Before her mother, Frances Keeffe, was diagnosed with amyotrophic lateral sclerosis (ALS), Etain co-founder and CEO Amy Peckham hadn’t given much thought to the medical potential of cannabis or considered it as a treatment option for “Granny Franny,” as Amy’s four children called her. It was 2009, and cannabis was still illegal in New York and therefore off limits.

Amy accompanied her mother to many of her appointments, and it was difficult to watch. Keeffe’s prescription list grew to the point where she was taking 18 medications a day to manage her symptoms, which included debilitating pain, excess saliva, digestion problems and nausea. Amy’s father, a lawyer, questioned the doctors, but with so many medical professionals involved, it was hard to know what was best and who was right.

“Never was [my mom considered] a holistic individual, with quality of life needs. [Her treatment] was taken piece by piece, and no one [questioned other] professionals,” Amy says. “It led to situations where she was quarantined because of drug reactions. It was clearly the combination of the medications, yet no one would decouple all the overprescribing. That was a very frustrating situation. My father had been a practicing attorney, and he would just sit there saying, ‘They’re killing her, they’re killing her,’ (as if she wasn’t in a terminally ill situation).”

A doctor suggested cannabis in 2012, the year her mother died, but with no access to tested, regulated product at the time, it wasn’t an option. Keeffe—who followed doctor’s orders and laws by the book—would not consider something illegal. But Amy wished her mom’s situation were different, and that there were an alternative.

Just two years later, the legal landscape would change, and Amy and her two daughters would not only champion the benefits of the plant but also launch a New York-based medical cannabis provider, called Etain.

Business and Personal

While Keeffe was struggling with ALS, also known as Lou Gehrig’s disease, Amy’s daughter Hillary Peckham was in college, dealing with a medical challenge of her own: After a failed hip surgery in her teens, Hillary was left in intense pain and had to relearn how to walk.

“I’m still in a lot of pain from my injury, and it’s been almost 10 years,” says Hillary, now Etain’s COO. “I was trying to get through school and college and was given an accelerant, like Adderall, and Percocet, so something to help me … stay awake while I was also taking an opioid. That didn’t give me any quality of life, and I had a lot of reactions to those types of medications.”

She longed for a better alternative.

Hillary was pursuing a career in music therapy, and her sister Keeley Peckham, who studied plant science and cell biology in college, was in New Orleans preparing to launch a horticultural therapy program at nursing homes in the area.

In 2014, when New York legalized cannabis for medicinal use, Amy dug into the research available and followed the legislative hearings, and it changed her perception of cannabis.

“I just felt very strongly that people should have more control over their alternative choices for care, and that there should be a more open discussion with the medical community,” Amy says. “There should be product safety, and as a mother of four, I wanted consumer safety.”

The Peckhams, despite their unfamiliarity with cannabis initially, had a background that happened to be ideal for running a vertically integrated cannabis operation. Amy had the legal and business acumen from her involvement in her father’s law practice and her husband’s family-owned construction company. Keeley, who is now chief horticultural officer at Etain, had the plant science background, and Hillary decided to pursue a business certificate at Dartmouth College.

But Hillary was surprised when her mom pitched the idea.

But she was eventually attracted to the opportunity for patients to live better lives and opportunities for women leaders.

From a Slow Start to Building a Team

Ten medical cannabis companies in New York serve more than 107,870 (and counting) certified patients. Well-known giants like Curaleaf, MedMen and Vireo Health are just some of the other organizations operating in the state. Each company operates a manufacturing facility and up to four dispensaries, per state regulations, which is partly why Etain closed its Albany location in 2017 to make way for its Manhattan dispensary, the smallest of its four storefronts, sandwiched between iconic New York City brownstones.

When Etain applied for its state license in 2015, the company had to commit to open a dispensary within 180 days. The Peckhams made that deadline but weren’t greeted with lines at the former Albany store or the Kingston location as seen in other states when they first roll out medical legalization. Not one patient visited that first day. Or the next. Or the entire week of Jan. 7, 2016.

“It took us two weeks to see our first patient,” Hillary says. “Things steadily improved from that point. There definitely was a lapse, and that was nerve-racking when you open your doors. It was a good opportunity for additional training for everybody to get ready, but they were very excited when the first person walked through the dispensary.”

After the slow start, the company began to grow (and now serves 25,000 patients in the state). Finding the right people to join the team was a major obstacle during the early years, recalls Hillary.

“Five years ago, when we were preparing for our [state license] … there was really a lack of legitimate and standardized knowledge,” Hillary says. “That still is not necessarily developed today, but it’s come a long way. Finding people with credentials and a real resume who wanted to work was very difficult. Most of the time we had to search in other industries to try and find relevant expertise because it didn’t exist for the cannabis industry. So, we had to find pharmacists, pharmaceutical manufacturing expertise, horticultural expertise.

“Especially with the competitive [license process], they do background checks on everybody, so using a cannabis cultivator from the illicit market, usually they have some sort of criminal background that pops up, or if they do an investigation, issues come up,” Hillary continues. In New York, the Compassionate Care Act prohibits registered organizations from being managed by or employing anyone who has been convicted within the past 10 years of any felony of sale or possession of drugs, narcotics, or controlled substances. This restriction only applies to those managers or employees that come into contact with or handle medical marijuana, according to the health department.

“So you can’t really use [illicit growers] as a resource even if they have knowledge, which is just a conundrum in the industry, [along with] finding people that were committed to make the quality product we wanted,” Hillary says.

Part of that quality involves keeping growing conditions consistent to keep plants and the product consistent, Keeley says.

“We take a really scientific approach to change. When you do find somebody who is a good fit and is excited and [has] good ideas, there is also patience required,” Keeley says. “We can’t just change what we’re doing. In order to implement an improvement, you need to try it on a few plants, and then some more. We go through about a yearlong process of testing an idea before we put it in a full production setting.”

For Keeley and her family, producing quality products for their patients and making it as easy as possible to consume is the overarching mission.

“Everybody deserves access to safe product, and that’s one of the fundamental aspects we look for in our HR process,” Keeley says. “Safety is our No. 1 priority. Our current cultivation manager is excellent, and we really have a good team. And that’s true for all our departments. We’ve got a great team on manufacturing, on cultivation and on pharmacy, and finding a good leader for those teams has been totally essential to our success—and they are actually all women.”

Women-Led

The fact that all team leaders are women at Etain isn’t surprising. Seventy percent of the company’s 50 employees are women. “In starting our own business, we wanted to create something that would help promote women in the workforce and give them opportunities to have a successful career,” Hillary says. They were able to find qualified candidates through Women Grow, a networking organization for women in the cannabis industry, and Joseph Stevens, their chief compliance officer, who had experience with hiring in the market.

“[My mom] Amy and I were inspired by the movement to have women enter the cannabis industry. Coming from a family that is in the construction industry, there is not a large female presence,” Hillary says. “We started going to a few conferences, and we found Women Grow. We were part of their very first meeting ever, and I was really captivated by the support that women give each other industry and the help that this gives patients.”

The Peckhams attribute much of their success to their team and say hiring women has been a smart business decision.

“Starting as a woman-owned company and making an effort to hire and promote women has turned out to be very advantageous,” Hillary says. “It has led to a staff that is very empathetic and compassionate toward patients. We’ve established that we’re willing to take as much time as necessary to answer any questions and help patients. All of our patients get a sit-down consult with our pharmacists, who are known to spend an hour with patients if that’s what they need, go through their medication history and also be in contact with their primary health provider so that patient is getting the best care possible.”

Often, the sit-down consults are patients’ first experiences with cannabis, Hillary says, and they want to be sure they feel safe, heard and understood.

Quality and Innovation

Innovation complements the Peckham’s mission to make cannabis accessible for all. Plus, New York regulations are stringent—combusting medical cannabis is not permissible, so you won’t find flower at dispensaries there. Edibles are also prohibited. Etain has created an array of products, all produced in-house, to make its medicine as accessible to as many people as possible.

“We just came out with our water-soluble powder that’s patent-pending, and we released our honey lozenges and lotions this year,” Hillary says. “We are actively pursuing and trying to figure out different methods of consumption to make it easier for people to medicate.”

That includes a peppermint-flavored spray for people who may not like the taste of cannabis or for people who have arthritis and may struggle with a pill bottle or fussy droppers that are prone to dispensing more medicine than the patient planned to consume. Etain’s tincture measures out in exact one-drop doses, Keeley says. The company also avoids any unnecessary additives and ingredients to reduce potential variability in the product and production complexity, Hillary says.

The cultivation facility follows the standard of Good Agricultural Practices, the manufacturing facility follows Good Manufacturing Practices and all ingredients are U.S. Pharmacopoeia Grade (USP), she adds.

“Especially the way we are regulated, reproducibility and consistency [are metrics] of our product,” Hillary says. Etain’s products are tested at the health department’s Wadsworth Center, which has strict criteria for acceptability. The company must predeclare dosing, with a small margin of error for how much potency can vary, Hillary says. All registered organizations are held to those same standards, according to the state health department.

Future and Family

Although a bill to legalize adult-use cannabis died in the New York state legislature this past summer, it is something the Peckhams are monitoring closely as much of their future depends on how the state proceeds with an adult-use program. Should adult-use consumption be allowed in New York state without allowing medical companies a path to transition, it would “essentially put us out of business,” Hillary says.

But that isn’t the only roadblock Etain is facing. There are potential fixes to the medical program that could improve the market’s standing, including whether the state expands its limited list of qualifying conditions, which currently includes ALS, cancer, epilepsy and neuropathy. Since the program’s launch, chronic pain and opioid-use disorder have been added to that list, expanding the number of patients who qualify. After chronic pain was added in March 2017, the number of registered patients nearly tripled in the state by the end of that year, going from about 20,700 to close to 58,000.

“The limited range of products, I think, has contributed to slower growth in the New York program,” Hillary says. “I’d like to see more development and regulatory changes to allow for more diversity of product. Additionally, something that would make the program more successful is if doctors can prescribe medical marijuana at their own discretion, as opposed to having to … take a course and only being able to write a certification for a select list of diseases that are legislated.”

Regardless of what happens, the Etain team says it will evolve alongside the program and patient needs, always relying on family through the process. In addition to Amy, Keeley and Hillary, Hillary’s twin brother, J.D., works for Etain, as do her and Keeley’s husbands. Hillary considers it to be an advantage.

“We’re all committed to the same goal, and in a way that is very unique for an employee because it is our lives,” Hillary says. “As owners, we spend as much time as necessary to get the job done and always stay committed to the goal and why we started the company. People talk about work/life balance, but I think that not having one has made us successful and allowed us to adapt very quickly and make changes on the fly.”

Competition for dispensary dollars isn’t cooling down. With online ordering and home deliveries becoming more popular, your circle of competitors keeps expanding. Will your customers love you or leave you? That may depend on your answer when they ask, “What’s in it for me?” Help can come in the form of a loyalty program that makes customers happy and your business profitable.

Cannabis Dispensary reached out to four dispensaries with loyalty reward programs. Here’s an inside look at what they offer and how they make customer loyalty work for customers as well as for their businesses.

Silver Stem Fine Cannabis, Colorado

Annalise Dean, Store and Social Media Manager

Program type: Visit- and spend-based

As manager of Silver Stem’s largest location and social media manager for the company, Annalise Dean oversees customer rewards for Silver Stem’s five Colorado dispensaries. The company is big on loyalty, and customers are big on Silver Stem’s program. “Our customers are earning lots of rewards,” Dean says.

What it offers:

Silver Stem’s loyalty program embraces visits and dollars spent. Members earn 30 sign-up points and 20 points per check-in. Instant redemption yields free branded lighters or rolling papers, but most members accumulate points toward prizes that range from edibles and merchandise to cartridges, resin and flower.

State regulations prohibit cannabis “gifts,” so many rewards have a penny price attached. “The most coveted prize is the ounce for a penny,” Dean shares. Members with 420 points get a penny ounce of the in-stock flower of their choice.

Spend-based rewards start with a 15-percent sign-up discount and continue with a 5-percent store credit ($10) for every $200 spent. On their birthday, members receive a pre-roll for 1 penny—no additional purchase required.

The enrollment process:

Silver Stem works membership into the checkout process. To register, customers enter their names, phone numbers and emails on an iPad. Staff encourages tourists to enjoy the benefits (and future marketing messages) as well. Existing members check in on the iPad by phone number and can view available points.

“We do suggest that our members save their points, because the penny ounce is the best deal rewards-wise,” Dean explains. “But it’s really good for people that are broke or out-of-towners to use them right away.”

Silver Stem hopes to enroll 90 percent of its customer base in its rewards programs; it currently has 70 percent to 80 percent enrolled, according to Dean. “Most people that don’t want it are still kind of afraid of having their number in a system somewhere,” Dean says. Staff work to ease those privacy fears.

Tools and tech that help:

Silver Stem simplifies tracking visits and buying habits with Flowhub point-of-sale (POS) software and Baker Technologies’ rewards platform. Members can check points at any location, and budtenders can view purchasing history to identify that awesome strain a member bought during their last visit.

“It’s a great way for us to know what our customers like,” Dean says. The system also provides fuel for targeted marketing texts, so members who prefer edibles get edible-related texts instead of messages on things they don’t like.

Why it works for Silver Stem:

One bonus at Silver Stem is the sense of family and friends its loyalty program fosters. Staff’s favorite days are when regulars come in—with extra-big smiles—to claim their penny ounce. “We definitely make a really big deal out of it, and we celebrate. We’re really big on high-fives,” Dean says. “[People] have a good experience and trust us. They tell their friends and family.”

Southwest Patient Group, California

Jay Araiza, Chief Communications Officer

Program type: Visit-based

Like many elements of California’s evolving cannabis industry right now, dispensary loyalty programs are getting makeovers to suit regulations. Southwest Patient Group’s (SWPG) long-standing loyalty program that rewarded visits and spending at its San Diego location serves as an example. The company had to end the program, and a transition program is in place. Chief Communications Officer Jay Araiza says a more permanent solution is currently being developed.

What it offers:

“We’ve always had a very unique, very popular loyalty rewards program,” Araiza explains. Under the old plan, every 15 visits, patients received a credit equal to their average per-visit spending during that period. Credits from $20 up to $500 were common. “People came to us because of our retention program,” Araiza says. New regulations that prohibit “gifts” ended the program’s run.

Members now receive a 50-percent discount every 15th visit, with no limit on the purchase amount. SWPG is still exploring options to work with new laws and simplify the program. “We also want to scale it back, because it was really good, but we were losing a lot on some of those visits. But the retention was there!” Araiza says.

The enrollment process:

SWPG’s membership program doesn’t require formal opt-in. Anyone entered in the POS system qualifies for rewards via the information the dispensary was required to gather by the state. While the old program was popular, members are warming up to the new structure.

“Some of our [longtime] patients have questioned our new policy and the changes to our previous format, but they’ve been understanding with the changes over time in the industry,” Araiza says. Members are buying more on their 15th visit, too.

Tools and tech that help:

SWPG’s POS system tracks visits and purchases, but all averaging and reward calculations were performed manually until now. Araiza feels SWPG’s attachment to its old program, which standard loyalty software didn’t accommodate, was the biggest hurdle to utilizing badly needed automation.

Now, ready to move on, the company is reviewing several cannabis-industry platforms—and leaning toward a points-per-visit program to encourage members to return more often. Automation will improve accuracy and reduce administration costs.

Why it works for SWPG:

“From the marketing standpoint, [a loyalty program] is a must-have tool, especially in this day and age when the customer has all the power to [shop around for] products and services,” Araiza says. “People can be more picky about where they go. As a business, you need to offer something that makes them want to come back to you.

“Overall, our main thought is we want to see good retention of our customer base. [With a loyalty program], you really get to know your customers—what they like, how frequently they come, how much they spend. From a customer standpoint, it shows you value them. They feel cared for,” Araiza says.

The+Source, Nevada

Dan Zarella, Director of Marketing

Program type: Spend-based

Insights driving The+Source’s customer loyalty program come from hundreds of in-store interviews conducted by Director of Marketing Dan Zarella at the company’s two Nevada locations. The result is a “super-duper simple” program that keeps rewards easy for customers and staff.

What it offers:

The+Source loyalty members earn one point for every dollar spent. Twenty-five points earns $1 in store credit. Members can earn and redeem points on any product instantly or after points accumulate. Points transfer between the company’s Las Vegas and Henderson locations. No black-out days or minimum thresholds for redemption exist. Zarella says that state regulations prohibit giving away products, so a minimum purchase is required.

The enrollment process:

Zarella’s in-store research yielded some unexpected insights. “One of the things that really surprised me, honestly, was how excited people were for the rewards program,” he says. Though current stats aren’t available, he says program participation historically has been high.

Recently streamlined, enrollment is simple. Customers text “REWARDS” to a designated phone number to register. Once in-store, staff verifies age and other essentials, and new members can opt-in to emails and texts. Future check-ins require ID—no extra loyalty cards. Customers can check their accumulated points in-store.

Tools and tech that help:

With a simple program, Zarella doesn’t believe extra technology is crucial to success. “Basically, every point-of-sale system I’ve seen in the industry can do our style of loyalty program,” he says.

The spend-based program wins out over visit-based rewards for member ease, Zarella says. “I think the customer experience is a lot more seamless with a dollar-based point system because it’s just in the POS system. There’s no extra process to check in,” he explains.

The most important “tool” for the program? The+Source staff. “Your staff is your best and first line of communication with your customers,” Zarella says. The+Source budtenders motivate customers to enroll by explaining the program’s value—and it helps when customers see members claim rewards.

Why it works for The+Source:

“The primary benefit [for us] is that we’re encouraging people to be loyal return customers,” Zarella explains. “Rather than go out and get a bunch of new customers, we’d really love to learn how to suit our existing customers so well that they go and tell 10 of their friends about the loyalty program.”

“At the end of the day, what really matters isn't the technology. It's: Are you listening to your customers and are you trying to give them what they're looking for? The technology is just a way to do that,” Zarella says. “I don't think you need a ton of it. I do think you need to care."

Green Lady, Washington

Mike Redman, President

Program type: Visit- and spend-based

Green Lady has experimented with different types of loyalty programs over the years. “We’re always the guinea pig for tech companies. It’s kind of an interesting place to be, but we like it,” President Mike Redman says. The company offers two programs in its three Washington locations.

What it offers:

Green Lady’s primary program rewards spending. Members earn 1 point for every $1 spent, and 100 points yields $5 credit. “That rewards them for regular shopping and kind of gives a volume discount,” Redman explains. Loyalty members also receive a 10-percent birthday discount.

Visit-based rewards focus on customer satisfaction “with a little bit of loyalty and retention thrown in.” At every 10th check-in, members earn a variable discount. Each check-in allows the opportunity to share requests or concerns. “If there’s something they want to see or something they’re not completely satisfied with, it gives them that interface with us, so the managers and owners can see everything at the sale level,” Redman says.

That’s not all. Green Lady throws two members-only parties a year, one for 4/20 and one for Halloween. (Think bands, food trucks, costumes, fire dancers and trapeze artists.) The last bash drew about 400 people, according to Redman.

The enrollment process:

Loyalty sign-up stays simple and, for those who want it, anonymous. Budtenders enroll members based on a name and phone number, real or fictitious. “They can have anonymity if they want,” Redman says.

Green Lady also lets members decide whether product preferences are tracked. As an incentive, members who opt in receive targeted text and email blasts with flash deals.

“In the beginning, [customers said] ‘Absolutely not!’ [to having product preferences tracked]. Now with cannabis legal in most of the country in one way or another, people are more comfortable. It becomes like their [grocery store] membership card,” Redman says. “By tracking preferences, we can make recommendations on strains they might like. If they have a request, we can track that [product availability] as well.”

Loyalty membership totals around 5,000 between Green Lady’s two Olympia locations, with another 1,500 members from its Lynnwood store.

“[Loyalty] really comes down to customer service. If you're using a good POS system, it makes you stand out more as far as service. It’s an important thing.” Mike Redman, President, Green Lady

Tools and tech that help:

Cannabis retail software keeps loyalty easy and efficient. “We use Cova for our in-store loyalty, all of our front-of-the-house point-of-sale, and for tracking all of our customer interface,” Redman says. The customer-satisfaction program uses the Baker platform.

Redman recommends a POS system with loyalty-program functionality that can track preferences and reward volume spending. “If they spend a bunch more on product, they should get kind of the ‘Costco price’ instead of the convenience store price," he says.

Why it works for Green Lady:

“[Loyalty] really comes down to customer service. If you're using a good POS system, it makes you stand out more as far as service. It’s an important thing,” Redman says. “Customers don't really know the nuts and bolts of the technology that we use, but … we're able to offer real-time information as far as strains they like and analytics.”