Medical Empires

You started your practice for freedom, more money, your own schedule, a higher standard of care. Then somewhere along the way it flipped and now you're the provider, the biller, the HR department and the janitor, doing notes until 10pm and starting it all over the next day. In this keynote to a room of nurse practitioners and clinic owners, I break down how to take your life back and build a practice that actually works for you instead of the other way around. I get real about the part nobody puts on the highlight reel. I've put myself in the hospital six times from anxiety building this thing and I share the simple method I use to shut that anxiety off instead of letting a worst-case scenario that will probably never happen run my life every single day. If you've ever thought about quitting, you're not broken, you're normal and this part is for you. Then I get into what actually fixed it. I took my company from 1 to 80 locations in six years and it nearly destroyed me, so we burned it down and rebuilt leaner and I walk through the four things we put in place to run it better. Why your culture and core values start with you and quietly lead to more money. How to hire on core values instead of resumes and why one A-player you overpay beats two B-players or five C-players. Why systems, not your own two hands, are what finally set you free. And the people decisions most owners avoid for way too long, including the hardest advice a billionaire ever gave me about loyalty. If you own a med spa, a practice, or any clinic that's slowly taking over your life, this one is the playbook for getting your time, your money and your sanity back. CHAPTERS 00:00 Why you really started your practice 02:30 What it actually turned into 04:00 The anxiety nobody warns you about 06:30 The method I use to shut anxiety off 14:00 From 1 to 80 locations, and why we burned it down 16:00 The four things we did to run it better 17:30 Live your core values, culture starts with you 24:30 Hire on core values, not resumes 29:30 Get the right people on the bus, A-players only 31:00 When you have to fire loyalty for efficiency 32:00 Systems will set you free Want to join my group of medical entrepreneurs building world-class businesses and world-class lives? Join Charismedx at joincharismedx.com Website: https://www.dralexspinoso.com/ Instagram: https://www.instagram.com/dralexspinoso/ YouTube: https://www.youtube.com/channel/UC2YAyl_kDyo-JP2VBuru5aw Facebook: https://www.facebook.com/aspinoso/ LinkedIn: https://www.linkedin.com/in/alexspinoso DISCLAIMER This talk is for general education only and is not medical, financial, or business advice for your specific situation. If you're struggling with anxiety or your mental health, please reach out to a qualified professional.

Everyone remembers the wigs, the rhinestones, the big laugh, the "dumb blonde from the mountains." Almost nobody realizes that was the strategy. Dolly Parton pulled off what I'd argue is the single greatest magic trick in business and in this one I break down how she did it and why it quietly made her one of the wealthiest self-made women alive. The centerpiece is a story that should be taught in every business school in America. Early in her career, Elvis Presley, the biggest star on the planet, wanted to record one of her songs. His manager slid one condition across the table. What this young woman from a one-room cabin in the Smoky Mountains did in that room broke her heart that night and made her a generational fortune almost twenty years later. I tell the whole thing and what it should teach you about the deals you'll be offered. From there I pull out the lessons her life hands anyone who's building something, about ownership, about why raw talent is actually the cheap part and about a truth most people get completely wrong when they watch someone succeed while being loved by absolutely everyone. She left behind a line I can't stop thinking about and I close on it. This is a tribute. It's also a blueprint. If you've ever been underestimated, you're going to want to hear how she turned that into her single biggest advantage. CHAPTERS 00:00 The greatest magic trick in business 00:48 Her persona was camouflage, not weakness 02:10 Why being underestimated is an advantage 02:24 The Elvis story they should teach in business school 03:58 Own your name, your brand, your song 04:44 Talent is cheap, operators build machines 05:49 You can be a killer and still be a good person 06:37 Find out who you are and do it on purpose Want to join my group of medical entrepreneurs building world-class businesses and world-class lives? Join Charismedx at joincharismedx.com Website: https://www.dralexspinoso.com/ Instagram: https://www.instagram.com/dralexspinoso/ YouTube: https://www.youtube.com/channel/UC2YAyl_kDyo-JP2VBuru5aw Facebook: https://www.facebook.com/aspinoso/ LinkedIn: https://www.linkedin.com/in/alexspinoso TikTok: https://www.tiktok.com/@dralexspinoso #dollyparton #business #entrepreneurship #ownership #mindset #success #leadership #motivation #elvis #DrAlexSpinoso

We had a 10x offer on the table for Genesis Lifestyle Medicine, almost half a billion dollars and we walked away from it. I sat down with Josh Ponton on ASHER Health's Standing in the Gap and told the full story: why the math didn't make sense, the multi million dollar stupid tax I paid learning how to sell a company and the month Brent and I spent wallowing in self pity asking ourselves if we even wanted to keep doing Genesis at all. We decided to burn it down and start over, go back to the core values we forgot while we were focused on the sale and build Genesis 2.0 the way we should have built it the first time. The rest of this conversation is about what it actually takes to build a medical business and most of it has nothing to do with tactics. I talk about convincing my wife to rent out our Palm Springs home so we could live in the foyer of a house where every bedroom was rented, saving up $100,000 and then spending $50,000 of it on a mastermind and carrying a bag of laundry and a bag of quarters across a highway to get to the laundromat. Josh asked me whether I remember my wins or my losses more. I remember the losses. I let them eat at me and that dark energy is still a big part of what drives me. I'm honest in here about whether that's healthy because it probably isn't and why I tell people to document their worst moments anyway. We also get into why 98% of people who own a business shouldn't, why success leaves clues and your first real step is finding a mentor, my grandfather's truck Big Blue and why the cars were never about the cars, what Antoni Gaudí and the Sagrada Familia taught me about building something bigger than your own lifetime and why life isn't short, death just takes a really long time. If you're a clinic owner, med spa owner, or medical entrepreneur who has ever looked at your business and wondered if it's worth it, this one is for you. Big thanks to Josh Ponton and ASHER Health for having me on Standing in the Gap. CHAPTERS 00:00 Burn it down and start over 00:25 Why the cars were never about the cars 13:32 Why 98% of business owners shouldn't own a business 19:15 The sacrifice nobody warns you about 26:06 Find a mentor, success leaves clues 34:56 The $50,000 mastermind that changed everything 49:48 Do you remember your wins or your losses 01:08:27 Walking away from a nearly half billion dollar offer 01:21:49 Life isn't short, death just takes a really long time 01:30:16 Gaudí and building beyond your lifetime Want to join my group of medical entrepreneurs building world-class businesses and world-class lives? Join Charismedx at joincharismedx.com Website: https://www.dralexspinoso.com/ Instagram: https://www.instagram.com/dralexspinoso/ YouTube: https://www.youtube.com/channel/UC2YAyl_kDyo-JP2VBuru5aw Facebook: https://www.facebook.com/aspinoso/ LinkedIn: https://www.linkedin.com/in/alexspinoso TikTok: https://www.tiktok.com/@dralexspinoso #medicalentrepreneur #clinicowner #medspaowner #entrepreneurship #businessmindset #successmindset #resilience #StandingInTheGap #GenesisLifestyleMedicine #DrAlexSpinoso

In 1975 there was a broke, 29 year old actor with about a hundred dollars to his name, no car and a face partially paralyzed from birth that gave him a slurred way of talking every casting director in Hollywood used as a reason to say no. He was so broke he had to stand outside a liquor store and sell his own dog because he couldn't afford to feed it. That man was Sylvester Stallone and what he did next is one of the greatest bet-on-yourself stories ever told. I tell this whole story in this episode because the numbers are the entire point. After watching a nobody club fighter go the distance with Muhammad Ali, Stallone went home and wrote the screenplay for Rocky in about three days. Producers loved it and wanted to buy it and the offer climbed to around $360,000, generational, life-changing, get-out-of-poverty-forever money for a guy who'd just sold his dog. But there was a catch and what he did when he saw that catch is the reason you know his name today. This one is about vision, self-belief and the kind of decision that quietly determines whether you build something that matters or stay a trivia answer. Because you are going to be offered your own version of that $360,000, the safe check, the comfortable exit, the deal that pays you today but quietly asks you to hand over the thing you actually believe in. Most people take it. The ones who change their lives are the ones who cannot be bought out of their own vision. There's even a new movie about this exact moment, I Play Rocky, coming out 50 years later because one decision was that important. So the question I want to leave you with is simple: what's your $360,000 and when they slide it across the table, what are you going to say? CHAPTERS 00:00 A broke actor with a hundred dollars to his name 01:00 So broke he had to sell his own dog 01:20 The fight that lit something up in him 02:00 He writes Rocky in three days 02:30 The $360,000 offer with one catch 03:00 Why he pushed the money back across the table 04:30 He bought his dog back and put him in the movie 05:00 What's your version of the $360,000 Want to join my group of medical entrepreneurs building world-class businesses and world-class lives? Join Charismedx at joincharismedx.com Website: https://www.dralexspinoso.com/ Instagram: https://www.instagram.com/dralexspinoso/ YouTube: https://www.youtube.com/channel/UC2YAyl_kDyo-JP2VBuru5aw Facebook: https://www.facebook.com/aspinoso/ LinkedIn: https://www.linkedin.com/in/alexspinoso #sylvesterstallone #rocky #motivation #mindset #betonyourself #entrepreneurship #success #selfbelief #iplayrocky #DrAlexSpinoso

I joined Neal Karski on the Aesthetics Millionaires Show for a conversation every med spa and clinic owner needs to hear, especially the ones who think the path to wealth is opening more and more locations. Because that's the exact mistake that nearly cost me everything. Most owners believe scaling means expansion: more clinics, more states, more rooms. I did too. I grew fast and found myself running a sprawling operation across multiple states and it was a nightmare, licensing differences, staffing spread thin, culture falling apart, overhead stacking up, problems with more zeros on the end. So I did the opposite of what everyone expects. I pulled back, cut way down and got focused. Fewer locations, run better, is worth far more than a pile of locations barely holding together. In this one I break down the scaling philosophy I coach owners on now: stay small and nimble, which does not mean small money, it means you dominate your area and become the undeniable best clinic in your market before you ever think about expanding. I explain why one clinic doing serious volume is worth more than ten clinics splitting the same revenue, how packing one or two locations full lowers your overhead and strengthens your culture and the real intangibles that quietly destroy multi-location operators. We also get into the entrepreneur's origin and mindset, how a hatred of bad bosses and a prison-yard job pushed me into building my own thing, why you have to surround yourself with other driven people to survive the hard seasons and a goal-setting exercise I give my mentees that most people have never actually done. You close your eyes, write out your perfect day in full detail, the house, the schedule, the life and then you work backwards from that to the exact numbers your business has to hit. Your business becomes the vehicle to a specific life, instead of a treadmill with no finish line. If you own a med spa, aesthetics practice or any clinic and you want to grow the smart way instead of the exhausting way, this conversation will save you years. Big thanks to Neal Karski and the Aesthetics Millionaires Show for having me on. CHAPTERS 00:00 The breaking point that pushed me out of medicine 02:40 Meeting my business partner in a mastermind 10:00 The real lessons behind building the company 27:30 Why scaling too fast almost destroyed everything 29:30 Stay small and nimble, dominate your area 31:00 Why one great clinic beats ten average ones 38:00 Surround yourself with other driven people 39:30 Set your own goals, not borrowed ones 40:30 Write out your perfect day, then work backwards Want to join my group of medical entrepreneurs building world-class businesses and world-class lives? Join Charismedx at joincharismedx.com Website: https://www.dralexspinoso.com/ Instagram: https://www.instagram.com/dralexspinoso/ YouTube: https://www.youtube.com/channel/UC2YAyl_kDyo-JP2VBuru5aw Facebook: https://www.facebook.com/aspinoso/ LinkedIn: https://www.linkedin.com/in/alexspinoso