear. We’ll be in the thick of it together!

Today, as is customary to close out the year, I wanted to give you guys a complete update on the state of Hospitalogy: business, personal, professional, and more.

Let’s dive in!

And please remember to ask and answer questions from your peers in the Hospitalogy Membership. I love learning from you guys in there.

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By all metrics, Hospitalogy had a blowout year. But I can’t help but feel like I left more on the table in 2025.

For that reason I want to chalk up 2025 as a paradox, but one that is sorting itself out entering the new year as we work through challenges but also celebrate victories. 

As a newsletter and emerging media brand ecosystem (newsletter, events, community, and more coming…scroll down for details), Hospitalogy crushed. No other way to put it, really. And I’m damn proud of that fact. Well over a million in revenue this year. 50,000 subscribers. My first in-person event. Over 100 newsletters sent. 

I also welcomed new faces to Hospitalogy at Workweek! New hires to help with Hospitalogy initiatives (membership, content - shout out Kaerrie, Jenn, Lindsey, and Kat). People to help me with severe logistical challenges (thanks Hanna, Becca, and Germana). And finally, OGs to help me think through strategy and growth (Adam & Keith). My fellow creators, and plenty of others who have a common goal to make work fun and bring smart people together across the hairiest of industries…and maybe even move that needle forward a little bit.

But I also hit major bandwidth capacity problems in 2025 and dealt with burnout. I feel guilty for not responding to Hospitalogy emails, or letting my inbox pile up. The inbox problem between socials and email (pitches, responses, work) gets overwhelming, and I tend to shut down. I meant to post more on social media to grow the empire. I could have maximized output a bit more.

But I also needed to learn to extend myself some grace and I am, after all, human, with waxing and waning emotions and ability. I am trying to take that to heart in 2026!

I wouldn’t be anywhere remotely close to where I am today without the support of these people, you guys reading and supporting me, my community, my family, and my faith. For this support, I am filled with immense gratitude.

So with a posture of humility, transparency, and gratefulness, here’s how Hospitalogy did, by the numbers, in 2025.

As of this writing, 50,382 of you are subscribed to Hospitalogy. That’s a big number. It’s just over 50% of the way there toward my ultimate goal of having enough subscribers to fill Texas’ Darrell K Royal Memorial Stadium.

With this growth, however, comes some saturation. Given some seasonality effects, a bit more commercialization, and a new community Q&A send beta to close out the year, confirmed (note: the most conservative estimate) unique open rate metrics dipped a bit in 2025, with the median open rate for 2025 sitting at 47.2%, down from 49.4% in 2024:

As you can see, total unique opens (the orange area chart) rose for most of the year until dipping late in Q4. I wanted to take a closer look at that period specifically to see what was going on, since I’m a freak and care deeply about the quality of my content and want to make sure you guys are getting the utmost value every time you open Hospitalogy (eagerly, of course).

The chart below is a little noisy, so I apologize in advance. But if you take a second to digest it, you can see a few different things going on in that yellow section worth highlighting:

• I had a cluster of 3 ‘holiday’ Thanksgiving sends in late November (what I’m thankful for, Giving Tuesday, and a fun Black Friday one). These always perform worse from an ‘opens’ perspective. Also, the Black Friday subject line probably got me sent to spam or promotions. Sigh.
• People open emails less often around the holidays.
• At the same, or similar time, as the holiday sends, we started testing a new ‘community’ send, where folks in the Hospitalogy membership platform ask questions, and other members answer. These are then leveraged for the newsletter. We’ve been testing this Q&A ‘Community Send’ over the past month and a half. And since it is a new format for Hospitalogy, I think it is possible that it is getting hit by e-mail filters, potentially causing some deliverability issues. My wife had hers go to spam once and she reads every Hospitalogy send end to end loyally!! (ok maybe not but she still opens them and for that I appreciate her). Beyond that, I do think that as this new send type gets off the ground there may be lower interest from you guys initially, and that’s okay. It’s worth experimenting because initiatives like these help free me up to create other kinds of content, or do deeper research on the things I’m interested in.
  • If you want to join the community to pose questions or answer them (and be featured in future Q&A sends!) please join the community here. It would be a huge help to me to continue to get this off the ground, and I am making a huge push for more intimacy and in-person membership initiatives in 2026!
• Finally, I think my content series around hospital Q3 earnings was tired by the end of November. So really, I felt content was strong all year but Hospitalogy opens were hit with some seasonality and pointed strategic content decisions rather than a ‘you’re falling off’ type of thing. Though I can only hope you guys would tell me if my content starts falling off!

On the social front, I could have done a better job of posting my content to LinkedIn and X. For one, I have struggled with X to be honest. I feel the ROI of the discussion and organic growth is not worth the effort given the amount of time you have to spend to continue to build a following. Everything has to be on-platform and it’s exhausting. And that’s before the fact that the algorithm is designed to optimize for engagement, therefore inciting violence in the comments section. I spent less time than ever on X in 2025 and it was primarily for mental health reasons. I also think the discourse for healthcare is largely an echo chamber on X.

LinkedIn, on the other hand, has grown into the platform of choice for my audience and niche. Even with posting less I saw great growth year over year and enjoy hopping on the platform to see interesting takes, updates on timely topics, and great visuals from a growing community of folks. LinkedIn will continue to be the platform of choice until the Hospitalogy community takes over that function for healthcare strategy and finance folks.

In 2026 I’ll look to, paradoxically, care a bit less about what I post on social media in order to spark better discourse, not optimize for algorithmic reach, and drive more organic growth.

I posted this back in September, but I did want to reflect on it again. It is a surreal feeling to create a brand from scratch, grow it for multiple years, and then find people so like-minded and enthusiastic about what you care about, that they choose to join you for an event, IN-PERSON.

This is obviously a very self-flattering statement and I don’t mention it to brag. Rather, my posture is more of one of disbelief. That people voluntarily chose to attend - and enjoyed! - a Hospitalogy event will be a career moment I remember forever. But we’re not stopping there. Creator-led, intimate events are the beginning, and I will be hosting another in-person summit in early November. You can reply to this email if you’re interested in being a part of that!

I want to thank Mr. Paul Keckley specifically for his help. He is one of the OG creators in the healthcare industry and his newsletter is one of the best. He has been nothing but kind to me and helped me set up the retreat for success in a big way. Paul, if you see this, I hope your surgery went well and that you’re recovering and able to get back out on the links soon.

I’d be remiss if I didn’t mention some of the challenges I faced in 2025, the first of which being some struggles with organic growth for the newsletter. This challenge was/is multi-pronged. As we put more resources into growing the community and the emergence of AI and content, we made a decision to go to a more ‘walled garden’ ecosystem approach, which has had some growing pains, but ultimately makes strategic sense for Hospitalogy and future B2B healthcare creator brands incubated from my community. It’s been a decision I’ve had a lot of heartburn about.

I also, as mentioned, dealt with certain personal struggles, bandwidth issues, burnout, and impostor syndrome in 2025. Is my content good enough? Am I still relevant? Can I continue to support my family? Am I working on the right things? Is there something better I could be doing with my time? Am I meeting the right leaders? Am I in the right rooms? Am I in one specific room in healthcare too often? I tend to think about these things more than the average person because I care. So. Much. About what I do and how I can deliver value for you guys.

Maybe this sounds a bit over the top but I do not want to stand still. I want to continue pushing my ability and stretching myself where I’m always a bit uncomfortable. I don’t want the reclining, plush massage chair. I want the exercise bike.

My content and quality comes first, but Hospitalogy IS a business too at the end of the day, and I would love to invite you guys to consider engaging even more in the Hospitalogy ecosystem to grow the community of thoughtful folks we’ve assembled. With that in mind, here’s how I would ask for you to support me:

• Open the newsletter, read it, and interact with relevant advertisements and sponsors. Reply to any interesting newsletters or if you have a differing opinion or see things in another light than I framed!
• Join the Hospitalogy community here!! If you are rejected by the auto-applicator let me know.
  • Engage in the community and help champion or attend in-person and virtual events.
• Connect me with companies who are interested in sponsoring Hospitalogy or want me to write about them for a sponsored deep dive.
• Reach out to me, introduce yourself, and of course let me know if you have any content ideas or ways to make Hospitalogy better. I’m on LinkedIn here or you can respond to this email!
• Let me know if you or your company is interested in hosting an executive dinner with Hospitalogy. As spaces grow more intimate, dinners will be a huge thing in the coming years for Workweek brands, I imagine.

Oh, and you can start listening to my podcast in Q1. I’m just throwing this in here as a teaser for those reading to the end for fun since it’s been in the works!

Introducing Claims Denied: A Hospitalogy Podcast. One man’s quest to learn everything there is to know about the business of healthcare. My goal is to explore different podcast formats including ‘All-in’, ‘Acquired’, hearing war stories from healthcare vets, and more. More info coming soon. Stay tuned.

My goal in 2026 is to get back to my bread and butter basics without overwhelming myself. Healthy limitations and leaning on support when needed.

With that in mind…I’ll always need your help, Hospitalogists.

• Who should I talk to in 2026?
• What underrated trend, startup, company, story, or policy deserves more attention that I should write about?
• What is your contrarian core belief about healthcare you’d never tell anyone outside of your inner circle?
• How can I help YOU succeed in 2026?

Let’s get after it fam. Healthcare is a big industry and we only have a short, short time here to make it better.

READS AND RESOURCES

NeuroFlow is helping to shorten wait times for patients' first behavioral health appointments. Time to treatment gaps were closed from 53.6 days to 34.2. Additionally, the study showed how appropriate intervention can help to avoid unnecessary ED visits.

On January 1, Medicare will begin AI-powered pre-treatment reviews for select health services in New Jersey, Ohio, Oklahoma, Texas, Arizona and Washington. As Axios reports, it’s “a major policy change that's aimed at rooting out unnecessary care — but alarming providers.” See why it matters.

Arbital Health provided a great breakdown of CMS’s new ACCESS Model and what it means for value-based care, clinical measurement, and technology-enabled chronic care. Read it here.

MISCELLANEOUS MADDENINGS

Have you guys ever tried smoked Cheez Itz? That's what we'll be making for the Texas-Michigan game in honor of the sponsor and if you haven't tried them, please do sometime. They are incredible.

By the way, it was damn near 80 in Dallas for Christmas and that is NOT ok. My 2 year old's new favorite toy is a drill. One day in, and the trigger mechanism is already sticking a little. They just don't make 'em like they used to anymore. Sigh.

Thanks for the read! Let me know what you thought by replying back to this email. Hook 'em.

— Blake  

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