April 24, 2024

0-140k Downloads: How Rupa Health Is Dominating The Medicine Category

Tom Hunt


Great to have you here…

We are going to go DEEP into why The Root Cause Medicine Podcast is dominating the Medicine category in the US in Apple Podcasts and has grown to 140k downloads per month… in six months.

This advice is going to be unconventional, different and potentially hard to understand, but I’m confident you will be able to keep up.

Here is what we have in store:

  • Step 1 - Intro, positioning and strategy
  • Step 2 - How to execute the perfect podcast launch
  • Step 3 - The importance of retention
  • Step 4 - Systemization and automation
  • Step 5 - Non-paid promotion
  • Step 6 - Paid promotion
  • Step 7 - Conclusion, lessons and the future 

Let’s get into it…

Step 1 - Intro, Positioning & Strategy

This show is crushing:

It’s called The Root Cause Medicine Podcast and it’s owned by Rupa Health. 

Rupa Health enables healthcare professionals to order and track tests from 30+ testing providers.

And therefore, building an audience of healthcare professionals that could in theory, order tests through their platform, would be a positive for the business.

This is why they came to Fame.

We then had to decide what the podcast should be about.

Now I’m not sure how much you know about the world of medicine, but right now there is a big shift away from having medicine treat the symptoms of an illness, and more of a focus on medicine treating the root cause of an illness. This is something that the Rupa Health team are passionate about.

So we decided to theme the show around this trend, and bring on healthcare professionals to talk about their specific expertise. The target listener of the show was both healthcare professionals (they want to learn more about their craft from the experts) AND consumers that maybe had the issue discussed in the episode and wanted to learn more about possible root cause treatments.

So what did we do well here?

We connected the theme of the show to a topic that was relevant to Rupa’s business AND also connected to an exciting and powerful trend in the industry. This should mean that as the “root cause” trend continues to build momentum, it will grow the podcast (and Rupa’s brand) along with it.

KEY LEARNING: Ensure your show’s strategy/positioning is slightly different/better/stronger than all the other shows out there in your niche.

Step 2 - How To Execute The Perfect Podcast Launch

OK next up…

It’s the BIG one.

It’s launch time.

Now we don’t have time/space to go into everything that needs to feed into a B2B podcast launch, but I am going to detail what your strategy should be and how we executed this for The Root Cause Medicine Podcast.

There is JUST one important thing to remember with podcast launches.

You simply need to feed as many new followers into Apple Podcasts in your chosen geography as possible within a 48 hour period.

Nothing else matters.


Because this is how Apple Podcasts ranks shows.

They check within a short time period (approx. 48 hours), how many new followers a new show is getting and then they rank it. It’s that simple.

Yes, I hear you, not everyone uses Apple. This is fair enough. 

So we are going to also promote our Spotify URL during the launch, but no other directories.

And how do we maximize new followers during this 48 hour period?

For this we need concentric circles.

Everyone that you and your business knows can be put into a concentric circle where the central, smallest circle is the warmest. This is typically co founders and employees.

All the way to people that don’t really know you at all.

We typically break this down into 8 circles:


Your customers

Your email subscribers

Your social followers

Known influencers

Launch episode guests

Relevant Linkedin/Facebook/Reddit/Slack communities

Paid audiences

You can see that #1 is the warmest and # 8 is the coldest right?

Therefore we would expect a higher conversion rate on our ask for the warmer contacts.

And what are we asking them to do?

Simply to follow on Apple Podcasts (or on Spotify if they have that, but really we want them to do it on Apple).

So your job as the launch master is to simply create the content that you will send to each of the 8 concentric circles during the launch 48 hours. 

Simple right?

This is EXACTLY what we did with The Root Cause Medicine Podcast, and here were the results:

Top 10 in Medicine in a couple of smaller countries but more importantly #30 in the US, the target category.

This was a solid start for the show… and of course, rankings have improved consistently since then:

Now you may have got all the way to the bottom of this email and thought: 

“Why? What is the point in ranking in Apple Podcasts during launch?”

It’s a great question…

There are two reasons:

When you rank, more people see your show in the category, bringing more listeners for free

When you rank, you can use this in marketing material in the future for both new listeners and guest outreach

Everything else in the life of your podcast will be easier if you rank in Apple Podcasts in your category during launch ;)

Step 3 - The Importance Of Retention

I gave you something interesting in Step 1 (strategy/positioning) and something exciting in Step 2 (launch)... and now it’s time for the boring stuff.

But first, let’s jump into some growth fundamentals.

I went through the very expensive and prestigious, Silicon Valley growth course: Reforge.

And maybe I’m a rubbish student, but the only thing that really stuck with me from the course was this:

👉 Retention is the foundation of growth

Think about that…

What it’s saying is that if you don’t have a great number of new users (read: podcast listeners) coming in than are going out… then your podcast will not grow.

And yes it is possible to keep a big stream of new listeners coming, but that is going to be expensive. 

The much more sustainable and healthy way to grow anything is to ensure that you retain as many users (read: podcast listeners) as you possibly can before you shift your focus to finding new ones.

As podcast producer (this is your job now), you MUST ensure that you are looking out for your listeners. 

And that their lives are improving with every episode.

So how do you do this?

Avoid sponsorship at the start: it’s better for first establish your value then potentially bring sponsors in later if needed

Send a survey to your listeners: on the thank you page give a link for them to book in a 15 minute call with them so you can ask them what they like/dislike about the show

Give feedback to your host: count how many filler words they use from a transcript and challenge them to reduce these

Build a backlog: if you have a backlog of episodes recorded you can relax and then spend more time working on getting bigger and better guests

Track consumption: log into Apple Podcasts Connect and then track consumption by episode and then also average this as show in the image below, this number should ideally be increasing over time:

Start having briefing calls with guests: if you are not already, then start having 15 minute briefing calls with guests to prep them on potential topics, their sound/video set up and the listener persona (your ideal listener)

Level up host audio: get your host a better mic and webcam to improve their audio and video, this can make a massive difference to listener enjoyment

Now of course, I assume you can’t execute all of these at once and they will take time to optimize… but the time to start is NOW.

When I say NOW, I mean soon after launch, we want your episode content to improve by 2% each episode… then after 50 episodes your podcast would have doubled in quality.

This will mean you will retin more users and growth will be MUCH easier.

If you check out earlier episodes of The Root Cause Medicine Podcast, you should be able to see the evolution (and improvement!) of the content as we go:

Early episode: How Should You Eat and Exercise During Each Phase of Your Cycle with Dr. Stephanie Estima

Later episode: Dr. Anthony Youn's Natural Skin Health Approaches for a Youthful Look

Ok awesome, we have defined strategy (Step 1), launched (Step 2), have started on the journey to continuous improvement (this Step), in the next email we move onto the more existing stuff again ;)

Step 4 - Systemization and automation

OK I lied…

Before we get into the exciting stuff, we have one more boring lesson to cover.

Again: boring but CRUCIAL.

Let’s get into it…

Every podcast expert will tell you that the #1 thing you MUST do if you want to grow your show is to be consistent.

And it’s great advice.

To stand a realistic chance of ranking in your category after the launch influx, is to stick to your release schedule for 6 months, minimum.

Though what most podcast experts either don’t know, or don’t tell you is HOW to be consistent.

And the answer to this question lies within two words that get operations people VERY excited:



You see, people are inherently lazy. The more time a task takes to complete and the more variable the work is, the less likely it is to be done consistently by a human.

Coming back to The Root Cause Medicine Podcast.

We actually chose a biweekly release schedule to start with whilst we honed and optimized the content and our system.

More recently we switched to weekly episodes when everything was running smoothly.

But let’s share with you how we got to this point, remember:



No we’ve been honing our podcast system since mid 2019, this is how we break it down:

Guest Booking/Communication

Rupa Health runs pre-specified amount of outreach to ideal guests based on the guest persona

Guests are booked into the hosts calendar

Calendar is set up to handle the rest of the core communication with the guest pre and post recording

We customize an email specifically for each guest, which is then sent out by Rupa Health on the launch day. This email contains assets and kindly requests them to share.

Asset Creation

Once a guest books, all tasks and assets have an associated Trello Card created for them and assigned to the relevant person, all with due dates automatically assigned

Once created, assets are reviewed by a project manager, then an account manager and then are released/sent to the client/guest

Process documents are written and updating explaining how each asset is created and what to do if anything goes wrong

As you can see from the above, each task detailed for each system has either been automated, or all variability has been removed, the process has been documented and then is implemented by a human, ticking off a checklist as they go.

This is how you can be consistent.

This is how you win in the long term: performing at a higher level AND with more consistency over a longer period of time than your competitors.

So before you start looking at creating video snippets or running Facebook Ads, PLEASE spend time working on your guest communication and asset creation process to ensure that you are able to execute consistently. 

There we go, Step 4 of the 0-140k Downloads series, Step 5 and 6 are going to focus on promotion…

Step 5 - Non-paid promotion


We get to talk promotion.

Specifically: non-paid promotion.

E.g. how you get exposure for your podcast, without spending ca$h.

There are four strategies that we implemented with the help of Rupa Health.

Written/Audio/Video SEO

This one is simple, long term, and compounds over time.

It’s just ensuring that if anyone searches for a keyword related to the podcast OR a specific episode… that we are found, whether that be on Google (written), Apple Podcasts (audio) or YouTube (video).

A written example:

Now there is also some podcast strategy work that can help here (remember Step 1?).

We opted to aim to address a specific medical condition from a “root cause” perspective in each episode. This simplifies our episode prep and guest communication system (Step 4), but then also enables us to position each episode for inbound search.

In audio:

And how do you do this?

It’s simple.

You just need to either analyse the episode post recording to pick out the optimal keyword for the episode… or even better, you choose a topic beforehand based on keyword volume.

And then simply ensure that this keyword is included in the blog post title, description, blog post (more on this shortly), the title, description and keywords associated with the audio file and then also the video file that is uploaded to YouTube.

And BOOM, if you get this right for each episode, you should have a baseline of relevant inbound search to your podcast that compounds over time.

Content Syndication

Think breadcrumbs.

Tasty little morsels of information spread around the internet left with the intent of converting the hungry consumer into a podcast subscriber

What we’re trying to do with Content Syndication is simply leave valuable ideas on our domain and social platforms with the goal of then linking people back to the show.

So what do we actually do:

Create a blog post with key takeaways and a full human reviewed transcript

Create quote images

Create snippet videos for YouTube/Instagram Reels/TikTok

We ensure that we pull out the most interesting, controversial, valuable points in each asset and then post them natively into social platforms or onto our own domain.

Guest Sharing

And then finally…

Each guest that comes onto a podcast has an audience.

However big or small.

If we have created something awesome, then it’s our duty to maximize the amount of people that consume the content.

So the question becomes… how can we maximize the amount of times and the amount of places that the guest shares.

Yes of course we will remind them a couple of times and ensure we send them assets we have created as Step of the Content Syndication section above.


The #1 way to get a guest to share… is to ensure they have an amazing guest experience AND get to share insights that truly resonate with them during the interview.

So how do you do this?

Ensure that you over communicate with the guest so they know what is happening at all times

Ensure that you thank the guest for their time

Ensure that you have collected information prior to the interview to ensure you are covering topics that they are passionate about

Ensure that your host is informed both about the guest and the topic and is continuous improving their skills (see Step 3)

If you manage all of these, your guest share rate will be sure to increase.

UP next: paid promotion strategies 📈

Step 6 - Paid promotion

OK here we go…

It’s time for paid.

Do you remember Step 3?

We were talking about launching a show and that we should focus all our efforts on driving new followers to Apple Podcasts?

Well the same also applies here.

Ranking in a category in Apple Podcasts almost guarantees free listeners.

It also affords your show massive social proof as you can say that “we are a top 10 [[niche]] podcast”.

And how do you do this?

In exactly the same way…

Rupa Health pushed as many new followers into Apple Podcasts as possible.

Now there are a multitude of paid channels that you can send paid traffic some, including but not limited to:

  • Google Ads
  • Facebook/Instagram Ads
  • Twitter Ads
  • Quora Ads
  • Castro Ads
  • Overcast Ads
  • Spotify Ads
  • YouTube Ads
  • Other related podcasts

We are going to focus on the strategy that Rupa Health followed to grow The Root Cause Medicine Podcast: Instagram.

Let’s jump in:

Targeting & Creative 

Remember Step 2 and 5?

Well now you know that each episode of The Root Cause Medicine Podcast focuses on a specific medical condition.

As well as being good for SEO, this approach is also great for paid spend targeting… using Instagram’s interest targeting, Rupa Health was able to promote a specific episode to a specific group of people interested in this condition.

To do so, specific quotes were pulled from the guest and inserted into a quote image as you can see below:

This quote has been pulled from an episode where the guest is talking about using food to prevent mental health.

Here are adding value in the ad, but then also building curiosity within the potential listener, which brings us onto the…


Remember the goal?

Get new followers on Apple Podcasts in order to boost rankings.

And fortunately Apple have created a little tool to help us with this…

It's called a deep link.

Click this on an Apple device: https://tinyurl.com/cbmpodcast

You will notice that it will direct your STRAIGHT to Apple Podcasts and it will then pre-populate a subscribe button and will allow you to subscribe with a single click.

And BOOM, we have a new follower.

We’ve removed all friction to the potential listener becoming a follower of The Root Cause Medicine Podcast.


Once you have this campaign up and running and pulling in new followers like nobody's business, you must optimize.

Think of the campaign like a little puppy: without fresh food and water, it will not thrive.

But fortunately with The Root Cause Medicine Podcast, each week we have a new episode live with a new guest talking about a new condition, with new quote images just waiting to be pulled out.

We can upload new images into the Instagram Ad account each week, give them 48 hours, and then cut those that aren’t working and boost those that are.

This way, we can look to continue to reduce our CPAPF: Cost Per Apple Podcasts Follower.

Finally, Apple started sharing follower data within Apple Podcasts Connect! So you can log in there and easily see if your Instagram Ad spend is impacting follower growth.

In summary, to extract a shed load of new listeners from Instragam, The Root Cause Medicine Podcast team:

  • Selected valuable/interesting content from a specific episode
  • Target specific people with this content
  • Provided a very smooth journey for them to subscribe

And the result?

Increasing downloads and rankings in Apple Podcasts in the Medicine category as you are already aware of:

Step 7 - Conclusion, lessons and the future 


It’s been a big post.

We’ve covered:

Step 1 - Intro, positioning and strategy

Step 2 - How to execute the perfect podcast launch

Step 3 - The importance of retention

Step 4 - Systemisation and automation

Step 5 - Non-paid promotion

Step 6 - Paid promotion

There is a concept that I want to communicate in this final lesson of the podcast course:

You may think that growing a podcast from 0-140k downloads in 6 months can be achieved by simply unlocking a growth channel or just spending a shed load of ca$h on ads.

And yes, those approaches MAY work.

But realistically, in order to do this you MUST take a holistic approach to the success of a podcast.

NOTE that only 2 of these seven lessons focus on promotion, because you need all the other boring stuff in place BEFORE you move over to spending money on ads:

Strategy and positioning

Guest experience

Systemisation and automation

Without these, you may see a spike on downloads, but it won’t be consistent month over month growth.

And there we have it team…

I hope you have learnt some different things during this course… I hope it made you think a little different about your existing podcast or the podcast you are planning to launch.

Hit reply if you have any questions, happy to respond… it may take a few days, but you WILL get a response ;)

And of course, if you would like the Fame team to help you with your show, then grab a podcast proposal by hitting the button in the top right and we can set up a time to chat 🤓 

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