LinkedIn just admitted something that should make every healthcare communicator pay attention.

In a recent analysis, LinkedIn's B2B growth team revealed that AI-powered search – what we've been calling GEO – cut their organic traffic by up to 60% on certain topics. Rankings stayed stable. But click-through rates cratered. People were getting answers without ever visiting the site.

If it can happen to LinkedIn, it can happen to anyone.

This is the new reality: the platforms we've spent years building on are increasingly intermediated by AI. And the reach we thought we'd earned? It was never really ours. Though I do miss the olden days of being satisfied with seeing likes on a tweet go up.

In this issue:

Let's starts with what's actually happening on social.

Facebook page posts now reach about 1-2% of your followers. Instagram? Around 9%… and that's being generous with data from 2024. The platforms that built their empires on connecting brands to audiences have quietly rebuilt those empires on making brands pay for the privilege.

Healthcare feels this squeeze harder than most. Our content already operates with one hand tied behind its back: fair balance requirements, MLR review cycles, platform ad restrictions that treat legitimate health information like snake oil. When organic reach cratered, we didn't just lose impressions. We lost the ability to actually show up in a meaningful way. It’s important to think about how to play to the algorithm and “dark social” these days – more on both in upcoming issues.

While you wait for those… as organic social reach continues to collapse, email is thriving.

Healthcare email campaigns are seeing open rates above 35%, the highest of any industry. Click-through rates hit 2.7% (50-100x higher than social). Unsubscribe rates sit at just 0.07%. And HCP preference for email as an engagement channel climbed globally to 15% in 2025, a new peak.

The renaissance of email shows that what is old is new again.

Healthcare has always been a reputation-first industry. We've measured reputation over awareness for decades, long before "brand authenticity" became a LinkedIn buzzword. (Sorry to keep ragging on LinkedIn but it’s true.)

Consider the dynamics:

Reputation requires consistency. Although algorithms are increasingly important now more than ever, you can't build a reputation if your audience only sees you when an algorithm allows it. Newsletters let you show up on the same day, at the same time, with the same level of quality. That reliability compounds into recognition.

AI search is reshaping discovery. As ChatGPT, Perplexity, and Google AI Overviews answer more health queries directly, traditional SEO is losing ground. But newsletters build audiences that don't depend on search at all. Your subscribers already found you. Now you just have to keep earning their attention.

HCPs are drowning in noise. Pharma companies sent 8x more emails to physicians in 2020 than 2019 and the volume hasn't slowed years later. On the other end, 70% of HCPs say pharma reps don't understand their needs. A well-crafted newsletter driven by communications and brand departments that delivers complementary value? That's differentiation. That's reputation.

I just finally purchased my own property so maybe I’m homeowner-pilled but the uncomfortable truth about digital and social media in 2026 is that you don't own your followers. You rent them. And the rent is increasing every year.

Every algorithm update, every platform policy change, every TikTok ban scare… these are reminders that building on someone else's land is inherently precarious. Your follower count is a vanity metric if the platform decides your content doesn't deserve distribution. Remember when we all spent YEARS building a community on Twitter? Oops.

Email flips this dynamic. Your subscriber list is yours. You can export it, migrate it, build on it (as long as you do it compliantly). If your platform disappeared tomorrow, your audience would still exist. Try saying that about your Clubhouse followers.

The newsletter boom reflects this reality. Substack hit 5 million paid subscriptions in early 2025 — up 67% year-over-year. Beehiiv, its primary competitor, grew to 140,000 newsletters, with publishers sending 28 billion emails to 255 million unique readers.

But the bigger story isn't platforms. It's who's using them.

A new generation of health influencers – the next evolution of who has influence from media to creators – are building massive audiences through newsletters. In the process, they are reshaping where healthcare professionals and patients find news, analysis, and perspective. These aren't wellness influencers hawking supplements. They're credentialed experts, veteran journalists, and industry insiders who've discovered that the inbox is the new front page.

Eric Topol, cardiologist, Scripps Research director, one of the top 10 most-cited researchers in medicine, and Editor-in-Chief of Medscape has built Ground Truths to over 190,000 Substack subscribers. Topol publishes deep dives on AI in medicine, genomics breakthroughs, and public health policy that shape how HCPs and patients think about the future of care. His COVID tweets were viewed over 300 million times. Now that attention lives in email.

Christina Farr, former CNBC health tech reporter, venture investor, and co-chair of Fortune Brainstorm Health runs Second Opinion, which reaches 25,000+ health tech executives, operators, and investors weekly. She went from reporting on the industry to investing in it to becoming a must-read for anyone tracking digital health trends.

Bob Wachter, Chair of Medicine at UCSF, author of the New York Times bestseller The Digital Doctor, and the physician who coined the term "hospitalist" built a following of 275,000 on X during COVID by synthesizing complex data into accessible, actionable insights. His audience stuck around because he showed up consistently with substance.

The through-line? People are finding healthcare news through email newsletters that these new health influencers are driving. The gatekeepers have changed. The people shaping opinion in your space increasingly live in the inbox, not the feed. Understanding who they are, what they're saying, and how they're building audience is now table stakes for anyone working in healthcare communications.

And to turn that from theory into practice…

1. Start with a clear audience and cadence. Don't try to be everything to everyone. A weekly digest for hem-oncs is more valuable than a monthly blast to "healthcare stakeholders." Pick your lane. Commit to a schedule you can sustain.

2. Lead with value, not vanity. The best healthcare newsletters aren't repurposed press releases. They curate what happened this week that your audience needs to know and tell them what it means. Save the self-promotion for the last 10%.

3. Sound like a human, not a compliance department. Yes, even in pharma. The companies winning in the inbox have voice, point of view, and personality. MLR review doesn't mean you have to be watered down… just compliant!

4. Build the habit before you need it. The time to build an owned audience is before the next platform crisis, before the next algorithm change, before you're scrambling. Start now, even if it's small. The biggest thing is to be consistent.

5. Measure what matters. Open rates and click-through rates are table stakes. Track reply rates, forward rates, and downstream engagement like webinar signups or content downloads. Email should connect to impact and outcomes, not just impressions.

6. Treat email as a reputation asset, not a campaign channel. Campaigns end. Reputation compounds. Think of your newsletter as a long-term relationship, not a quarterly tactic.

The social platform era trained us to chase reach. The newsletter era rewards us for earning reputation.

For healthcare communicators, this is a moment to reclaim the direct relationship with audiences that social platforms intermediated away. It's a chance to build something durable in a landscape that rewards consistency, expertise, and genuine value.

The inbox isn't sexy. But it works.

And in 2026, "works" is exactly what healthcare brands need.

Final quick hits on what’s trending for the curious

1. Pharma social spend officially tops linear TV. For the first time ever, pharma marketers are spending more on social media than linear TV — with social climbing 18.1% to nearly $6 billion while linear dropped 11% to $5.56 billion. By 2027, linear TV will account for just 12% of pharma ad spend, down from over 30% in 2021. (eMarketer US Healthcare and Pharma Ad Spending 2025, via Campaign US)

2. TikTok US deal closes — but the app may look different. TikTok officially signed a divestment deal in January, with Oracle, Silver Lake, and MGX taking control of 45% of US operations. Reports suggest the current app may be discontinued and users transitioned to a new platform. Healthcare brands that built TikTok strategies: stay nimble. (TechCrunch)

3. FDA DTC crackdown extending to social. The agency issued over 100 letters last September, calling deceptive advertising "the current norm" on social platforms. Expect tougher enforcement on influencer marketing and social ads in 2026. (Source: Pharmacy Times)

4. Reddit Q4: 121M daily users, $2.2B revenue, AI-powered growth. Reddit added another 5 million daily actives (now 121.4M), with full-year revenue up 69% to $2.2 billion. The platform credits AI-powered ad targeting and being one of the most-cited sources by AI chatbots. For healthcare marketers watching GEO, Reddit's positioning as an AI training ground is worth noting. (Source: Social Media Today)

5. Social engagement is going passive. Socialinsider analyzed 70M posts and found average comments per post fell 24% on TikTok and 16% on Instagram YoY. TikTok still dominates engagement at 3.7%, while Instagram sits at 0.48%. The takeaway: audiences are watching, but they're talking less. And that might be okay (more in a future newsletter!) (Source: Socialinsider)

What’s your take on newsletters?

✌️ j