Do Membership Pauses Sink the Boat? Empathy versus Sustainability

Author: Landen Green, DO

There’s a moment a DPC doc eventually faces — the one where your “human” brain and your “business” brain start politely wrestling in the corner of your mind.

For me, that moment came when a long-time patient reached out to ask if I could “pause” their membership. The reason? Job losses. Tight economy. The usual suspects.

I’ll admit, my instinct was to say yes before they even finished the sentence. I like helping people. I like loyalty. And the thought of adding “losing your doctor” to someone’s “lost job” felt downright cruel.

But my business brain — the one who pays rent, keeps the lights on, and occasionally side-eyes my student loans — reminded me: I can’t pause my expenses. 

So, I did what any conflicted modern professional does: I posted about it on Facebook.

The Pause Debate of 2025

Within minutes, the comments were rolling in from fellow DPC docs.

Half were in the “be generous” camp:

“People will never forget how you made them feel.”
“Business grows at the speed of trust.”
“I’ve done this and those patients would bleed for the practice now if asked.”

The other half were firmly in the “don’t do it” camp:

“Bills don’t pause for anyone.”
“You have to put your mask on first.”
“Solid doctor move, terrible business move.”

Others were more structured with practice policies: one-time freezes, hardship discounts, grace periods. Others simply didn’t allow it, citing messy bookkeeping and the danger of setting unsustainable expectations.

It was an even split.

My Call

Thanks to the insight from my colleagues, I landed here:

“It would be poor form for me to have you lose your jobs and your doctor all at the same time. Let’s come up with a way to make this work! 

You and your husband pay whatever you feel like you can for 3 months and then we will re-evaluate. If that is $0, that’s completely okay. Or, we can potentially barter! Even if you can’t afford the membership, maybe you and your family can help us in some way? We could use some artwork in the office, think your kiddos would be willing to work on something for us? 🙂 

The point is, I don’t want to change your health care based on the economy or job loss. I will take care of you and your family just like I always have for the next three months regardless of payment. I am on a waitlist now, so things are busy and my rent and mortgage can’t be paused, but we can continue care in the same way.  I will pause the payment completely, reduce the payment, or change the payment medium (barter) – whatever works best for you and your family and we will discuss it again in 3 months. 

Let me know your thoughts! 

Best,

Dr Green”

She lit up. And soon, I had a gorgeous portrait of a boat hanging on my wall (the image above) — a daily reminder that kindness has a way of coming back to you. 

They’re now back to paying full price, they’ve referred several of their colleagues at their new jobs, and I’d bet my next cup of coffee they’ll be with me for years to come and will refer me to many, many more patients.

Why This Worked

It was personal, not policy.
I like the fact that I can meet people where they are and customize a response that fits their needs and situation. This is one of the great things about small business ownership. I didn’t announce a blanket freeze for everyone who was “worried about the economy.” This was a real hardship, addressed one-on-one.

It kept the relationship alive.
Dropping care during a tough time can feel like abandonment. By staying in their corner, trust soared. Not only that, the family of 4 members never left the system. It’s much easier to retain current patients than bring in new ones. 

It turned generosity into marketing.
The best kind of organic, word-of-mouth, “you have to meet my doctor” kind of marketing.  I didn’t lose out on future revenue and gained more from their referrals. In this case, the “human brain” won and ended up shocking the “business brain” by coincidentally increasing revenue. 

The Takeaway for DPC Docs

Your business brain isn’t wrong. Neither is your human brain. The trick is figuring out where they can coexist without burning out one or bankrupting the other.

Sometimes that means holding the line. Sometimes it means bending — but in a way that feels intentional, sustainable, and aligned with your values. Being able to determine which should win can be a powerful skill and is a great part of being a business owner. 

In my case, it meant a free membership for three months, a priceless piece of art, and a patient who’ll advocate for my practice far more effectively than any paid ad.

Because here’s the thing: Good people still exist. Doing good for the sake of doing good is still the best way to move in both the human brain and business brain, and they don’t have to be opposite. Often, doing the right thing isn’t just morally satisfying; it’s good for the brand. And what’s good for the brand is good for business.

In a world where trust in healthcare is in incredibly short supply, that boat painting is worth more than a few months’ membership fee.

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