Most clinicians don’t set out to build the wrong practice model.
They build the model they were told to build.

Someone on Instagram says memberships are the future.
A colleague swears packages are the only way to create continuity.
A consultant insists fee-for-service is the simplest path to scale.

So clinicians adopt a model that looks good on the surface.
And six months later the numbers feel off, the delivery feels heavy, and the business feels harder than it should be.

Not because the model was wrong.
Because the strategy behind it was never intentionally designed.

When I look at how a practice should be structured or evolved, I never start with trends or what is working for someone else. I start with three lenses. These three lenses determine whether a practice model becomes sustainable or starts unraveling the moment more patients come in the door.

This is the real work behind every membership, every package, and every fee-for-service clinic that actually runs smoothly.

#1: How You Will Deliver the Care Inside the Model

This is the most overlooked piece.

You cannot choose a business model without designing the clinical delivery that supports it. The model and the medicine are inseparable.

If it is a membership, how do patients move through it?
What outcomes are you promising over time, and what structure supports that level of consistency?

If it is a package, what ensures the experience feels guided and results-driven instead of transactional?

If it is fee-for-service, how do you create continuity of care and perceived value so patients stay engaged long-term?

Delivery determines reputation.
Reputation determines demand.
And demand determines revenue.

You cannot sell a model you cannot operationalize.
And you cannot operationalize a model that does not match your clinical flow.

#2: How You Will Position and Sell the Model in Today’s Market

Every model lives and dies by its positioning.

You can have a clinically sound service, but if the value is not communicated clearly, it will not convert. This is the gap that separates practices with full calendars from practices that always feel one month away from a dip.

So I ask:

How does this model fit into today’s market?
Is there a clear emotional and financial reason for a patient to choose it?
Are you articulating an actual transformation, not just access?

Memberships sound simple to sell, but they are difficult to position in a way that reflects clinical credibility. Packages work beautifully when they are outcome-based, but fall apart when the marketing reads like a menu of sessions. Fee-for-service models can thrive when framed as luxury care, but fail quickly when priced like convenience medicine.

Positioning is an art.
Clinicians who understand it will always outperform those who rely on credentials alone.

#3: How You Will Operationalize the Model With the Team and Resources You Actually Have

This is where reality checks the vision.

It is not about which model feels appealing. It is about what your team can sustain today and what your systems can support without overwhelming you.

So we look at:

What does your current staffing allow?
How efficient is your scheduling, automation, and communication?
What revenue will this generate in real life after margins, time, and workload are factored in?

The most dangerous model is not the one that fails.
It is the one that succeeds at the expense of your energy and your profit.

Every sustainable practice model is built on operational alignment. If your capacity cannot support the model, the patient experience suffers, the team fractures, and the financials never stabilize.

The Real Reason Most Models Fall Apart

There is a reason not every clinician with a membership is thriving.
There is a reason not every package-based business feels organized.
There is a reason many clinicians default to fee-for-service even when they know it limits growth.

Because designing a scalable model is not about the model.
It is about the strategy behind it.

A membership is not a business strategy. A package is not a business strategy. Fee-for-service is not a business strategy. They are containers. The success of each container depends on the delivery, the positioning, and the operational backbone behind it.

When those three elements align, the model works.
When even one is off, the entire structure strains.

The Bigger Picture

If building a sustainable practice model were as simple as choosing a recurring revenue structure, everyone would be doing it successfully. They are not.

Because the choice is not the work.
The design is the work.

The right model is the one that supports how you practice medicine, how your patients experience transformation, and how your business operates behind the scenes.

When you start viewing your practice through the three lenses of delivery, positioning, and operations, you stop chasing trends. You stop comparing your offering to what someone else is doing. You start building for clarity, longevity, and stability.

And that is the model that lasts.

If this resonated, here’s your next step.

Designing a sustainable practice model is not about guessing, copying, or trial-and-error. It requires structure, strategy, and support that bridges clinical excellence with real-world business execution.

That is exactly what we do inside The Business Academy.

The Academy is designed for clinicians who are ready to stop reacting to trends and start intentionally building a practice model that works for their patients, and their life. We guide you through designing your delivery, positioning, and operations together so your business grows without burning you out.

If you are ready to build a model that actually lasts, join the waitlist for the next enrollment of The Business Academy.