Client: American Medical Association (AMA)
Challenge: Flat membership, physician apathy, and a story no one was telling effectively
Outcome: Membership growth rate doubled; acquisition costs fell; retention rose; member satisfaction reached new highs
The Situation
Most executives would have filed it away. Unger flew to meet him for lunch.
What he found in that airport hotel was a doctor who had written a book about what it felt like to be a physician in America today — spending two hours on administrative work for every hour of patient care, fighting insurance companies for basic approvals, watching patients leave the pharmacy unable to afford their prescriptions. The second chapter of that book was titled: Why the AMA Must Die.Unger’s takeaway wasn’t defensiveness. It was clarity. “If I had him for 20 minutes,” he said, “I could turn that around. But I can’t fly all over the country and have lunch with everyone who doesn’t like the AMA. How do we scale this story?”
That question became the foundation of what Unger and Sequence Consulting would call the Digital Reboot.
What We Found
When Sequence began working with the AMA, the organization had done many things right. It had made changes, invested in modernization, and tried to keep up with a rapidly shifting profession. And yet membership was flat. The largest segment of physicians had no opinion about the AMA whatsoever — not hostile, not engaged, simply apathetic.
The diagnosis Sequence brought was precise: the AMA had a storytelling problem, not a product problem.
The organization was doing consequential work — speaking for physicians in Congress, confronting chronic disease epidemics, removing the administrative barriers between patients and doctors, driving the future of medicine. None of it was breaking through. Physicians didn’t know what the AMA was doing because the AMA had never built the infrastructure to tell them.
Three specific findings shaped what came next:
Physicians didn’t need more benefits. They needed a reason to believe. The instinct in most membership organizations is to add value through discounts, access, and tangible perks. What Sequence and the AMA team found was that these incentives could push someone over the edge — but they couldn’t create the underlying will to join. That required a clear, compelling answer to a simpler question: does the AMA represent me? Most physicians couldn’t answer yes, not because the AMA didn’t represent them, but because they’d never been told how.
Demographic segmentation wasn’t predictive. Behavioral segmentation was. The AMA had extensive research on physicians by age, specialty, and career stage. But these segments weren’t reliably associated with membership likelihood. Sequence led a mapping exercise that traced physician journeys from medical student through retirement — and the AMA team then built a data-driven behavioral segmentation from actual content interactions across email and web. Three segments emerged that were genuinely predictive: Practice Innovators (focused on running their practice and keeping up with technology), Activists (deeply engaged in advocacy), and Learners. Each needed different content, different messages, and different reasons to join.
The AMA’s publishing model was organized around internal priorities, not member needs. Content was produced by business units promoting their own work. The result was a fragmented publishing platform that served the organization’s internal structure rather than the interests of the physicians it was trying to reach. A tectonic shift was needed: from community newspaper to strategic publishing platform, with every piece of content evaluated against whether it served the member segments the AMA was trying to reach and retain.
The Approach
Working with Unger and the AMA membership and marketing team, Sequence helped design and execute the Digital Reboot — a comprehensive strategy to rebuild how the AMA recruited, engaged, and retained members across every digital touchpoint.
1. A new value proposition — built from listening, not assumption. The team went back to physicians, students, and residents and asked what they actually needed from the AMA. What emerged was a positioning built around a single idea: the physician’s powerful ally in patient care. Every word was chosen deliberately. Physicians had entered medicine as a calling. In an era when control over their practice was being stripped away — by insurers, by administrative burden, by technology — they needed someone unambiguously in their corner. That’s what the AMA could be, and that’s what the new positioning said.
2. Behavior-based segmentation driving personalized outreach. The new segmentation — Practice Innovators, Activists, Learners — replaced the old demographic approach and became the organizing logic for all membership communications. Instead of broadcasting the same message to all physicians, the AMA could now speak directly to what each segment cared about. An Activist received messages about what the AMA had saved them — “Did you know the AMA saved physicians $500 million a year by blocking that merger?” A Learner received content tied to clinical and educational resources. The response was consistent: I had no idea.
3. Membership Moves Medicine — a campaign built on proof points. The AMA launched a membership campaign called Membership Moves Medicine, built on a library of concrete, translatable proof points drawn from across the organization. The hard work wasn’t creative — it was canvassing every corner of the AMA, listening to what was actually being achieved, and translating organizational wins into language that a physician would recognize as relevant to their daily life. The campaign closed the gap between what the AMA was doing and what physicians knew it was doing.
4. Making physicians feel powerful — literally. One of the most unexpected elements of the campaign came from a photographer who normally shoots celebrities. The AMA began photographing its own members — physicians, students, residents — in the same style. When one member picked up her photo, she said: I feel really powerful. That moment crystallized something important. The AMA’s value proposition was about being a powerful ally. If the organization could make physicians feel powerful through its marketing — in an era when control was being taken from them — that was the brand strategy made real. Forty-foot banners with member faces hung from the ceilings at the AMA’s annual meeting. For many staff, it was the first time they’d seen a member’s face in the building.
5. Rebuilding the affinity program around real physician needs. The existing affinity program was a semi-random basket of discounts — including a popular Mercedes-Benz discount that drove joins but not loyalty. Members would join for the discount and leave. Sequence helped the AMA rethink the program from scratch: not what could generate revenue or partner fees, but what would meaningfully address the real problems physicians faced. The result included partnerships targeting physician burnout (Headspace meditation, offered free for two years) and medical student debt (Laurel Road financial services). Benefits that aligned with the AMA’s mission and built the kind of value that drove renewal.
The Result
The AMA doubled its membership growth rate.
Acquisition costs fell. Retention improved. Member satisfaction reached new highs. And critically, the Digital Reboot didn’t just produce numbers — it produced a repeatable system. The behavior-based segmentation, the proof-point publishing model, the Membership Moves Medicine campaign infrastructure — these weren’t one-time interventions. They were capabilities the AMA now owned and operated.
The results have been independently corroborated by multiple external sources. ASAE’s Associations Now reported that “AMA experienced a 35 percent growth from 2011 to 2020. And, during the first year of the pandemic, membership was the greatest it’s been since 1949.” At the AMA’s 2024 House of Delegates meeting — documented in a report published by PubMed — the CEO stated that membership had “climbed to levels not seen for decades” and that the AMA had achieved “outstanding financial stability.” These are not claims made by Sequence. They are documented by independent editorial and institutional sources.
“We doubled our rate of growth much faster than expected. Our acquisition costs are lower. Our members are happier and more engaged. Retention is up.” — Todd Unger, Chief Experience Officer / SVP Physician Engagement, American Medical Association
“It’s been a dramatic impact. Transformative. They’ve been critical in achieving what we have in two years. We could have never done it without Sequence.” — Todd Unger, American Medical Association
What This Means for Your Association
The AMA’s challenge before the Digital Reboot is one of the most common patterns Sequence encounters: an organization doing genuinely valuable work that its members don’t know about, communicate in language its members don’t connect with, and structured around the organization’s internal logic rather than the member’s actual experience.
The instinct, when membership is flat, is to add benefits, run promotions, or invest in acquisition campaigns. What the AMA’s story shows is that none of that works until the underlying story is right. Incentives can push someone over the edge. They can’t create the will to join.
Three questions worth asking about your own association:
If a physician — or engineer, or attorney, or accountant — asked you why they should join, could you answer in 30 seconds in a way that made them feel represented and understood? Or would the answer be a list of benefits they could probably find cheaper elsewhere?
Does your content serve your members’ interests, or your organization’s internal structure? The two are often not the same.
Do your members know what you’ve done for them lately — specifically, concretely, in terms they recognize as relevant to their daily work?
For the AMA, the answers to those questions in 2015 were uncomfortable. The work of making them comfortable again is what the Digital Reboot was. And the growth that followed wasn’t luck — it was the predictable result of an organization that finally learned to tell its own story.
About Sequence Consulting Sequence Consulting works exclusively with professional and trade associations to grow membership, strengthen revenue, and clarify strategy. Founded in 2001 by Chris Vaughan, PhD and Lisa Vaughan, Sequence brings the rigor of Big Strategy consulting to mission-driven organizations. Trusted by 12 of the top 20 U.S. associations.
