I don't think it sucks at all. I enjoy reading it and do not agree with the person. The problem for me is that substack has suddenly become way too crowded with an embarrassment of riches-- too many options for people to follow. If I paid for every subscription for every person I enjoy reading on here I wouldn't pay my mortgage. I think it's interesting how Substack has evolved from a simple blogger site to what it is now with shows and videos. When originally, I appreciated it just to hear from people who wanted to share their thoughts. Now everyone wants to monetize everything, everywhere which is fine. Thats how it is now. Just helping you understand my perspective on why I don't pay.
I like the honesty in the articles. As a surgeon and EHR “maker” I would like to see more reviews of products. As a subscriber, I have not made my mind up if it is a good investment and will give it a full year.
Talk about software that doesn't always work - the poll wouldn't load on my app or browser :)
I don't think "gossipy and condensing" makes a good selection because I don't think it's gossipy at all in the sense like many others are gossipy. Condensing perhaps a bit, more like combative and ferocious. That's a part of it. That said, sometimes the combative tone overshadows the truly deep and real research inside. Personally I might have preferred it a bit more balanced. Maybe 60% ferocious now to 40% ferocious and 60% fundamental?
I definitely commend you on trying to improve (publicly). I think you're getting a lot of good comments here already. I'll try to address the request for feedback directly.
I might not have described it as "gossipy and condescending" though I suppose I understand where that person is coming from. I personally don't read your pieces for that part and generally skim past it. Some of the deeper investigative stuff is good. The analysis is good. I personally would prefer it a bit more condensed—because as others are saying here, the amount of stuff coming through Substack is just overwhelming these days. Perhaps that also fits with some of the critique?
... That all being said, people subscribe to Substacks for an individual's personality too. Unless you're seeing some kind of hemorrhaging of subscribers, it doesn't seem like it's a particularly crucial thing to "fix." I suppose you can try it and see, but no one subscribes to a Substack (typically) just for the raw data/info.
Thanks, James. I really appreciate your feedback, as always. I totally agree about the personality aspect. And no, I’m not hemorrhaging subscribers. Quite the opposite. 😉 And subscriber growth it’s not the only goal for me.
I enjoy reading your commentary and most times find interesting facts and perspectives. I will say that your AI tourist comments are not helpful as most ambient AI players mix multiple models in their solutions, not just one model. I’d suggest reducing your expressed level of disdain as it affects your credibility. Like you, AI players try and optimize outcomes with varying degrees of success. And the market will probably be driven by adoption levels by clinicians and not by marketing campaigns. Keep it up.
Sergei, I’m posting this to reinforce and illustrate the point. While I haven’t had anybody flat out write to me and tell me what they are unsubscribing, I see this pattern all the time. And I relate it to why someone is attracted to my writing in the first place. I have not created my Substack to be a paid subscription engine with a clear product and focus. It’s my outlet for my inspiration, passions and desire to share as a storyteller.
I’ll post a copy of the past 90 days subscriber graph in your DM Chat as I can’t post it here. You’ll see increases and then decreases. Decreases seem to align with the day I post an article/email. My suspicion is that if it doesn’t align with why they subscribed to me (say the Lung Transplant Stories) they reach a breaking point when they have had a slug of healthcare IT or AI articles.
So I have a choice…pick an audience and narrow the scope of my creative juices to feeding a revenue stream…OR…let freedom ring to write anything that inspires me in the moment.
Take my Lotus Agenda story. It fit in with my 38 years story to my Reasoning engine that I explained in another article, and I wanted to explain to people too young to even have any construct that such a thing as a Lotus Agenda existed.
It tied to the emotional story I had to tell and hopefully enlighten people that the drive to cognitive support from software systems has truly been there for decades and predates what is now recognized as AI. Perhaps only those with enough grey hair to have experienced the long run journey, can truly tell that story :-)
First of all, this 'Stack doesn't suck. Your readers appreciate the work and time you put in.
I've actually been collecting my thoughts on this. I am also a physician who studied AI. I looked for blogs, Stacks, X feeds that would help keep me updated as to what's going on in healthcare AI. There's so much in this area to cover, and I still think that we are in the early stages of what the field will become. Here are 5 types of blogs I've encountered:
1. Basic research into algorithms to help CV and CDS.
It would be too wonky for your blog to cover this, but if there were a true breakthrough, like Attention, then it would be great to educate your audience. Like promising breakthroughs in inference or vision transformers, with commentary.
2. Reports on how existing models are effective and advancing healthcare AI.
There are a few other blogs that do this. They are links that the blogger thinks are important to highlight.
3. AI healtcare startups – strengths and weaknesses; such as how they deceive or underperform.
This is your 'Stack, and I haven't found another quite like it.
4. Obstacles that impede AI adoption in healthcare.
This information I find in journal articles instead of blogs. Could be worth a post.
5. Perceptions of AI use in healthcare by stakeholders (patients, doctors).
There are a couple of blogs I follow written by physicians who cover this topic. Infrequently updated, though.
This person received no replies, possibly because no one had the expertise or experience to answer. Perhaps something like this could launch an article, or certainly generate discussion amongst your readership. Maybe you could have guest writers? Especially from physicians.
Again, there's SO MUCH one could cover in this field. Don't give up!
Wow! Such excellent points. I agree wholeheartedly, with some comments.
On number 3. Yes, I know that many subscribers are coming for health tech company investigations and honest reviews. I understand that no one else does it. That is because it comes with risk. What I, as an independent journalist, may perceive as truth, to the best of my knowledge, based on my research, the company may perceive as an attack, etc. While readers only see my articles, there is a lot of sh*t and threats happening in the background. But despite that, the work continues, because I know it is important to the industry, and no one is willing to do it.
In terms of a guest writer, I am a loner, but at the same time I would love to have guest writers. I do have a couple of ideas in the making on that.
Some people want more frequent posting. Right now I am doing about one article per week. We live in a world of TikToks and Instagrams where people post 100 times a day for a 7-second attention span. I do NOT want to move in that direction. It is one of those nuance things. Hypothetically, I could hire someone or set up an AI bot to "stamp" something out quicker. Hypothetically, I could have sponsors. I feel like those things would make this different. Not what people came to appreciate me for and respect me for, which is thorough analyses and investigations. As I said, I am a loner. I do research at my pace. But I understand that some folks want more.
Decisions. Decisions...
Thanks again. This is great feedback. And thanks for your support, of course. Let me know if you ever need anything, or if you'd like to chat, etc.
It doesn't suck--i just can't afford it right now. I have access to one of your articles (for free)--the one about ChatGPT and health records.
I am vibe coding an app that makes health records more interoperable without burdening doctors so I was just naturally curious about how ChatGPT interacts with health records. In general I'm of the opinion that healthcare is ripe for disruption but the path forward is still quite unclear at the moment.
In the meantime I peruse various doctors' Substacks / social media to get a feel for what's happening on the ground.
The more I read the more I believe the real unlock has to be legislative--and therefore not my expertise. Nevertheless, appreciate all the hard work 🫡
Thanks for the feedback and for the kind words. 🙏 I appreciate your curiosity and willingness to learn. By the way, I’m not asking for subscriptions. I genuinely want to know how I can be a better contributor to the industry and to society.
I would say to keep playing with tech and to keep writing down your observations and conclusions. Also, to be very clear in letting technologists know what’s the biggest unlock they could possibly work on at this moment in your opinion. And in the same way, letting politicians know what they could work on that would be the biggest unlock in your opinion
I’m not a paid subscriber so I can’t comment on some of this. But this is a crazy question: With 9000 subscribers aren’t you doing pretty well? And you probably know more than I do about this, but isn’t some level of churn normal?
I don't think it sucks at all. I enjoy reading it and do not agree with the person. The problem for me is that substack has suddenly become way too crowded with an embarrassment of riches-- too many options for people to follow. If I paid for every subscription for every person I enjoy reading on here I wouldn't pay my mortgage. I think it's interesting how Substack has evolved from a simple blogger site to what it is now with shows and videos. When originally, I appreciated it just to hear from people who wanted to share their thoughts. Now everyone wants to monetize everything, everywhere which is fine. Thats how it is now. Just helping you understand my perspective on why I don't pay.
I came to say the same thing. It’s just impossible to subscribe to everything you want to!
I understand 😊
I like the honesty in the articles. As a surgeon and EHR “maker” I would like to see more reviews of products. As a subscriber, I have not made my mind up if it is a good investment and will give it a full year.
It always goes back to know who your audience is.
Yes. Thank you, Russell. 🙏
🙏
Talk about software that doesn't always work - the poll wouldn't load on my app or browser :)
I don't think "gossipy and condensing" makes a good selection because I don't think it's gossipy at all in the sense like many others are gossipy. Condensing perhaps a bit, more like combative and ferocious. That's a part of it. That said, sometimes the combative tone overshadows the truly deep and real research inside. Personally I might have preferred it a bit more balanced. Maybe 60% ferocious now to 40% ferocious and 60% fundamental?
Makes sense. Thanks so much for the feedback and for your support, Sergei. 🙏
I definitely commend you on trying to improve (publicly). I think you're getting a lot of good comments here already. I'll try to address the request for feedback directly.
I might not have described it as "gossipy and condescending" though I suppose I understand where that person is coming from. I personally don't read your pieces for that part and generally skim past it. Some of the deeper investigative stuff is good. The analysis is good. I personally would prefer it a bit more condensed—because as others are saying here, the amount of stuff coming through Substack is just overwhelming these days. Perhaps that also fits with some of the critique?
... That all being said, people subscribe to Substacks for an individual's personality too. Unless you're seeing some kind of hemorrhaging of subscribers, it doesn't seem like it's a particularly crucial thing to "fix." I suppose you can try it and see, but no one subscribes to a Substack (typically) just for the raw data/info.
Thanks, James. I really appreciate your feedback, as always. I totally agree about the personality aspect. And no, I’m not hemorrhaging subscribers. Quite the opposite. 😉 And subscriber growth it’s not the only goal for me.
I enjoy reading your commentary and most times find interesting facts and perspectives. I will say that your AI tourist comments are not helpful as most ambient AI players mix multiple models in their solutions, not just one model. I’d suggest reducing your expressed level of disdain as it affects your credibility. Like you, AI players try and optimize outcomes with varying degrees of success. And the market will probably be driven by adoption levels by clinicians and not by marketing campaigns. Keep it up.
Thank you, Hans. This helps. 🙏
Sergei, I’m posting this to reinforce and illustrate the point. While I haven’t had anybody flat out write to me and tell me what they are unsubscribing, I see this pattern all the time. And I relate it to why someone is attracted to my writing in the first place. I have not created my Substack to be a paid subscription engine with a clear product and focus. It’s my outlet for my inspiration, passions and desire to share as a storyteller.
I’ll post a copy of the past 90 days subscriber graph in your DM Chat as I can’t post it here. You’ll see increases and then decreases. Decreases seem to align with the day I post an article/email. My suspicion is that if it doesn’t align with why they subscribed to me (say the Lung Transplant Stories) they reach a breaking point when they have had a slug of healthcare IT or AI articles.
So I have a choice…pick an audience and narrow the scope of my creative juices to feeding a revenue stream…OR…let freedom ring to write anything that inspires me in the moment.
Take my Lotus Agenda story. It fit in with my 38 years story to my Reasoning engine that I explained in another article, and I wanted to explain to people too young to even have any construct that such a thing as a Lotus Agenda existed.
It tied to the emotional story I had to tell and hopefully enlighten people that the drive to cognitive support from software systems has truly been there for decades and predates what is now recognized as AI. Perhaps only those with enough grey hair to have experienced the long run journey, can truly tell that story :-)
Thanks for sharing, Stuart. You’re doing the right thing. Please keep it up.
First of all, this 'Stack doesn't suck. Your readers appreciate the work and time you put in.
I've actually been collecting my thoughts on this. I am also a physician who studied AI. I looked for blogs, Stacks, X feeds that would help keep me updated as to what's going on in healthcare AI. There's so much in this area to cover, and I still think that we are in the early stages of what the field will become. Here are 5 types of blogs I've encountered:
1. Basic research into algorithms to help CV and CDS.
It would be too wonky for your blog to cover this, but if there were a true breakthrough, like Attention, then it would be great to educate your audience. Like promising breakthroughs in inference or vision transformers, with commentary.
2. Reports on how existing models are effective and advancing healthcare AI.
There are a few other blogs that do this. They are links that the blogger thinks are important to highlight.
3. AI healtcare startups – strengths and weaknesses; such as how they deceive or underperform.
This is your 'Stack, and I haven't found another quite like it.
4. Obstacles that impede AI adoption in healthcare.
This information I find in journal articles instead of blogs. Could be worth a post.
5. Perceptions of AI use in healthcare by stakeholders (patients, doctors).
There are a couple of blogs I follow written by physicians who cover this topic. Infrequently updated, though.
All have their place.
Recently I saw this posted in HackerNews: https://news.ycombinator.com/item?id=46780038
This person received no replies, possibly because no one had the expertise or experience to answer. Perhaps something like this could launch an article, or certainly generate discussion amongst your readership. Maybe you could have guest writers? Especially from physicians.
Again, there's SO MUCH one could cover in this field. Don't give up!
Wow! Such excellent points. I agree wholeheartedly, with some comments.
On number 3. Yes, I know that many subscribers are coming for health tech company investigations and honest reviews. I understand that no one else does it. That is because it comes with risk. What I, as an independent journalist, may perceive as truth, to the best of my knowledge, based on my research, the company may perceive as an attack, etc. While readers only see my articles, there is a lot of sh*t and threats happening in the background. But despite that, the work continues, because I know it is important to the industry, and no one is willing to do it.
On number 4. I actually did a pretty extensive article on obstacles that impede AI adoption in healthcare, based on my experience and based on my published paper, "Advancing AI in Healthcare". https://sergeiai.substack.com/p/painful-ai-adoption-in-medicine-10
In terms of a guest writer, I am a loner, but at the same time I would love to have guest writers. I do have a couple of ideas in the making on that.
Some people want more frequent posting. Right now I am doing about one article per week. We live in a world of TikToks and Instagrams where people post 100 times a day for a 7-second attention span. I do NOT want to move in that direction. It is one of those nuance things. Hypothetically, I could hire someone or set up an AI bot to "stamp" something out quicker. Hypothetically, I could have sponsors. I feel like those things would make this different. Not what people came to appreciate me for and respect me for, which is thorough analyses and investigations. As I said, I am a loner. I do research at my pace. But I understand that some folks want more.
Decisions. Decisions...
Thanks again. This is great feedback. And thanks for your support, of course. Let me know if you ever need anything, or if you'd like to chat, etc.
It doesn't suck--i just can't afford it right now. I have access to one of your articles (for free)--the one about ChatGPT and health records.
I am vibe coding an app that makes health records more interoperable without burdening doctors so I was just naturally curious about how ChatGPT interacts with health records. In general I'm of the opinion that healthcare is ripe for disruption but the path forward is still quite unclear at the moment.
In the meantime I peruse various doctors' Substacks / social media to get a feel for what's happening on the ground.
The more I read the more I believe the real unlock has to be legislative--and therefore not my expertise. Nevertheless, appreciate all the hard work 🫡
Thanks for the feedback and for the kind words. 🙏 I appreciate your curiosity and willingness to learn. By the way, I’m not asking for subscriptions. I genuinely want to know how I can be a better contributor to the industry and to society.
I would say to keep playing with tech and to keep writing down your observations and conclusions. Also, to be very clear in letting technologists know what’s the biggest unlock they could possibly work on at this moment in your opinion. And in the same way, letting politicians know what they could work on that would be the biggest unlock in your opinion
I’m not a paid subscriber so I can’t comment on some of this. But this is a crazy question: With 9000 subscribers aren’t you doing pretty well? And you probably know more than I do about this, but isn’t some level of churn normal?
Thank you, Bryan! Of course, churn is normal. I’m just trying to be better. Or, as some say, "be best." 😉