The Program vs. Membership Conundrum: Which Model Is Right for Your Brain Focused Practice?
Over the last decade, best practices for structuring a functional medicine clinic have shifted dramatically. One undeniable truth has emerged: a traditional fee-for-service model—whether through insurance or cash—often fails to capture the true value that functional medicine doctors bring to their patients. By focusing on “visits” alone, fee-for-service overlooks the ongoing education, personalized protocols, and deep-rooted lifestyle transformations that functional medicine practitioners provide.
In response, two primary models have risen to prominence:
Program (or “Package”) Model
Membership Model
Each has unique benefits, drawbacks, and suitable use cases. Let’s explore how these models work, why many clinics are still facing hurdles in implementing them, and how a new multi-tiered Brain Health Membership could be a game-changer.
The Program (Package) Model
A program or package model bundles services together for a set timeframe or a set outcome—like reversing a chronic illness, healing a gut issue, or tackling a detox plan.
Why Some Clinics Prefer Programs
Specific Outcomes: Patients know exactly what they’re buying into—e.g., “12-week gut reset” or “6-month autoimmune recovery plan.”
Upfront Revenue: You receive a larger payment early on, which can help with cash flow and reaching profitability.
Clear Start & End: Both you and your patient have well-defined milestones and timelines, making progress (and results) easier to measure.
Where It Falls Short
Limited Long-Term Engagement: Once a patient finishes their program, they may not maintain a relationship with your practice—even if ongoing support would benefit them.
Fee-Shock: A larger lump sum upfront can feel daunting for certain patients.
Missing Maintenance: Chronic illness reversal often requires continuous follow-up and adjustments. A single “program” may not fully address long-term brain health or other ongoing needs.
The Membership Model
In a membership arrangement, patients typically pay a monthly or annual fee for a range of benefits—unlimited visits, group sessions, email support, or other value-add services.
Why Some Clinics Use Memberships
Predictable Recurring Income: With monthly or annual dues, you can forecast revenue and budget more reliably.
Long-Term Relationship: You help patients with prevention, maintenance, and health optimization, rather than just short-term fixes.
Ongoing Support: Patients remain engaged in their care and can tap into new protocols or updates as they arise.
Potential Limitations
Not Always Outcome-Specific: Patients with acute or time-sensitive health issues might hesitate to pay recurring fees if they only need short-term help.
Slow Initial Profit: Memberships can take time to build up enough volume to surpass the immediate revenue a program would bring.
Expectation Setting: If patients assume “unlimited” contact, you need clear boundaries to avoid burnout and ensure everyone gets fair attention.
The Brain Health Membership: A Multi-Tiered Approach
What if there was a model that blended the best of both worlds—addressing a specific, high-stakes outcome and creating a long-term support structure? Brain health is increasingly recognized as an area where ongoing engagement pays off. The last thing a patient wants is to slip into memory decline after completing a one-time program. Preventing—or reversing—cognitive decline often requires continuous tracking, coaching, and updates to protocols.
That’s why more clinics are adopting multi-tiered memberships specifically for brain health. Pioneered by practitioners like Dr. Lara Salyer these memberships offer:
Tier 1: Intensive, outcome-focused care over the initial months to address immediate concerns or early cognitive symptoms. Provider, coach and community time all included and prioritized.
Tier 2: A lower-level monthly membership after reaching initial milestones—providing maintenance, lifestyle support, group visits, office house, opportunity to book appointments, etc.
Tier 3: Additional add-ons or advanced testing for patients who need deeper or specialized interventions.
Why This Works
Long-Term Brain Maintenance: Cognitive function isn’t just about “fixing it once.” Patients appreciate a structure that supports them for life.
Sustainable Revenue: You generate significant initial income from higher-intensity tiers while maintaining recurring monthly fees for ongoing support.
Personalized Pathway: Each tier caters to different needs—whether someone is in early intervention mode, active treatment, or longer-term prevention.
Adaptability: Patients can move between tiers as their brain health evolves, ensuring they only pay for the level of care they need at any given time.
Where Do You Go From Here?
If you’re struggling with the “Program vs. Membership” conundrum, consider leveraging a multi-tiered Brain Health Membership. By combining the accountability and revenue boost of an initial intensive program with the longevity and relationship-building of a membership, you’ll create a robust framework for both your patients and your practice.