How Long Should Your Membership Be?

Overview

Longer term memberships should be both maximize patient benefits as well as your success as a business.

Throughout my work in the Incubator program, I receive many questions about this topic, and I just want to share with you what my experience has been developing my own membership and how that experience changed how I viewed successful patient care in this area. Because, at the end of the day, making sure the patient benefits is the ultimate goal. 

What I Do

I currently operate a twelve-month membership with lead-in appointments. For these lead-in appointments, I have a discovery call that includes the initial consultation, then a foundational assessment after which the decision is made on whether to move forward with membership or not. Currently, the membership includes five visits with myself over the course of twelve months, three visits with my health coach, and one 90-minute appointment with a therapist. Both providers are independent contractors.

So how did I determine this twelve-month program? And were there any issues with patients being unwilling to commit to such a long membership? These are the questions that I typically get from providers, who typically favor shorter memberships. I find that a lot of providers want to start with an eight-week or a three-month program, rather than the full year which may seem like a more difficult sell. The common belief is that doing a twelve-month membership is a lot of commitment for the patient, so how do you successfully convert the initial appointment to a full membership? My solution to that is by having a very clear, not confusing, not overwhelming, lead-in process that includes, as mentioned before, a discovery call and a foundational assessment. 

Discovery Call

During the discovery call, we introduce the patient to the practice in general, and I discuss with them how I would approach their specific case and what steps would be taken next. If that conversation goes well, the next step for them would be the foundational assessment, but before that appointment there’s another thing that’s very important for you to do. After the discovery call, but before the foundational assessment, you should send them an email informing them of the twelve-month membership and explain in broad terms what would take place during those twelve months. Our method is that we send an email with a video attached discussing in clear, easy-to-understand terms the reasons for a membership, possible barriers, and why we operate the way we do. For my current Incubator members, that video is visible in the Incubator Course. You can see the exact email and video that we send out for a good example of what one of these emails may look like. Check it out if you want, just remember to  make it your own. The exact details of the email are secondary so long as the patient is gradually on-boarded to the process. After the patient is introduced to the idea of the membership, it’s time to meet back up with them for the foundational appointment. 

Foundational Appointment

This one-time appointment is a ninety-minute appointment with myself where we do a deeper dive into the patient’s bloodwork and discuss foundational support such as nutrition, stress, sleep, exercise, etc. During that appointment, I’m collecting both subjective and objective data so I can clearly discuss what that membership would look like based on the patient’s needs. It is a very in-depth appointment. We're going through their history from birth, and we're identifying the imbalances of both their external and internal environments in an effort to find the root of the issue. At the end of that appointment, I now have all of this information about the patient and I inform them that if they choose to move forward, the next step is the membership. 

The Twelve-Month Membership

The reason that we do a membership including treatment over several months is that healing takes time. In addition, the length of the membership allows me to support the patient as things might come up so we can make changes along the way. It is very important that you email them about the membership before the foundational assessment, after the discovery call. It's important that the patient is pre-educated, so they can make an informed decision about their treatment. They shouldn't be learning about your membership for the first time at the end of the foundational assessment, or that may lead to confusion and hesitancy to commit to the program.

For example, if you discover at the foundational appointment that somebody has some symptoms like endocrine disruption, hyperthyroid issues,  chronic fatigue, insomnia, migraines, or other similar symptoms, we would discuss any advanced testing that may be needed at that point. Depending on the symptoms, I may want to do an adrenal saliva test or a gut workup, maybe additional food sensitivity or nutrient testing. These tests are chosen based on the information collected during the foundational assessment. After explaining what tests may be needed, I explain to them why we can't do all the tests at once or the treatment all at once. The process takes time. It's like peeling back layers of the onion.

In my experience, I like to first identify food sensitivities and nutrient deficiencies and then see how the patient improves over the course of two or three months. At that point, if it seems like there are some stress issues occurring, the adrenal saliva test is appropriate, then treat that and follow up a few months later. So as you can see, we're already at the six-month mark, and we're still in the process of peeling back the layers and treating different issues as they become apparent over time. 

Again, it Takes Time

When I first started, I realized that when I described it like that, patients really understood the benefits of a long-term approach. This had the added benefit that if they wanted a quick fix, if they just wanted to see what their saliva test was or, to do the stool analysis, for example, and they just wanted those results and they didn't really want to work with me over the long term, that was pretty clear from the beginning. But people who were really invested in this integrative, holistic approach of the combination of lifestyle and internal and external environments, understood that it takes time to treat and it takes time to see change. Initially, I did have three-month and six-month programs, and I found that most people can feel better in three months, when we clean up their diet, replace some deficiencies, get some gut support, etc., but the twelve-month program allows us to create far more long-lasting benefits as we go through the process of peeling away those layers of the issue. And if you're implementing a protocol, either for gut health or adrenal health, a lot of times it takes two to three months to see a change, assuming the patient regularly does the recommended interventions.

So, if they're just doing a six-month program, there’s only the initial appointment, reviewing the test results, and implementing the plan, then following up in two to three months to review. And then after those six months, you might retest and find that there are still other layers to pull back and other issues that could be treated. Because of this, I find that twelve months gives enough time for multiple issues to be treated and the results evaluated, rather than just one. Then, at the end of twelve months, we ask if they are at a place that feels complete, or if we need to move on with a maintenance-based approach.

Another Point...

I also want to point out that after the foundational assessment, some people are responding to the issues they see with lifestyle interventions, and that's enough for them and they don't need the membership. The whole idea is to meet them where they are at each stage, so if someone is able to reach a point where they don’t require the membership, that’s a success as well. However, I do feel pretty strongly that the twelve-month membership with the initial consultation is key to establishing a relationship, so they really understand their unique setting and situation,  and why we need this longer-term solution. Their issues didn’t all show up in a matter of three months, so it just makes sense that we can't expect to unravel all of the imbalances and behavioral issues on the path to healing in just three months.

This is what I teach in the Incubator and I highly encourage you to consider that kind of approach for both your stability as a business and as a practitioner, but also for improving patient outcomes. I think this method is very beneficial for both of you. For Incubator members, if you have any questions, please set up a coaching call so we can review your membership and work through some of these things. If you are not a member and you're interested in learning more about what we teach in the Incubator, go ahead and set up a strategy session.

Thanks for reading!