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Bob Wachter engagement report

@Bob_Wachter - 239K followers on X

Measured over 6 original posts from a 30-day window, last computed on September 28, 2026.

Engagement

Per follower
0.017%
of 239K followers
Per impression
0.355%
12K views on a typical post
Reach
4.88%
of its followers see a post
Typical post
42
interactions (median)
Saved
0.184%
22 bookmarks on a typical post
Posting rate
0.3/day
active 30% of days
Peak time
19:00 UTC
Tuesday

Early reading. We have captured 6 original posts for this account, below the 8 we require before treating a median as settled. The numbers above describe what we have seen so far, not a finished profile of the account.

A typical post picks up 42 interactions against 239K followers, an engagement rate of 0.017%. Posts are seen about 12K times each, and 0.355% of those impressions turn into an interaction. That is about 4.88% of the follower count, which is the gap between an audience on paper and an audience in a timeline. Posting runs at about 0.3 posts a day over the last 30 days, though only 30% of days saw any activity at all. Most posts go out around 19:00 UTC, and Tuesday is the busiest day of the week. Of the 6 posts sampled, 33% carry an image or video and 100% link out. The account's strongest tracked post pulled 16K interactions, about 379x its own typical post. Only 6 original posts have been captured so far, fewer than the 8 posts we want behind a median before treating it as settled. Read the figures above as an early measurement of this account, not as a finished profile of it.

Measured over 6 original posts from a 30-day window, last computed on September 28, 2026.

Where this sits in the catalog

At 0.017%, Bob Wachter sits above the 10th percentile of the 205,582 accounts in this comparison. That places it in the bottom 25% band, which runs below 0.024%.

p100.004%
p250.024%
p50 (median)0.143%
p750.679%
p902.56%
p9982.4%
Engagement rate as a share of followers, across the 205,582 accounts we have scanned enough to measure. The axis is logarithmic, because the top and bottom of this population are about 22,893 times apart and a linear axis would flatten everything below the median into a single point.
Show the percentile table
Engagement rate percentiles
PercentileEngagement rate
10th percentile0.004%
25th percentile0.024%
50th percentile0.143%
75th percentile0.679%
90th percentile2.56%
99th percentile82.4%

This ruler is the whole measured catalog, not a size-matched group: it shows where the raw rate falls across every account we can measure, all of which are large. For a like-for-like comparison, read the size-band percentile above instead. See how the bands are built

Posting timing

This account posts most often around 19:00 UTC, and Tuesday is its busiest day of the week. The bars below are the catalog-wide pattern, with this account's own busiest slot marked. They do not show how this account performs at each hour: we keep one aggregate per account, not one per hour, so that measurement does not exist in our data.

Engagement by hour posted, UTCTwenty-four bars, one per UTC hour. Each bar shows how posts published in that hour compare with their own authors' median engagement. Bars above the centre line ran higher than the median, bars below ran lower. A marker flags Busiest hour: 19:00 UTC.
0003060912151821
Above the authors' own mediansBelowScale: plus or minus 111%Busiest hour: 19:00 UTC
Show engagement by hour posted, utc as a table
Engagement by hour posted, UTC
Hour (UTC)Vs author medianPosts
00:00 UTC-1%89K
01:00 UTC-2%90K
02:00 UTC-3%88K
03:00 UTC-4%94K
04:00 UTC-5%76K
05:00 UTC-4%75K
06:00 UTC-5%86K
07:00 UTC-5%93K
08:00 UTC-4%108K
09:00 UTC-4%124K
10:00 UTC-3%129K
11:00 UTC-3%141K
12:00 UTC-3%154K
13:00 UTC-3%167K
14:00 UTC-4%173K
15:00 UTC-2%176K
16:00 UTC-3%171K
17:00 UTC-3%159K
18:00 UTC-2%149K
19:00 UTC-2%141K
20:00 UTC-1%131K
21:00 UTC0%116K
22:00 UTC-2%100K
23:00 UTC-1%90K
Engagement by day of weekSeven bars, one per weekday, Sunday first. Each bar shows how posts published on that day compare with their own authors' median engagement. Bars above the centre line ran higher than the median, bars below ran lower. A marker flags Busiest day: Tuesday.
SunMonTueWedThuFriSat
Above the authors' own mediansBelowScale: plus or minus 111%Busiest day: Tuesday
Show engagement by day of week as a table
Engagement by day of week
DayVs author medianPosts
Sunday+5%393K
Monday+1%483K
Tuesday-2%520K
Wednesday-3%472K
Thursday-2%430K
Friday-3%447K
Saturday+2%393K
See what moves engagement across the whole catalogWhat counts as a good engagement rate at this size

Formats this account uses

Its own posting mix on the left, and what each of those formats does across every account we track on the right. Only formats where the effect clears our publish test appear here, so an empty row is a format we could not measure rather than one that does nothing.

This account's posting mix compared with catalog-wide effects
FormatThis accountCatalog effect95% intervalAccounts behind it
Image or video33% of posts+111%+108% to +115%34K
Outbound link100% of posts-41%-42% to -40%32K
Typical length-no effect-2% to -1%42K
  • 33% of this account's sampled posts carry an image or video. Across the catalog, posts with an image or video run 111% above the same accounts' other posts.
  • 100% of its posts carry a link off X. Across the catalog, posts with an outbound link run 41% below the same accounts' other posts, so a large share of this account's output sits in the weakest bucket we measure.
  • Its average post runs 269 characters, which falls in the 180 - 280 characters band. Across the catalog, posts of 180 to 280 characters match the same accounts' other posts almost exactly.

These are catalog-wide differences applied to this account's own posting mix, not a measurement of how each format performs for this account specifically. We keep one median per account, not one per format per account, so the second thing is not something this data can tell you.

Best tweets

  • Mar 15, 2026379x their median

    I've used em-dashes my whole life — they add rhythm and grace to writing. But now they're an AI tell. Can we get a grandfather clause for those of us who were fluent in em-dashes before ChatGPT launched in November 2022?

    14K1.2K802309746K viewsView on X
  • May 5, 202612x their median

    Missing from the “will AI replace doctors?” debate is that doctors (and lawyers and psychologists and bankers) all vote & form the donor base to political parties & have deep community ties. The government will largely determine what AI is allowed to do, no matter what it can do

    37830791550K viewsView on X
  • Aug 15, 202612x their median

    30 years ago today, L Goldman & I coined the term "hospitalist" in @NEJM. I suspected the field would matter; I didn't guess it would be the fastest-growing specialty in US history. To the docs who turned an idea into something real–& now essential–thanks! https://t.co/c5G1NLbSLN

    41155231181K viewsView on X
  • Apr 10, 20265.2x their median

    One of most joyful events each year @UCSF medicine residency: Music night at my house, with performances by our crazy-talented group of residents. Highlight video below. Thanks to @audreyamadean & @Pooja_L1 for organizing. I'm on piano, my son singing, at the end of the video. https://t.co/LBBcktAW2B

    198145328K viewsView on X
  • Apr 17, 20264.6x their median

    My new Substack: Epic, the leading EHR vendor, has released >100 AI tools. Choosing them over third-party tools has become the safe choice for many health systems. I explore why, and the bigger questions: can – and should – something be done about it. https://t.co/9Eg2IGYwUE https://t.co/sXtrXUKeHB

    14432116119K viewsView on X
  • Apr 14, 20264.0x their median

    In today's @washingtonpost, a terrific piece on the risk of AI-based deskilling in medicine, along with some sensible recommendations. I'm quoted, along with @CarlaPughMDPhD. Authors: Rebecca Adams/Laura Landry. https://t.co/eDlBmNvyXV

    122368321K viewsView on X
  • Mar 9, 20262.4x their median

    My latest Substack: Why predictions that radiologists will be replaced by AI (including, famously, by genAI founding father and Nobel laureate Geoffrey Hinton) have been wildly off base, and what that teaches us about job replacement for doctors. https://t.co/hz2gKz6Ewh https://t.co/waJUY22Qk1

    1262410327K viewsView on X
  • Sep 15, 20263.2x their median

    We're in the midst of a Category 5 AI backlash that will likely slow the progress of frontier models. Fine – the frontier can wait. But given healthcare's problems with quality, safety, access, & cost, thoughtful adoption there can't. My latest Substack: https://t.co/MaFsolDXPm https://t.co/5n0hWVZGCH

    932411612K viewsView on X
  • Jun 16, 20263.1x their median

    Thrilled that my friend and colleague Andy Josephson will be the next dean of @UCSF School of Medicine. Brilliant clinician, gifted teacher, and one of the warmest people I know – a perfect fit for the moment. Can't wait to work with him in this role. https://t.co/szEKzkg9XA

    112154015K viewsView on X
  • Sep 1, 20262.9x their median

    Grateful to The HealthTech Signal for placing me at #2 on its list of 100 health tech influencers. There are many worse fates than trailing @EricTopol, and the list includes many of the folks I follow for health tech/AI insights. https://t.co/m4EUNckpsH https://t.co/8YsxgfkO6c

    10487112K viewsView on X

Ranked by total interactions across everything we have tracked for this account, which is a longer history than the 30-day window the rates above use. The multiple compares each post to this account's own median.

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Reading these numbers

A typical post picks up 42 interactions against 239K followers, an engagement rate of 0.017%. Posts are seen about 12K times each, and 0.355% of those impressions turn into an interaction. That is about 4.88% of the follower count, which is the gap between an audience on paper and an audience in a timeline. Posting runs at about 0.3 posts a day over the last 30 days, though only 30% of days saw any activity at all. Most posts go out around 19:00 UTC, and Tuesday is the busiest day of the week. Of the 6 posts sampled, 33% carry an image or video and 100% link out. The account's strongest tracked post pulled 16K interactions, about 379x its own typical post. Only 6 original posts have been captured so far, fewer than the 8 posts we want behind a median before treating it as settled. Read the figures above as an early measurement of this account, not as a finished profile of it.

What is Bob Wachter's engagement rate on X?
Bob Wachter (@Bob_Wachter) has an engagement rate of 0.017%, based on the median interactions across 6 original posts from the last 30 days against 239,112 followers. Replies, reposts and quote-posts of other people are excluded from that sample.
Is that a good engagement rate?
At 0.017%, Bob Wachter sits above the 10th percentile of the 205,582 accounts in this comparison. Those comparison accounts are all large ones, because our scanning cadence is weighted towards big accounts, so this is a ranking among peers of similar scale rather than a ranking across X.
Does @Bob_Wachter have real engagement?
There is not yet enough sample to rank this account against others of its size.
When does @Bob_Wachter post?
Most posts go out around 19:00 UTC, and Tuesday is its busiest day, at roughly 0.3 posts per day across the measured window.

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