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
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%.
Show the percentile table
| Percentile | Engagement rate |
|---|---|
| 10th percentile | 0.004% |
| 25th percentile | 0.024% |
| 50th percentile | 0.143% |
| 75th percentile | 0.679% |
| 90th percentile | 2.56% |
| 99th percentile | 82.4% |
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.
Show engagement by hour posted, utc as a table
| Hour (UTC) | Vs author median | Posts |
|---|---|---|
| 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 UTC | 0% | 116K |
| 22:00 UTC | -2% | 100K |
| 23:00 UTC | -1% | 90K |
Show engagement by day of week as a table
| Day | Vs author median | Posts |
|---|---|---|
| Sunday | +5% | 393K |
| Monday | +1% | 483K |
| Tuesday | -2% | 520K |
| Wednesday | -3% | 472K |
| Thursday | -2% | 430K |
| Friday | -3% | 447K |
| Saturday | +2% | 393K |
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.
| Format | This account | Catalog effect | 95% interval | Accounts behind it |
|---|---|---|---|---|
| Image or video | 33% of posts | +111% | +108% to +115% | 34K |
| Outbound link | 100% 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?
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
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.