Dr. Stillman's Practice Blueprint
My guide to building a practice you will love
I have spent the last four years building my practice. It is now a practice I am very happy to own and operate. I have worked in a wide range of practices over the past ten years, met with hundreds of practitioners, and spent more money than I care to admit on "business development."
If you want to learn more about my journey, read this post:
I regularly meet practitioners who are burned out, broke, scattered, distracted, frazzled, and otherwise unhappy. They are this way because they have not figured out how to run their practices well.
If you're interested in meeting with me to get my advice on how to optimize your practice, how to start your practice, or in any other way develop or improve your practice, fill out this form and we can jump on a call if I think I can help you.
Over the past few years, I've continually improved my practice so that my patients and I are happy with the results and service. We have an 80-100% renewal rate from month to month, and we regularly receive referrals from current patients. I've been able to have time and space for my family, while also being able to pay myself and my staff appropriately for what we do.
Why am I creating this guide?
I remember what it was like to start my practice and then try to figure out how to run it. It was grueling. I often got bad advice that back-fired on me. I just don't want other practitioners to have to deal with what I went through.
So here's the keys to my practice.
One quick disclaimer before we begin. You might be nothing like me. The more different you and I are, the more different our practices will probably be. That's okay. I will explain along the way why I made the choices I did, but you get to choose your own adventure.
I think this blueprint will work for:
General practitioners
Nutritionists and dieticians (and anyone similar)
Personal trainers
Dentists
Doctors of all kinds
Coaches of all kinds
I will refer throughout this guide to Alex Hormozi's books, "Offers" and "Leads." Forget business coaching, masterminds, and consultants - just go buy his books, listen to his podcast, watch his videos, and you'll get more from him than you will ever need.
I am not going to cover how to start a practice here. Alex Hormozi covers that in spades in his book, “Offers.” If you want to know how to start a practice, go there and dive in. If you want advice from me personally, fill out this form.
I also can't cover how to fix big, unwieldy practices either (multiple practitioners, lots of employees, complicated therapies, and so on). This is for solo-practitioners who are working up to a full-time practice, or practitioners with only a few employees at most.
Step 1: Commit to 100% patient satisfaction
I made this commitment last year and it changed my life and my practice.
Your goal should be to maximize referral and retention. I am not going to go over why this is, but if you want to know why, read Dan Kennedy's guide to maximizing referrals and customer retention. It's a brilliant book. The genius of his book is baked into Hormozi’s books (I can feel Kennedy’s influence on Hormozi in everything he does).
When you tell your patients that you are committed to 100% satisfaction, they are empowered to let you know when they are not satisfied.
This provides you with the feedback you need to improve the practice. This is the beginning of practice improvement.
Step 2: Commit to a membership-based practice
You need to define who you serve and commit to serving them for the long-haul. You can't serve everyone if you commit to 100% patient satisfaction. This is the dilemma conventional healthcare finds itself in. It just isn't realistic to create a practice that is perfect for everyone, and therefore where 100% of people are satisfied. Therefore, you must define who you serve and create a membership that caters to them. Your focus and goal is 100% member satisfaction. This is achievable only when you do not try to please everyone.
The days of the "fee for service" model are quickly drawing to a close. You need memberships. I could write a whole essay on this. See my prior post on why I created a membership based practice if you want more details. You could offer programs, which I explain in this post. However, programs are, by definition, short-term. People do not want short-term doctors. They want to have a long-term relationship with someone who will consistently show up. Once you've gotten them better, they want you to keep them better.
What does a membership look like? You can take mine as a reference point. You will find them here.
Step 3: Define your offerings
You need to define what you're offering. There are two big categories.
Goods
Services
Goods include:
Labs
Supplements
Medications
Medical equipment
Services include anything and everything you can use your time to do for your patients. Here's an idea:
Consultations
Urgent care
Emergent care
Setting and casting broken bones
Stitching up wounds
Physical exams
Paperwork
Nutritional counseling
Physical training
Prescribing and managing medications
Performing specialized procedures
Therapies like osteopathic manipulation or chiropractic adjustments
Make your list. Next, it’s time to define the terms under which you offer them.
Step 4: Set your terms
You have to set the terms under which you are offering your services.
Services are bounded by time.
When do you provide your services? Define this carefully.
How fast will you respond to inquiries of various kinds?
How quickly will you provide follow up notes or prescriptions?
Services have to be accessed.
How will patients access your services?
Services in 2025 are accessed via technology.
Here's how patients can access your care:
Phone call
Text message
Email
Follow up notes
Automated scheduling programs
Video calls
Electronic medical records, which typically include:
Chart portals
Text messaging integrations
Email integrations
Online courses
Automated scheduling
Lots of other nifty integrations and features
Everything has to have terms like, "I respond to non-urgent texts, emails, or phone calls on the next business day." You have to define these things, otherwise you will get swamped and overwhelmed.
Go back to your list of goods and services and in a new column, answer these questions:
During what hours do I provide this?
What geographic region do I provide this to?
How quickly can patients expect a turn-around on this?
How quickly can patients expect a response regarding this good or service, or fulfillment of the good or service?
How do I schedule or arrange for this good or service?
Here's a quick example from my practice:
I provide consultations via Zoom that are arranged either via automated scheduling between 10 AM and noon, Monday through Thursday. Patients can expect follow up notes within 24-72 hours, along with prescriptions and other orders. Patients generally have to wait 2-3 weeks for an appointment.
Here's another quick example:
I provide cell access between 7 am and 9 pm. For non-urgent matters, we will schedule an appointment to review your case within the next two to three business days. For urgent matters, we will address immediate next steps, like prescriptions, imaging, or in-person examination, and then schedule time to review non-urgent elements of the case within two to three business days. For urgent issues that can be dealt with in-person, we will arrange a time to meet at the office or for a home-visit, whichever is more convenient for us, as soon as possible.
Step 5: Set prices
Time to set prices. Go back to the list of goods and services you defined in step 3. Next to each product or service on your list, decide what you would be willing to pay for each of these services based on your zip code. Think, "what would I immediately be willing to pay for this, without haggling or being sold?"
If you're wondering how to price goods and services, here's the simple way to do it.
Pricing for goods is easy - what are other people charging and what are other people paying? For example, I've seen people charge $100 for a lab test that costs $2 wholesale to me as a clinician. I am not suggesting you charge $100 for a $2 test. I am suggesting you offer your members a "members-only" price. This is a huge value to them.
When pricing services, take the hourly rate of the employee (including you) and multiple by 3-5. That's what you'll find people are paying. For example, the average price of functional medicine consultations is between $400 and $500. If you divide this by 3-5, that's what the average functional medicine doctor is probably being paid if they are an employee. This is similar to what they make as employees at big clinics and hospitals.
Next, you need to modify these prices based on when you are offering them. Set a price for business hours, weekends and evenings, and important holidays or personal dates (anniversaries, birthdays, etc.). Feel free to create black-out dates. For example, if you offer services 24/7, your membership needs to reflect it. Decide what a 30 minute consult at midnight on your birthday would cost, for example. I’m kidding, but hopefully you get the idea.
Once you’ve created a list of prices, it’s time to create your membership tiers.
Step 6: Create tiers of membership
You should have at least three tiers of membership. More than that is a bit overwhelming and fewer than that doesn't give you enough latitude to cater to different budgets and levels of medical complexity.
Bundle goods and services together to create membership tiers. Provide more generous terms at higher levels of membership.
Based on the regular price of what you do, create a member's only price. I did this by taking a reasonably high price for my labor (I've been paid as much as $800 an hour for consultations) of $597 per hour.
I cut this by 25% to reward members for membership. I then shrank my "hour" visits to 55 minutes so I am not booked solid (a miserable experience that I don't recommend). My 55-minute visit for members is $425 (as of this writing).
Do this for all goods and services. Do what feels right, without bankrupting yourself while making sure that your members feel like it's a "good deal."
Total the cost of the membership based on "non-member" prices and then based on "member" prices.
These are your membership prices. This needs to include an annual membership fee as well (this is your base price).
Make sure the prices for the membership tiers are sustainable for people. This may depend on your location. For example, I know providers in Naples (high-end zip code) who are charging double or triple what similar providers are offering elsewhere. If you don't have a local practice, look at what similar practices to yours are charging online.
What you'll find is most of these practices haven't done this basic work to define what they're offering. They are either still operating in the old, outmoded a la carte model, or they are offering memberships where the exact terms are vague. Usually, they are "all-inclusive." Does this mean they will interpret advanced labs? Will they review diet and lifestyle? How much depth will they get into? All of this varies widely. I have found it incredibly helpful to myself and my patients to be as specific as possible.
Have a policy regarding family members. Our policy is simple. If the primary member has family under their roof, they can book time for them as needed. No need for duplicate memberships.
Now that you've got your membership tier prices and policies in place, give members a discount for committing to any given tier.
Why?
Because this makes people feel good, which leads to maximizing your referrals. If you are good at what you do and offer it at a reasonable price, people will send you everyone they know. Maximizing referral is the name of the game - read Alex Hormozi's books or Dan Kennedy's book on the topic to understand the mathematics of why (links above).
What does this actually look like?
I'll use my Silver membership as an example.
Initial consult = $597
Membership fee = $400
Two nursing consults = $90
Total price = $1,087
I cut the price to $997 for the sake of simplicity. That's $597 due at initiation and $40 monthly for ten months.
Let's take a look at the Platinum membership.
Initial consult = $597
Membership fee = $400
Group coaching calls = $1,250
Chat portal support = $480
Quarterly visits with Dr. Stillman = $860
Total = $3,587
I cut the price to $2,997. I generally look for an 8-20% reduction in price. If you've followed everything I've laid out above, you should be able to afford this, still offer great service, and make a great living.
We work business hours and are not available outside of business hours. We try to get back to people within one to three business days.
Now that you've got your memberships priced, it's time for the most important step.
Step 7: Get feedback
Make a list of your favorite clients or patients. Feel free to include people who you wish were clients or patients. Tell them you're working hard to improve what you do and how you do it, and you would value their feedback. Make it clear that you love serving people like them, so you want to make sure that whatever you're planning on launching in your memberships is as close to perfect for them as possible. They'll be flattered. They'll be excited. Ask as many questions as possible and listen as much as you can.
Arrange your memberships so that the people say, “this is such a good deal, if you put it together and launched it tomorrow, I would tell everyone I know about it.” That’s how you create massive growth in your practice, without spending a dime on marketing. This is how I did it and intend to continue to do it. I didn’t need to do this - I could have just generated tons of leads from my social media, provided terrible service, and just replaced old patients with new patients. That business model nauseates me. I am committed to 100% patient satisfaction.
If this still feels overwhelming, then fill out this form and let's talk about it. I would be happy to help you troubleshoot your practice to turn it into what you want.
Until next time, be well,
Dr. Stillman