Membership Model Workshop
Sep 07, 2023In this blog and video, we're going to workshop together how to effectively create a membership model that adequately describes the value of your practice and conveys that value to your potential patients. Keep in mind that we are working from the "dream phase" of our practice and will be discussing initial plans and thoughts as you are just brginning.
At this point, you have examined how having a cash-based membership model is one of the best things you can do for the health outcome of your patients and also create business stability for your practice. You have established that this is the way you can provide for yourself, provide for your family, and have freedom of time, location, and quality of life.
But where to begin??
Getting Started
I'm going to go ahead and share my screen. [See video component to follow along with the shared screen portion.] We're going to do this together. Start on paper or on a digital document. I prefer using a Google document, and I've named this one, “Membership Outline Workshop.”
One of the things to remember is that you need to start by thinking of the ideal person that you want to work with. For today's purposes, I'm just going to say a 45-year-old female. Now, some of you who work more in pediatrics, for example, can input another patient, but you're going to implement a typical client for your practice and someone who you are likely to work with.
Patient Problems and Complaints
I'm going to start by listing out the patient’s problems. The way I think about this is by asking the question, “What are this patient’s chief complaints that he or she is coming with?” In integrative medicine, sometimes we get things like headaches or migraines, but a lot of times it's a little bit more nuanced, especially in the integrative and functional world. This patient might feel that she is fatigued. She doesn't feel like herself in her own skin, difficulty with weight loss, improved musculoskeletal function, and improved sleep. She also may have some brain fog and some joint pain. Let’s say these are all things that she is coming to you with.
Provider’s Perspective
Then I break up from a provider perspective, what her problems are into internal and external environments, because that is typically what we are dealing with.
Internal Environment
A lot of times, I'm going to be concerned about her gut health. She may have poor gut health, nutritional deficiencies, and issues with proper detoxification in terms of not having adequate bowel movements or sweating. She may also be dehydrated and not urinating properly. She may need more vagal tone, meaning that her stress response is suboptimal. So, she may have suboptimal hormones or imbalanced hormones as well. Those are typically the issues that I'm seeing in her internal environment.
External Environment
Now, in her external environment, this patient is typically stressed at home. And at work, a lot of times, it’s a stressful environment in general. She feels like she doesn't have enough time. She may be in an effort to lose weight, adding additional stress or workouts. She may struggle with food, like lacking the time to cook and/or be cooking for her entire family, who may not be eating the same way that she is. And she may feel isolated—alone as well. She may not have a tribe. Also, she may have personal care products that are adding to the toxic burden in her home, whether that's makeup, cleaning products, or detergent.
Membership
Next, I'm going to start to think about my membership. The membership shall aim to decrease the patient's time and effort in achieving her health outcome. So, what I initially think about is that a membership does not mean that you, the provider, need to see her every single month. What we know is that when you implement your treatment plan and you're prescribing prescriptions or supplements or labs, you need to give it a month or two to give it time for those interventions to work. Also, within the membership, you have the one-on-one time, and then you have just the external support—the tribe and the education.
One-on-One Time
Take a moment to think about just the one-on-one time. I will like to see this patient say five times throughout the year. The initial cadence of five or six doctor’s visits throughout the year—every other month—is what I start out with in my practice. That works well for an entire year.
Internal Issues
When I'm looking at these internal issues that are happening for this person, these are tools in my toolbox as a practitioner. As I start to formulate that in my brain, I'm probably going to start by replacing nutrient deficiencies. I may start by doing a gut rehabilitation program to improve the microbiome. Then I may start with the HPA axis and start by supporting the adrenals thyroid and the sex hormones. I may move on to improving detox pathways, just supporting that in general. As a practitioner, these are like those one-on-one appointments. So, if I am seeing her about five times throughout the year, this will be blood work. The advanced lab for that will either be a stool test, and I may need to do a SIBO test. This may be saliva, adrenal curve, or Dutch test, depending on what she needs. I can have a look at genetics here, or, you know, so on and so forth. I may need to do a mycotox test, if I suspect mold. So, as you can see, this is a personalized approach to this person. I'm just trying to create that framework for you now.
Other Professionals
I may at this point consider or bring up the possibility of including other professionals to engage in healing processes for the patient as well.
External Issues
When it comes to external support, this is really where that membership piece comes in because we're going to be taking these problems and these external issues, and we're going to start to think about what kind of education, what kind of support this person may need to get through this.
I will want to have a health coach or nutritionist, and this is where one-on-one appointments help with my interventions. This helps to bring it from theory to intervention action. So, this patient will schedule a visit with a health coach/nutritionist.
What I find helpful for my patients in my practice, as well, is having a therapist visit them, especially if there is something deeper in a mental health perspective that we need to explore. So, this patient will schedule a therapist appointment as well.
These things are all from one-on-one visits.
Education
I also think that this patient will need education on what personal care products to use. She needs education on basic gut health and how it works, and why it's important to take care of that. She also needs education on hormone health, signs and symptoms, when the major players like cortisol, thyroid, sex hormones are imbalanced. She needs education on what that looks like and what contributes to that. She may need a cooking class or just education on healthy eating from a convenience standpoint as well. She may need recipes, ideas for snacks, breakfast, lunch, and dinner, as well as cooking for a family with different needs. Also, she needs to be educated on how to improve the vagal tone. I know most of my patients this age really need to support the parasympathetic nervous system. So, I need to educate her on how to do that and why that's important. And she also needs a group, the tribe, feeling supported all together.
What this piece may look like is a monthly live education series, where we talk about these things. I'm thinking about everything that she needs to be successful and how I may deliver that.
So I'm just going go down the list:
- Personal care products
I may be able to take care of this with either a recorded video or maybe a handout, where I give recommendations for makeup, mattresses, cookware, or water filter, just kind of all those things that will help decrease the toxic burden on her body. I think this can probably be taken care of in the beginning of the membership.
- Gut health & hormone health
These both definitely need to be a live talk with me.
- Cooking class education
This will be on healthy eating and just some basic recipes where she will go to my health coach or nutritionist to take care of that piece of it. Recipe ideas will be on a handout, and I will probably outsource that to my health coach or nutritionist. Cooking for family with different needs can be part of that class, as well.
- Improving the vagal tone support parasympathetic nervous system
I think that will be a live class about thought work or diaphragmatic breathing—all the different ways that we know on how to improve that tone. I can teach that, or I can outsource that to a mind/body expert.
- Group, tribe, and feeling supported
I can make sure that I create a community of members either on Facebook or whatever platform I may be using. Also, what will be helpful is coming together live in person or via zoom.
- How to work out in middle age
I didn't include this earlier, but I think teaching her how to exercise as she is now middle aged will be a good series, and I will probably outsource that to some sort of trainer or some sort of fitness expert as well.
So what I have now needs reorganized a bit. I need to put my classes together. This, “gut health,” is a class, so I'm going to put that down here. And then “improving the vagal tone” is another class that I've decided to teach. There is the “nutrition cooking class,” and then we have the “hormone health,” and then the “working out in middle age.” So, we have hormone, cooking, vagal tone, gut, and working out—five classes. Now, in terms of organizing these classes throughout the year, you can just cycle through them. So, I will pick an order to put them in and then just keep going through that throughout the year.
First Draft
This is my first draft of my membership, really catering to this kind of individual. And as I sit with this and become more and more intentional and create lists for what I need to do for this kind of patient, what I hope you're realizing is that a membership model is so much more than how many appointments with you, how many appointments with the health coach, unlimited portable portal messaging, and discount on supplements. That's the structure, but what will really make your membership thrive and really have your patient light up and be like, “Oh, my goodness, this practice was created for me. This is exactly what I need.”
That is when you're really looking at “What does this patient need? What problems is she facing? What are the issues that you see as a provider from her internal and external environments?” And a lot of these internal environments are what you deal with at those one-on-one appointments. That is what you help your patients with, but you don't have time—even though these appointments are longer, typically 45 minutes to an hour—to address all these other needs. All these other needs are quite frankly the reason why some patients might quit, or they feel like they can't do it because, yes, they can maybe take the prescribed supplement or prescription.
Conclusion
Remember when patients leave your office and go back to their life, it might be difficult for them to keep up with all you have shown them. That is why they need education. They need handouts. They need support with other providers, like a health coach, therapist, trainer. Make sure you are thinking of this path in your dreaming and creating process. Don't think logically like “How am I going to hire these people? How am I going to pay them? I'm only one person.” Don't go there quite yet. We're going to talk about that soon. But at this point, you're just thinking of the patient and dreaming about what kind of support he or she might need. And then we'll continue on from there.
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