Field notes from the operator’s chair. Sourced numbers. Scored predictions. Every piece in text and audio.
By Steven F. Gonzalez
President and CEO, HealthView · Founder, CultureAI
Twenty years across healthcare and health tech. Works backwards from the hospice bed.
New episode ·
Nº 23 · Field noteOutside the Training Data
In 1961 nine in ten doctors surveyed said they kept a cancer diagnosis from the patient. In 1977, 97 percent said they told. Hospice began the same way, outside the consensus, which is the one place a model trained on medicine can’t look.
23 field notes from Steven · 200 min of audio
Start here
The manifesto, Nº 06
Nobody with a rocket company is coming to fix post-acute care. So we are taking it on ourselves. California first, because it is the hardest state. A method that survives here survives anywhere.
- Kindness
- Unity
- Humility
- Patience
Latest
Nº 22 · Forbes Business Council
Culture Works When Nobody Has to Step Away From Their Work
7 min listen · 5 min read
Nº 21 · Field note
The Invoice
18 min listen · 12 min read
Nº 20 · Field note
The Fourth Lesson From Surfing
20 min listen · 14 min read
Nº 19 · Field note
The Permission Machine
17 min listen · 13 min read
Nº 18 · Field note
The Rocket
17 min listen · 11 min read
Nº 17 · Field note
Working Backwards
22 min listen · 15 min read
Nº 16 · Field note
Why I Open-Sourced the Way I Run My Companies
15 min listen · 12 min read
Nº 15 · Field note
The Yield
13 min listen · 10 min read
Published in Inc. and Forbes
Steven’s columns for Inc. Magazine and the Forbes Business Council, each with its own narration.
Nº 12 · Forbes Business Council
Culture Isn't A Speech, It's A Habit You Prove Under Pressure
5 min listen · 4 min read
Nº 11 · Forbes Business Council
How Scale Can Break Everything (And How To Prevent It)
5 min listen · 3 min read
Nº 10 · Inc. Magazine
Why Your Best Managers Are Your Most Valuable Data Source
7 min listen · 4 min read
Nº 09 · Forbes Business Council
The Metric Of A Great Team: Recovery Speed
6 min listen · 4 min read
Nº 08 · Inc. Magazine
Pay Attention to the Quiet Ones
4 min listen · 3 min read
Nº 07 · Forbes Business Council
Financial Disruption: 20 Early Warning Signals To Watch For
4 min listen · 3 min read
Nº 05 · Inc. Magazine
The Capacity Illusion: Why High Performers Burn Out
2 min listen · 2 min read
Nº 04 · Inc. Magazine
In a High-Tech World, Presence Matters More Than Polish
2 min listen · 2 min read
Nº 03 · Inc. Magazine
Certainty Is Overrated. Presence Is Underrated.
2 min listen · 2 min read
Nº 02 · Inc. Magazine
The Most Undervalued Leadership Skill: Listening
2 min listen · 2 min read
Nº 01 · Inc. Magazine
3 Leadership Lessons From Surfing
2 min listen · 2 min read
On the Ledger
10 predictions on the record, each with a date, scored in public. These resolve first.
OpenResolves Nov 30, 2027
Home care aide turnover in the Home Care Salary and Benefits Report that HCS publishes in late 2027 is still above 30 percent. The industry keeps paying the invoice.
Confidence 70%
OpenResolves Sep 30, 2028
HealthView appears on at least one of the two national audited lists again, the Inc 5000 or Fortune’s Best Workplaces rankings, while the playbook keeps publishing.
Confidence 80%
OpenResolves Dec 31, 2028
By the end of 2028, at least 15 states have laws requiring that patients be told when AI is used in their care. Telling wins again.
Confidence 60%
Every field note
Nº 23 · Field note
Outside the Training Data
In 1961 nine in ten doctors surveyed said they kept a cancer diagnosis from the patient. In 1977, 97 percent said they told. Hospice began the same way, outside the consensus, which is the one place a model trained on medicine can’t look.
16 min listen · 10 min readOn the Ledger
Nº 22 · Forbes Business Council
Culture Works When Nobody Has to Step Away From Their Work
A goal-tracking dashboard that stayed green while nobody logged in, the survey score that is still a scoreboard, and the department with one employee whose job is to give hours back. Why a system that lives outside the work is already dying, and the three questions to ask before you launch anything.
7 min listen · 5 min read
Nº 21 · Field note
The Invoice
Culture has a price, and it comes due as turnover. One lost nurse, itemized line by line, and the ratio it adds up to: what it costs to lose a clinician against what it would have cost to keep her.
18 min listen · 12 min readOn the Ledger
Nº 20 · Field note
The Fourth Lesson From Surfing
I published three leadership lessons from surfing in Inc. Then I read the man who wrote surfing into his employee handbook, and met the lesson my article was missing, in the year Patagonia nearly died of growth.
20 min listen · 14 min readOn the Ledger
Nº 19 · Field note
The Permission Machine
Everyone in healthcare says the words prior auth. Almost nobody can tell you what actually happens between a doctor’s order and the thing that never arrives. So I traced the machine, all the way back to 1965.
17 min listen · 13 min readOn the Ledger
Nº 18 · Field note
The Rocket
My company's logo is a rocket. My battle cry says nobody with a rocket company is coming to fix post-acute care. I paid for one a year before I wrote the other, and never put them together until one late night at my desk. This is a field note about what a company can compress into a flag, with the receipts that make it more than a story.
17 min listen · 11 min readOn the Ledger
Nº 17 · Field note
Working Backwards
I run a hospice company, which means my work keeps me close to the end of life. It is the best education I have ever received, it has made me better at nearly everything, and it is the reason I think about healthcare backwards: starting from the last room and designing toward it.
22 min listen · 15 min readOn the Ledger
Nº 16 · Field note
Why I Open-Sourced the Way I Run My Companies
Culture is a clinical outcome multiplier, which makes hoarding culture practice a patient outcomes decision. Software settled the rest of the argument decades ago. So I open-sourced how I run my companies.
15 min listen · 12 min read
Nº 15 · Field note
The Yield
I spent a year learning how Elon Musk runs a factory. Then I asked what healthcare manufactures, and the answer rearranged how I run my company.
13 min listen · 10 min readOn the Ledger
Nº 14 · Field note
294 Views
Seventeen years on YouTube. 294 views. The whole SpartX story, told in receipts, and the timing lesson it left behind.
5 min listen · 4 min read
Nº 13 · Field note
Three Septembers
The internet opened in 1993. Facebook opened in 2006. Healthcare AI opened this month. What the gated phase teaches, with the receipts and a dated prediction.
12 min listen · 10 min readOn the Ledger
Nº 12 · Forbes Business Council
Culture Isn't A Speech, It's A Habit You Prove Under Pressure
Forbes Business Council. The organizations that build real, lasting culture are not the ones with the best-written values statement. They are the ones where someone can point to a specific Tuesday and say: that is the day I knew it was true.
5 min listen · 4 min read
Nº 11 · Forbes Business Council
How Scale Can Break Everything (And How To Prevent It)
Forbes Business Council. Culture does not scale on its own. It either gets built intentionally or gets replaced quietly by whatever behaviors growth introduces.
5 min listen · 3 min read
Nº 10 · Inc. Magazine
Why Your Best Managers Are Your Most Valuable Data Source
Inc. Magazine. Culture influences employee experience, but manager behavior is what drives retention or turnover.
7 min listen · 4 min read
Nº 09 · Forbes Business Council
The Metric Of A Great Team: Recovery Speed
Forbes Business Council. Why the best teams are measured not by the setback, but by the speed of what comes next.
6 min listen · 4 min read
Nº 08 · Inc. Magazine
Pay Attention to the Quiet Ones
The best leaders right now are not the loudest ones. They are the ones watching, testing, and asking questions most people are not ready to answer yet. This piece is about why that quiet signals something important about the leadership that actually compounds in disruption.
4 min listen · 3 min read
Nº 07 · Forbes Business Council
Financial Disruption: 20 Early Warning Signals To Watch For
A Forbes expert panel on the earliest warnings of financial disruption. Steven's signal: listen to the frontline conversations before the spreadsheets.
4 min listen · 3 min read
Nº 06 · The manifesto
Culture Is Not a Values Poster
The founding argument of The Culture Lab: healthcare has mistaken the cosplay of culture for the real thing for too long.
18 min listen · 14 min read
Nº 05 · Inc. Magazine
The Capacity Illusion: Why High Performers Burn Out
Your highest performers are not leaving because they lack grit. They are leaving because you built a system that rewards their overextension until they break. A reframe of burnout as a design failure, not a people problem.
2 min listen · 2 min read
Nº 04 · Inc. Magazine
In a High-Tech World, Presence Matters More Than Polish
AI can write the memo. It cannot replace the meeting. As communication becomes more automated, the leaders who win will be the ones who show up with real curiosity and genuine attention.
2 min listen · 2 min read
Nº 03 · Inc. Magazine
Certainty Is Overrated. Presence Is Underrated.
In volatile environments, leaders instinctively reach for certainty as a stabilizing force. This piece argues that is the wrong instinct. What teams need most is not certainty - it is consistent, visible, human leadership.
2 min listen · 2 min read
Nº 02 · Inc. Magazine
The Most Undervalued Leadership Skill: Listening
Most leaders are hired to have answers. The best ones are distinguished by their questions. The case for listening as a structural leadership advantage, not a soft skill.
2 min listen · 2 min read
Nº 01 · Inc. Magazine
3 Leadership Lessons From Surfing
The ocean does not negotiate. Neither does change. Three surfing principles that translate directly into how the best leaders navigate AI disruption, generational shifts, and a workforce that keeps moving.
2 min listen · 2 min read
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The discussion for every field note lives on LinkedIn, in public, with names attached.
Follow on LinkedInAbout the author
Steven F. Gonzalez
President and CEO, HealthView · Founder, CultureAI
Steven Gonzalez has spent two decades testing one conviction: culture is not a values poster. It is the operating system of care. He leads from both sides of that idea, as President and CEO of HealthView and as founder of CultureAI, the platform the Culture companies run on, built on the belief that great culture and great systems are the same discipline. HealthView is a home health, hospice and palliative care company founded in 1967, a Fortune Best Workplace in Health Care, and #97 on the Inc. 5000 with 2,802% growth over three years. Before HealthView he co-founded SpartX and helped build PokitDok from the founding team, both later acquired. He speaks nationally and advocates in Washington on the future of post-acute care. He writes for Inc. Magazine and Forbes through The Culture Lab.