The Spinoso Podcast

The FDA just reclassified peptides and it is going to reshape how med spas and medical practices operate in 2026. In this episode I break down exactly what the new FDA 503A peptide rules mean for your med spa business, which compounds are still legal to prescribe and the four step framework I am using to protect my own clinic and actually grow from this instead of getting crushed by it. Most clinic owners are going to panic or ignore this. I have watched both play out and neither one works. I walk you through what goes in the trash, what you can do this week with zero legal risk, what to build over the next few months and the long game I am playing while everyone else waits to see what happens. I also go compound by compound through the peptides every physician entrepreneur should understand right now, from BPC 157 and TB 500 to Semax, MOTS-c, GHK-Cu, and more, and where each one fits inside a real med spa business plan, a GLP-1 program or a recurring revenue membership model. If you are a physician entrepreneur, med spa owner or healthcare professional trying to move from doctor to CEO, this is the exact conversation I wish someone had walked me through before I built 80 locations. Learn more about Charismedx at joincharismedx.com Website: www.dralexspinoso.com Instagram: www.instagram.com/dralexspinoso YouTube: / @alexspinosomd Facebook: / aspinoso LinkedIn: / alexspinoso TikTok: / dralexspinoso

Mexico had already won their group. They rested players. So why did they play like it was the final? I flew to Mexico City with my wife to watch that match and I walked away with a lesson about discipline and standards that I have not stopped thinking about since. The game did not matter on paper. Mexico had already secured first place. The standings were not going to change no matter what happened. And yet nobody in that stadium acted like it did not matter. Over eighty thousand people, packed in, singing before kickoff, strangers hugging strangers, beer flying through the air. The players chased down balls they did not need to chase and slid into tackles they did not need to make. They played like it was the championship. That got me thinking about something I see all the time with successful people. There comes a point where one bad day will not ruin you. One slow month will not destroy your company. One missed workout will not erase years of discipline. You have built enough momentum that a single mistake probably will not define you. And that is exactly where most people start letting their standards slip. Here is what I have learned. Standards are not based on the scoreboard. They are based on identity. You do not work hard because this one day decides your future. You work hard because that is who you are. The truly great people do not coast because they are ahead and they do not lower their standards because the standings look good. In this episode I break down why every game matters, how yesterday's success quietly becomes today's excuse and why the real test is not how you show up in the big moments but how you show up when no one is counting. Your legacy is not built during the championship. It is built by how you treat the last patient on a Friday afternoon, the employee you train on a random Tuesday, the vendor call you almost pushed to next week. Whatever is in front of you today, play it like it matters anyways. Because somewhere, someone is watching how you play the game that does not seem to matter, and that is exactly how they know who you really are. #discipline #standards #mindset #selfdiscipline #highperformance #consistency #successhabits #leadership #entrepreneurship #DrAlexSpinoso Learn more about Charismedx at joincharismedx.com Website: www.dralexspinoso.com Instagram: www.instagram.com/dralexspinoso YouTube: / @alexspinosomd Facebook: / aspinoso LinkedIn: / alexspinoso TikTok: / dralexspinoso

Here's a question I ask almost every single clinic owner I coach, usually within the first ten minutes of working with them. If you disappeared for 30 days, no phone, no email, no check-ins, what happens to your clinic? Most of the time there's a long pause. Then the honest answer comes out. It would fall apart. My staff wouldn't know what to do. Revenue would stop. If that's your answer too, I need you to hear this and I need you to hear it with compassion, because I've lived this myself. You didn't build a business. You built yourself a very demanding job. That's not a mistake, that's just the first chapter. The mistake is staying there the entire time. I get into why competence becomes a cage, why the better you are at the work, the harder it is to imagine anyone else doing it. I talk about working in your clinic versus working on it and why almost every owner I've ever coached starts out 90% in the business when it needs to flip. I get into the real reason owners don't delegate and it's not a skills problem, it's fear, fear of losing control, fear that quality slips, fear of who you are if you're not the one everyone needs. I also talk about knowing your floor, the actual minimum number you personally need each month, because fuzzy numbers keep you trapped and afraid and clear numbers give you the confidence to actually build. And I get into why urgent things scream and important things whisper and why if you only ever respond to what's urgent, you'll never get to what's important. If you're a clinic owner or a medical entrepreneur and you're busy every single hour of every single day but can't tell if the business is actually getting closer to where it needs to be, this one's for you. Go build that life. Share this with your team, share it with anyone who needs to hear it. Learn more about Charismedx at joincharismedx.com Website: www.dralexspinoso.com Instagram: www.instagram.com/dralexspinoso YouTube: / @alexspinosomd Facebook: / aspinoso LinkedIn: / alexspinoso TikTok: / dralexspinoso

I used to think confidence was something you earned. Build enough businesses, hit enough milestones and eventually that voice in your head telling you that you don't belong would just disappear. I found out the hard way that's not how it works. I was standing backstage at Andy Andy Frisella's Operator Standard event about to walk out in front of 3,000 people and I heard it anyway. Who am I to be up here? Who am I to tell these people anything? It didn't matter that I've built multiple 8-figure businesses or spent years practicing medicine. That voice doesn't check your resume before it shows up. In this episode, I talk about why imposter syndrome doesn't actually go away, no matter how successful you get and why trying to overcome it might be the wrong goal entirely. I share what I learned from watching some of the most successful people I know, including a multi-billionaire mentor, still deal with the exact same self-doubt I do. And I break down the real difference between people who let that voice run the show and people who just execute anyway. If you're a business owner, entrepreneur or physician building something of your own and you still feel like a fraud some days, this one's for you. Confidence doesn't come first. Execution does. Want to go deeper on scaling your medical business? Learn more about Charismedx at joincharismedx.com Website: www.dralexspinoso.com Instagram: www.instagram.com/dralexspinoso YouTube: / @alexspinosomd Facebook: / aspinoso LinkedIn: / alexspinoso TikTok: / dralexspinoso

Amanda and I sat down to actually look back at what three years of doing this taught us and I'm gonna tell you right now, most of it isn't what you think. Genesis is growing. Pharmacy is growing. PRP is growing. Stature is growing. Coordinating a full day, sometimes two days, of recording together has turned into a logistical nightmare and it's only gonna get worse. So we're making a change. Going forward this show is mostly me, solo, 20 to 30 minutes, no fluff, highly tactical. Business, entrepreneurship, mindset, medical content because I got away from actually educating people and there's a whole bunch of idiots out there with no medical background talking about stuff they have no business talking about. I'm coming back for that. Amanda's not gone. She'll still be on for the bigger conversations. But the day to day is changing. In this one I get into what 300 episodes actually taught me. Podcasts aren't gonna make you rich and if that's why you're doing it, stop now. You can never speed up time, no matter how much money you throw at it. Patience isn't the same as being passive. Good enough to ship beats waiting around for perfect every single time. And there's a real difference between being a good person and being a nice person who gets walked on, most people get that one wrong their whole life. If you're building a business or a brand, or a podcast of your own and you feel like you're just spinning your wheels, this one's for you. Want to go deeper on scaling your medical business? Join Charismedx at joincharismedx.com Website: www.dralexspinoso.com/ Instagram: www.instagram.com/dralexspinoso/ YouTube: www.youtube.com/channel/UC2YAyl_kDyo-JP2VBuru5aw Facebook: https://www.facebook.com/aspinoso/ LinkedIn: www.linkedin.com/in/alexspinoso TikTok: www.tiktok.com/@dralexspinoso

I grew up a comic book nerd. Spider-Man, Batman, Iron Man, Captain America, Wolverine. I loved all of it. But here is what I want you to understand. It was never about the powers or the capes or the gadgets. It was always about the journey. How an ordinary person becomes something extraordinary through the hardest seasons of their life. Joseph Campbell was a mythology professor who spent his entire career studying stories from every culture, every era, every continent in human history. And what he found was that they were all telling the same story. Not similar stories. The same story. Different names, different settings, different powers. But the same fundamental journey. He called it the Hero's Journey. And once you see it you cannot unsee it. You see it in Star Wars. You see it in The Lion King. You see it in every Marvel movie ever made. And you know where else you see it? In your clinic. In the story you are living right now. In this episode I walk you through every stage of the Hero's Journey and show you exactly where you are on that map. The Ordinary World. The Call to Adventure. The Refusal. Crossing the Threshold. The Ordeal. The Transformation. The Return. If you are in the cave right now, in the dark season, in the hardest stretch you have ever been through, do not mistake the difficulty for failure. The ordeal is not the end of the story. The ordeal is the story. Nobody reads the comic for the ordinary world. Nobody buys the movie ticket to watch the hero stay safe.  They read it for the journey. You need to live like it is the same. For more free tools and resources visit: https://www.dralexspinoso.com/ Instagram: https://www.instagram.com/dralexspinoso/?hl=en YouTube: / @alexspinosomd Facebook: / aspinoso LinkedIn: / alexspinoso TikTok: / dralexspinoso Charismedx: / joincharismedx.com

I was a prison doctor two years out of residency, watching the clock, getting yelled at for seeing too many patients and planning a double pension by 60. I thought I had it figured out. I didn't. I walked into a $50,000 mastermind with more degrees than anyone in the room and less money than all of them combined. I kept my mouth shut, I listened and everything changed. In this episode I sat down with Todd Hartley on The Todd Hartley Show to talk about what it actually took to go from treating inmates at California Department of Corrections to building Genesis Lifestyle Medicine into one of the fastest growing healthcare organizations in the country. We talked about why physicians get stuck, why analysis paralysis kills more practices than bad marketing ever will and why the smartest move you can make as a provider is to be the dumbest person in the room. If you're a physician or clinic owner who knows you're built for more but can't figure out why the business side keeps pulling you under, this conversation is for you. We cover the love it versus hate it list that will free up your calendar, why reinvesting back into the business is the move most providers are too scared to make and how Charismedx was built to give medical entrepreneurs both the tactical playbook and the mental edge to actually scale. Learn more about Charismedx at joincharismedx.com Website: https://www.dralexspinoso.com/ Instagram: https://www.instagram.com/dralexspinoso/?hl=en YouTube: / @alexspinosomd Facebook: / aspinoso LinkedIn: / alexspinoso TikTok: / dralexspinoso

Most clinic owners think the biggest threat to their business is the medical board, the FDA or some regulation they didn't know about. It's not. The most dangerous thing in your clinic is fear. I see it constantly. Trained providers and smart business owners who are so paralyzed by what they might not be allowed to do that they stop doing the work they were built to do. They stop innovating. They stop growing. They run their practice from a defensive crouch and call it being responsible. It isn't. It's slowly killing the business they worked so hard to build. In this episode I break down the difference between integrity based compliance and fear based compliance. One makes you better. The other makes you smaller. I'll tell you who actually gets in trouble in this industry, why it's almost never the person lying awake at two in the morning worrying about the rules and what to do instead when a competitor files a complaint or a board comes knocking. I've been sued. Multiple times. Some of it was complicated and some of it was completely absurd. I'll share what I learned and why getting big enough to be worth coming after is not the end of the story. If you run a med spa, a functional medicine practice, an aesthetic clinic or any independent medical business, this one is for you. Get your compliance house in order, get the right attorney, operate with integrity and then get out of your own way and focus on the patient in front of you. Stop avoiding sin. Start doing the work. Check out the Charismedx Mastermind for medical and aesthetic entrepreneurs at JoinCharismedx.com

Most business owners hit a ceiling and never figure out why. The answer is almost always the same. They keep everything in their head instead of documenting it. That is what this whole episode is about. Amanda and I sit down and go through the four things you have to document if you actually want to grow a business. We start with your calendar. If it is not on there, it does not happen, period. Then we get into communication, because verbal conversations get twisted and remembered wrong every single time. I tell the story about a miscommunication that cost us eighteen grand in legal fees. That one still bugs me. We also talk about capturing your ideas before they disappear, and the trap of chasing every new idea the second it pops into your head. I share the exact systems we use to capture everything so nothing gets lost. And then the big one, the part most people skip, which is taking what you learn and turning it into an actual SOP and training so the knowledge is not just stuck in your head or one manager's head. We get into time blocking, time audits, why back to back meetings make you useless, how we documented our way to 80 locations, and where to start if you have zero systems right now. This stuff is not complicated. It is simple. It just takes doing it over and over. Build the systems and the scaling takes care of itself. If you did not document it, it did not happen.

Everyone keeps telling you the same thing. Social media is killing your focus. Your phone is hijacking your attention. Modern life is too distracting. And look, some of that is true. These apps were built by the same minds that built casinos, engineered to pull you in and keep you there. But here is what nobody wants to hear. Distraction is not your real problem. A lack of clarity is your real problem. In this episode I break down why you cannot white knuckle your way to focus, why willpower and discipline are not the answer and why the people who seem impossibly focused are not superhuman. They are just clear. When your vision is vivid, specific and personal, distraction handles itself. The fly in the corner of the room stops existing. I talk about the exact difference between discipline and clarity, why most people stay vague because vagueness is comfortable and never wrong and the specific questions you need to ask yourself to get unabashedly and insanely clear on what you are actually building. Not grow my clinic. Not financial freedom. Real, specific, close your eyes and touch it clarity. If you are an entrepreneur, clinic owner or business owner who feels busy all the time but never makes real progress, this one is for you. You do not have a focus problem. You have a vision problem. For the frameworks and exercises I mention, go to dralexspinoso.com and head to resources.

Everybody keeps asking the same question. What if it gets worse. What if AI replaces everything. What if the whole thing falls apart. That question has no floor. You can ask it forever and it only leads to more fear. In this episode I give you a different question. Not what if, but even if. Even if the economy tanks, you're going to find me building. Even if the rules change, you're going to find me adapting. I dug into the parts of history they don't teach you. Newton invented calculus during the Great Plague while he was bored and stuck at home. Shakespeare wrote Macbeth during plague lockdowns. The Slinky came out of a wartime accident. Zookeepers marched penguins around bombed out London to lift people's spirits during the Blitz. Every one of those stories has the same thing in common. Nobody waited for conditions to be perfect. If you're a business owner in 2026, you are building during a genuinely turbulent moment. Regulatory shifts, market changes, AI disruption, culture anxiety. All of it is real. The people who wait for the perfect year never build. The people who build anyway are the ones whose names we know. You don't get to opt out of the chaos. The only thing that was ever optional is what you choose to do in the middle of it. Stop asking what if. Start declaring even if. Now go do something worth doing.

At 30 years old I had a government job a nice house in Palm Springs a view of the mountains and I wanted to walk into traffic. Not because my life was falling apart. Because it wasn't going anywhere. I was a doctor working at the California Department of Corrections done with my day by noon reading business books for the rest of the afternoon because there was literally nothing else to do. Everyone around me said I made it. I knew I hadn't. So I convinced my wife to move out of our house rent it on Airbnb and move into a 100 square foot dining room with plywood sheets for doors and our clothes in trash bags on the floor. We lived like that for months. Saved everything we could. Then I found out about a mastermind run by Andy Frisella and dropped $50,000 which was half of everything we had saved on a bet that it would work. It did. This episode is the full origin story. From prison doctor to building Genesis Lifestyle Medicine to 80 locations. What actually pushed me to leave stability behind how I found my business partner what it really costs to build something from zero and why the most important decision I ever made was the one that scared me the most.

Michael Jackson rehearsed 6 to 8 hours a day. Not occasionally. Constantly. The same moves. The same transitions. The same runs. Over and over until they stopped being something he practiced and became something he was. Most people look at that and think obsession. What they're missing is the deeper mechanic underneath it, repetition as identity. Not repetition as a grind you push through, but repetition as the actual construction process for who you become. In this episode I break down what Michael Jackson's approach to performance actually teaches us about mastery in business, leadership, fitness, and every other area where people want results without putting in the invisible work that earns them. The truth is most people overestimate intensity and underestimate consistency. They show up hard when the lights are on and disappear when nobody's watching. That's why most people stay average. Greatness doesn't get built in championship moments. It gets built in the rehearsals nobody claps for.

Motivation is going to let you down. It's not a matter of if, it's when. I've pulled out of a PE deal that should have been the biggest win of my career, rebuilt Genesis from the ground up, had to have conversations I didn't want to have with people I cared about, and kept going anyway. Not because I was fired up. Because the systems were in place and the right people were around me. This episode covers the five things that actually move you forward when motivation disappears. Getting crystal clear on what you actually want, not what looks good on Instagram or what your parents told you to want. Knowing what a real no sounds like and actually using it. Expecting the hard and building around it instead of waiting for it to get easier. Engineering your environment so taking action is the default, not the exception. And being ruthlessly selective about who is in your circle at home and at work, because the wrong person doesn't just fail to help you, they actively slow you down. There was a study I came across that showed one high-functioning A-player with zero trust from the rest of the team reduces that team's efficiency by 50%. One person. That alone should make you rethink who you're keeping around. Motivation is temporary. Clarity, systems, and the right people are not.

Most people think discipline is about motivation. It's not. Motivation is temporary. Feelings are temporary. Standards are supposed to be permanent. In this episode I'm pulling a leadership lesson from one of the most unlikely places. The Mandalorian. And before you scroll past, hear me out. Underneath all the sci-fi, the show actually reflects timeless truths about discipline, responsibility, and what it means to show up even when you don't feel like it. There's a phrase they repeat throughout the entire series: This is the way. And that phrase carries more weight than most people realize. It means there is a code. There is a standard. And you operate by that standard regardless of how you feel that day. We live in a world now where people treat emotions like absolute commandments. If they don't feel like doing something they assume they shouldn't have to. If they lose motivation they assume that's the universe telling them to quit. But discipline doesn't work that way. Discipline means you lead your business on the days you don't feel like it. You have difficult conversations with employees on the days you don't feel like it. You show up for your spouse and your kids on the days you don't feel like it. Because mature people understand that your mood is not your standard. That is what real leadership looks like. Not loud. Not flashy. Not yelling from a stage. Quietly competent. Controlled strength. The ability to carry weight without constantly complaining about it. This is the way I lead my family. This is the way I run my business. This is the way I keep my promises. And if you're serious about building something that lasts, it has to become your way too.

Motivation is not going to save you. It never was. I sat down with Amanda May to break down why chasing motivation is exactly what keeps most people stuck. We opened with real wins from our Charismedx Q1 event in Dallas. One conversation with a clinic owner and she added $140,000 in EBITDA. Another dropped her payroll from 33% to 21% of gross earnings. That is what clarity and execution looks like when you stop chasing the feeling and start doing the work. If you do not know exactly what you want, vividly and specifically, you are never going to get there. Most people are pursuing things because their parents told them to or because it looks good online. That is not a reason. That is a trap. And the moment it gets hard, you will quit, because you were never really in it for yourself. Knowing what you refuse to accept is just as powerful as knowing what you want. No is a complete sentence. We also break down the Medvi telehealth collapse. A guy who went from a Forbes cover to a full federal investigation in less than 48 hours. Eight hundred fake AI doctors. Zero HIPAA protection.  That is what the easy path looks like at scale. Nothing good comes from it.

Everyone wants the fun part. The wins. The momentum. The days where it all clicks. Nobody talks about the years of boring, repetitive, unglamorous work that had to happen before any of that was even possible. In this episode I get into something most entrepreneurs won't say out loud: business was never supposed to feel good every day. The pressure, the difficult conversations, the long hours, the delayed gratification. That is the job. And if you went into business expecting it to feel exciting most of the time, you were already set up to quit. I've built businesses across multiple states and multiple verticals. And I can tell you without hesitation, the people who win are not the ones who found their passion. They're the ones who stopped needing it to feel good before they showed up. We talk about why social media has created a generation of entrepreneurs addicted to stimulation, why boredom in business is almost always mistaken for the wrong path, what meaningful work actually costs, and why the shift from "is this fun" to "is it worth it" is the most important mindset upgrade you will ever make. If you are waiting to enjoy the process before you commit to it, you are already behind. Stop asking if it's fun. Start asking if it's worth it.

Everyone wants the exciting part. The wins. The momentum. The days that feel like you were born to do this. Nobody talks about the years of boring, repetitive work that had to happen first before any of that was even possible. In this episode, Amanda and I get into something most entrepreneurs won't admit: they're addicted to entertainment. The highs. The lows. The rush of solving a problem. And the moment the work turns monotonous, they call it a passion problem and start looking for the exit. I've built and rebuilt businesses across multiple states. And I can tell you without hesitation, the boring work is the only work that compounds. Passion runs out. Repetition doesn't. We talk about why grit matters more than talent, why feeling stuck is almost always just boredom in disguise, what the hockey stick of growth actually looks like from the inside, and why the people who master the mundane are the ones who end up winning. If you're waiting to feel passionate before you do the work, you're already behind. Master the mundane. That's the whole game.

Most people walked into that McDonald's and saw a burger. Ray Kroc walked in and saw a machine. Same building. Same kitchen. Same food. Completely different outcome because of one thing. Attention. In this episode, I break down why attention is the most underrated skill in business right now. Not intelligence. Not luck. Not connections. Attention. The ability to slow down, look past the obvious, and see the system when everyone else is focused on the surface. We're living in a world built to destroy your focus. Endless scrolling. Constant notifications. Dopamine on demand. And the people losing aren't losing because they're not smart. They're losing because they stopped noticing. People who don't pay attention will still pay. They'll pay in missed opportunities. They'll pay in stalled growth. They'll pay in problems they never saw coming. This episode is about training the skill that changes everything. Let's get into it.

Everyone wants the highlight reel. The viral moment. The overnight success story. Nobody talks about the part that actually builds it; the boring, repetitive, unglamorous work that happens every single day before any of that shows up. In this episode, Amanda and I get into something most entrepreneurs run from: boredom. The monotony of doing the same thing over and over. The SOPs nobody wants to write. The meetings that feel pointless. The systems that seem too simple to matter. That's exactly what builds a scalable business. I've built and rebuilt companies across multiple states. And I can tell you without hesitation, the boring work is the only work that compounds. The adrenaline runs out. The grit doesn't. We talk about why most entrepreneurs sabotage themselves chasing the next shiny thing, what mastering the mundane actually looks like in a real business, why feeling stuck is usually just boredom in disguise, and how the hockey stick only happens after a very long boring handle. If you're waiting to feel excited before you do the work, you're already behind. Boring wins. It always has.

Most people spend their whole life grinding toward something. The dream car. The dream house. The financial freedom they swore they'd have someday. And then one day it happens. You get there. You have it all. And it feels nothing like you thought it would. That's what this episode is about. Not the highlight reel. Not the cars or the house or the wins. The real conversation that nobody has after they hit the goals they spent years chasing. I bought a McLaren. A Lamborghini. A Shelby Cobra for my dad. I bought the house I used to drive past and say "someday." And I'm telling you honestly, the high faded faster than I ever expected. That forced me to ask a question most successful people are afraid to ask. Why didn't that feel the way I thought it would? The answer changed how I look at everything. Goals. Success. What it actually means to build something worth building. If you're in the middle of the grind right now, watch this. If you've already hit your goals and still feel empty, watch this even more. The object was never the point. Who you become to get there, that's everything.

Everybody is busy. Nobody has time. But I am going to tell you something nobody wants to hear. Being busy is exactly what is holding you back. I have built companies to tens of millions of dollars and I can tell you right now that busy never got me there. Productive did. In this episode Amanda and I break down the four steps I actually use to cut through the noise and move the needle every single day. Block time to think. Reverse engineer what you want. Filter the loud from the important. Execute with critical tasks. Stop confusing motion with progress. Priorities do not set themselves. You have to decide what matters. You have to build your days around that decision. And you have to stop lying to yourself that being busy means you are winning.

More goals. More habits. More plans. More routines. More systems to track, optimize, and eventually feel guilty about. But almost nobody stops to ask the more important question. What should I get rid of? In this episode, I walk you through what I call soft minimalism. Not just as a design philosophy for your home, but as a blueprint for your life. Because the truth is, most people's lives aren't designed. They're accumulated. Layer after layer of obligations, habits, and routines that made sense at some point but have been quietly draining you ever since. When you remove what doesn't belong, everything changes. Your priorities get clearer. Your focus sharpens. Your energy comes back. Clarity doesn't come from adding more systems. It shows up when the noise disappears. Your life shouldn't be empty. It should have personality, character, and the things that actually make it meaningful. But it should be built on purpose. Not just stacked together over the years. So before you add anything else, ask yourself the better question. What needs to go?

Most people are not lazy. They are unfocused. And there is a difference. In this episode of The Spinoso Podcast, Dr. Alex Spinoso and Amanda break down the four enemies of focus that are quietly costing you your time, your money, and your results. These are not obvious distractions. These are the habits and patterns that feel harmless in the moment but compound into massive losses over time. If you are a business owner, a leader, or someone trying to build something real, this episode is going to hit hard. What you will learn: The real reason you cannot say no and why it is costing you everything. How indirect communication is draining your energy and destroying your culture. Why your environment is working against you and what to do about it. The hard truth about why most people never reach their goals. Focus is not a gift. It is a decision. And it is one you have to make and protect every single day. If your results are not where they need to be, this episode will tell you exactly why.

Something changes when you start having real success. You think freedom means saying whatever you want to whoever you want. No filter. No pause. You call it confidence. But if you have to react every time something triggers you that's not freedom. That's compulsion. If your responses are automatic your emotions are in control. Not you. So the shift is simple. Pause. Create space. Don't react right away. Because real freedom isn't saying whatever comes to mind. Real freedom is choosing what doesn't come out of your mouth. And the real flex is restraint.

Everybody wants to be seen as a nice person but most people do not realize that being nice is exactly what is holding them back. There is a difference between being kind and being nice and if you do not understand that difference it will cost you your team your standards and your future. In this episode we break down what really happens when you avoid hard conversations keep the wrong people around and say yes when you should be saying no. Being nice feels good in the moment but it slowly erodes everything you are trying to build. This is about leadership. This is about accountability. This is about doing what is necessary even when it is uncomfortable. If you feel stuck in your business or your life this might be the reason why.

Most people think the problem is not doing enough, but the real issue is how much time they spend stuck trying to get everything right before they move. This episode goes straight into that. The pressure to be perfect feels productive, but it actually delays the things that create real results. We talk about how your expectations of yourself are often way higher than what anyone else sees, and how that creates hesitation and second guessing. You will hear why people rarely notice the mistakes you obsess over, and how moving forward anyway is what actually builds confidence. The conversation also shifts into what happens when other people do not meet your expectations. Not because they are trying to let you down, but because they will never be as invested as you are. We break down how to set real standards, lead with accountability, and still leave space for grace. If you have been overthinking, holding back, or feeling frustrated with yourself or others, this episode will help you reset and focus on what actually moves things forward.

Everyone wants to talk about growth and scaling but almost nobody talks about the moments where you quietly lose respect for yourself. This episode goes straight into that. The real problem is not failure or bad luck. It is when you break your own standards and start saying one thing while doing another. We talk about why integrity is the foundation of confidence and how the small daily decisions you ignore are the ones that slowly destroy your self trust. You will hear how cutting corners shows up in business and in life, and why you always know when you are not giving your full effort. This conversation breaks down the difference between holding yourself accountable and beating yourself up in a way that does nothing for your growth. It also covers why perfectionism is actually holding you back and what it really looks like to focus on progress instead. If you feel off, stuck, or out of alignment, there is a reason for it. This episode will help you identify it, fix it, and get back to operating at a level you can actually be proud of.

Most people think kids slow you down. They don't. They expose you. In this episode of The Spinoso Podcast, Dr. Alex Spinoso breaks down how raising young kids forces you to level up as a leader whether you're ready or not. Chaos, emotion, unpredictability it is all there, and it is the same game you are playing in business. You will hear real, unfiltered lessons on what parenting teaches you about leadership at a high level. Why chaos is the training ground for leaders who actually scale. The reality that logic alone does not lead people and emotion cannot be ignored. How your discipline directly impacts everyone depending on you. Why your team will never rise above the standard you live by. And how kids accelerate your growth as a leader faster than anything else. This is not about parenting advice. This is about ownership, standards, and becoming the kind of leader people follow at home and at work. If you can lead in a house full of chaos, you can lead anywhere.

Most people want access. They want proximity, attention, and a moment they can post. But they have not earned it. In this episode, I break down why I stayed away from Andy Frisella and focused on something that actually matters. I did not ask questions. I did not try to get noticed. I listened, executed, and built real results. When I finally reached out, I did not come with curiosity. I came with proof. If you want to be taken seriously by high level people, stop talking about what you are going to do. Do the work. Bring evidence. Execution is the highest form of respect.

You don't have a hiring problem. You have a placement problem. Too many business owners get seduced by technical skill and completely ignore the reality of the role. You hire a killer operator, then get pissed when they can't communicate, lead, or connect. That's on you. If the job requires human skills, hire for human skills. If it doesn't, stop forcing people into positions they were never built for. In this episode, we break down the real framework behind hiring that actually scales. We talk about why mismatching skill sets will always blow up in your face and how to properly test for emotional intelligence without overcomplicating it. We also cover the truth about "weird" high performers and where they actually belong, and why your best hires care more about growth than stability. We get into the shift from managing people to coaching and leading them, and why adaptability and accountability are the traits that future proof your business. We also get into the hard truth most owners avoid. Sometimes you hire for where you are today and you know you will replace that person later. That is part of the game. But if you want to build something real, you need to start hiring for where you are going, not where you are stuck. Because the difference between a five million dollar business and a fifty million dollar business is not strategy. It is people. And the uncomfortable part is that the people who get you to the next level are going to cost you. But if you do it right, they do not cost you. They multiply you.

You think money is the ultimate unlock? I used to think that too, until I spent two years trying to get a car. I'm sitting inside my 2024 Lamborghini Revuelto, spot number 37 in the entire United States. What getting here taught me has nothing to do with cars and everything to do with how the real world works at the highest levels. Here's the truth nobody talks about. At a certain point, people stop selling to you and start choosing you. There are rooms you will never enter just because you grinded harder. There are doors that will never open just because your numbers are good. Access is the real currency, and it's earned through reputation, relationships, consistency, and character built long before you ever need anything from anyone. In this episode, I'm sharing what I'm learning in real time about playing the long game. Why revenue matters but reputation matters more. Why grinding alone will make you rich but never make you invited. And the one question you need to ask yourself right now if you're serious about reaching the next level. This isn't a highlight reel. This is day one. And I'm committed to playing it the right way. Ask yourself: If money were removed from the equation, would anyone still want you in the room? Let's get into it.

Everyone loves to talk about remote work, hybrid teams, and the "future of hiring." But most of that conversation is disconnected from reality. In this episode, I break down what hiring actually looks like in 2026, from building remote executive teams to why most people simply can't work effectively from home. We also discuss the powerful interview question used by Elon Musk to expose whether a candidate actually solved a real problem or is just repeating something from their résumé. The truth is, the companies that win aren't hiring based on prestige, degrees, or impressive job titles. They're hiring based on skill, accountability, and whether someone can actually solve problems. I explain why skill-based hiring is replacing résumé-based hiring and how businesses should evaluate character traits like humility, grit, and the willingness to learn. We also talk about the one asset that is becoming more valuable as AI expands: human skills. Emotional intelligence, communication, presence, and the ability to read people are now premium currency in business. If you want to scale a company, build strong teams, and hire people who actually move the business forward, this episode breaks down what matters and what most companies are still getting completely wrong.

Everyone loves to talk about vulnerability. The gurus post about it. The influencers film themselves crying about it. Brené Brown built an empire on it, and good for her. But somewhere between the research and the reels, we completely lost the plot. In this episode, I'm breaking down why most of what people call "vulnerability" is actually just emotional dumping dressed up as leadership, and why there's a massive difference between the two. Your team doesn't need to know how burnt out you are on a Monday morning. They need you to show up and lead. I'll tell you exactly what real vulnerability looks like, why handling your battles in private is one of the most powerful things you can do as a leader, and how to be honest and human without turning your team into your therapy group. Be real. Read the room. And for the love of God, stop using your following as your journal. If you want to build something, lead someone, or just stop getting leadership completely wrong, this one's for you.

Everyone wants momentum. Everyone wants to move fast. But most businesses don't collapse because they moved too slow. They collapse because they moved too fast without the systems to support it. In this episode, Dr. Alex Spinoso breaks down one of the most expensive lessons in entrepreneurship: speed without structure will eventually destroy what you're trying to build. After nearly selling Genesis and stepping back to evaluate what was missing, Alex shares how rebuilding systems, processes, and the right team became the foundation for scaling a multi-eight-figure company the right way. This conversation dives deep into the realities most entrepreneurs don't want to hear. There is no perfect balance when you're building something massive. There is no overnight success. And there is no sustainable growth without slowing down long enough to design the structure that can actually hold the weight of your vision. Alex also talks about the discipline required to play the long game, why most people fail because they chase speed instead of systems, and the uncomfortable truth about competition in business. If you want to build something that lasts decades instead of something that burns out in a few years, this episode will challenge the way you think about growth, leadership, and resilience. Because the companies that win aren't the ones that move the fastest. They're the ones built strong enough to survive the long game.

Everyone wants the win. Nobody wants the loss. But the ancient Greek Olympians didn't prepare by visualizing victory. They prepared by sitting alone and imagining humiliation. Public failure. Pain. Shame. They felt it fully. Then they accepted it. And once they accepted it, fear lost its leverage. In this episode, I break down what they understood that most modern entrepreneurs refuse to admit. Fear only controls you while you're protecting a version of yourself. Once that version dies, fear dies with it. This past year was the strongest year of my life on paper. Revenue up. Growth up. Big wins. And at the same time, anxiety through the roof. Exhaustion. Betrayal. Failed deals. Lawsuits. Identity fractures. The kind of pressure that strips you down to the core. What I realized is this: the crushing season is the gift. Not because suffering is noble. Not because pain is glamorous. But because defeat produces something far more valuable than hype ever could. Clarity. Depth. Resilience. Freedom. Once you've truly been to the bottom and survived it, you stop flinching. You stop posturing. You stop asking what if this goes wrong. You already know. You've lived it. This episode is about why you should stop numbing the collapse, stop dressing it up with fake optimism, and instead go all the way down. Sit in it. Let the fear burn out. Then ask the question the Greeks asked: If this is as bad as it gets, who am I now? Because when you can answer that honestly, you finally get to play the game clean.

I forgot my own name at the start of this episode, we joked about donuts, shouted out Sugar Llamas in Heath, Texas, and then we went straight into something that actually matters. This episode is about what Stonehenge taught me about building companies. Stonehenge was not built in a summer, it was not built by one person, and it was not built perfectly. It was layered, refined, adjusted, and expanded over centuries, and that hit me hard because most founders today are trying to compress centuries into six months. They want to go viral, hit eight figures fast, open ten locations before optimizing one, and scale as quickly as possible without respecting the one thing they cannot control, which is time. No matter how much money you have, you cannot speed up time. That is the most frustrating part of business, because even when you have capital, resources, and leverage, things still require reps, iteration, feedback, and failure. In this conversation we break down why instant mastery is a social media illusion, why fast growth often builds fragile foundations, why perfection kills momentum, why ego pushes expansion instead of optimization, and why every serious entrepreneur eventually hits a moment where they think everything might collapse. If you are in that moment right now and wondering why it feels like you are getting punched in the face every day, it is not because you are uniquely unlucky. It is because you are trying to build something real. Every founder I know who has built eight and nine figure companies has gone through bankruptcy scares, massive staff turnover, and moments where liquidation felt inevitable. Those are not detours. They are rites of passage. You do not build something legendary in a summer. You build it in layers, you survive the gauntlet, and you play the long game.

On this episode of The Spinoso Podcast, I'm talking about shoes. But not really. I've built multiple seven, eight, and nine figure medical companies. I've negotiated with investors. I've rebuilt P and Ls from scratch. I've scaled clinics across the country. And I've also walked into rooms feeling like I didn't belong there. So when I read Shoe Dog by Phil Knight, the founder of Nike, I expected strategy. I expected playbooks. I expected legendary brand moves. What I didn't expect was this: the guy behind one of the most iconic brands in human history struggled deeply with imposter syndrome. Lawsuits. Banks breathing down his neck. Competitors trying to bury him. The company on the verge of collapse more than once. And still, he felt like he didn't belong in the room. That hit me. Because imposter syndrome isn't weakness. It's proof you're in the arena. It means you're building something big enough to scare you. It means you care. It means you're not coasting. In this episode, I break down what I learned from Phil Knight's journey and my own. Why pressure forges real leaders. Why every great company looks like a dumpster fire at some point. And why you don't wait for confidence to start moving. You move first. Confidence catches up later. If you're building a business and part of you feels unqualified, outmatched, or a little scared, good. That means you're exactly where you're supposed to be. Throw on your sneakers. Get out of your head. And just do it.

In this episode of The Spinoso Podcast, I sit down with my business partner and CEO of Stature Skin, Amanda May, and we cut through the noise in the skincare industry. No fluff. No 30-step routines. No marketing hype. We break down what actually works when it comes to tone, texture, hydration, brightening, and long-term skin longevity. Why most people fail with skincare isn't because products don't work. It's because they're confused, inconsistent, and sold too many things they don't need. We talk about actives versus buzzwords, why aggressive exfoliation is overrated, why hydration is misunderstood, and how we built a simplified system designed for real consistency. We also get into the business side—why we refused to rush products to market, how to simplify retail inside a clinic, and what's coming next. If you want skin that looks strong, healthy, and built to age well without 15 steps, this episode is for you. Disclaimer: This episode is for educational purposes only and is not medical advice. Always consult a licensed healthcare professional before starting any skincare or medical treatment. Individual results may vary.

Everyone is chasing upgrades. Better hair. Better body. Better house. Better brand. Better numbers. And I get it. I've done it. I was going bald. I hated it. So I fixed it. I got the transplant. I built the clinic. I grew the beard. I leaned into it. Look good, feel good, play good. I'm not anti-upgrade. I built businesses around external upgrades. But here's what nobody tells you. Fixing the outside does not fix the inside. Hair didn't give me direction. Looking better didn't give me purpose. Confidence without clarity is still hollow. Success without alignment is still exhausting. In this episode, I break down the trap high performers fall into. The belief that if we just optimize the surface, the depth will sort itself out. If I make more money, I'll feel settled. If I look sharper, I'll feel clear. If I upgrade the body, the noise in my head will finally shut up. It won't. At some point, the mirror stops being the problem. The real work is internal. It's discipline over distraction. It's deciding who you're becoming. It's building a life that feels aligned instead of just impressive. It's the quiet decisions you make when nobody is watching. Upgrade the outside if you want. You should. Just don't confuse upgrades with answers. Because what's in the mirror isn't the work.

Let's stop pretending this isn't happening. AI does not get tired. It does not argue with its spouse before work. It does not transpose a decimal. It does not forget to ask the question you were supposed to ask. It works 24/7. No holidays. No emotion. No ego. No fatigue. Just execution. In this episode, we break down what artificial intelligence and telemedicine are actually going to do to medicine, business, and leadership. Not the fear-based nonsense. The reality. We talk about robotic surgeons outperforming humans. AI qualifying patients before they ever speak to a provider. Contracts summarized in 30 seconds. Chief Revenue Officer brains built from decades of sales and marketing data. What happens to low-level employees. What happens to average performers. And why high-value operators are not going anywhere. We also cover compliance, DEA regulations, synchronous vs. asynchronous telehealth, HIPAA systems, and where the legal lines still exist. Because discipline still matters. Here's the truth: AI is not replacing excellence. It is replacing mediocrity. If you are great at what you do, AI amplifies you. If you are average, it exposes you. The future of medicine is speed, precision, consistency, and scale. The companies that win will remove bottlenecks, eliminate busy work, and deliver service faster than ever before. The human connection will still exist. It just will not live in the same place it used to. This is not about fear. It is about leverage. Adapt or get replaced.

In this episode of The Spinoso Podcast, I tell a story I don't share often. It's the first year of Arete. I'm broke, overworked, and all-in. I'm working three jobs. I've spent half my life savings just to be in the room. And then Tim Grover takes the stage. Next thing I know, he stops the room and asks for me by name. Not because I was special. Not because I asked for it. But because he was paying attention. He publicly breaks down who I am, what I'm doing, and why excuses don't survive in the presence of discipline. He compares the work ethic required to build a real business to the standard demanded by people like Michael Jordan and Kobe Bryant. And then he drops a line I'll never forget. That moment didn't change my trajectory overnight. But it fueled the hell out of it. We talk about being recognized when you're not looking for applause, what it means to be a "Cleaner," why Cleaners never think they are one, and how quiet execution compounds over time. This is a full-circle moment, a leadership lesson, and a reminder that the work always shows… eventually.

In this episode, I break down where business is actually going, not where people hope it's going. Telemedicine, AI, automation, and remote services aren't trends. They're the new front door. And if your business isn't built to deliver speed, access, and convenience, someone else will eat your lunch. This isn't just healthcare. This applies to every industry that touches a customer. We get real about why most outpatient medicine no longer needs a physical exam, how telehealth has quietly existed for decades, and why cash-pay, convenience-driven care is accelerating fast. I talk about hormones, weight loss, MedSpas, commoditization, big players like Hims, regulatory shifts, and why the businesses that adapt early will scale while everyone else complains about margins and churn. Then we zoom out. Real estate, beauty, architecture, home design, retail, customer service, training, content, even checkout experiences. Every industry has its own version of telehealth. The winners are building hybrid models that remove friction, move faster, and let technology do what humans shouldn't be doing anymore. This episode is a warning and a roadmap. Adapt now, or get left behind.

Most people don't fail because they lack information. They fail because they're addicted to the idea that their situation is different. In this episode, I break down a lesson that's followed me since Jesuit high school. A priest once explained why nothing shocks him anymore. Not sin. Not failure. Not excuses. And it turns out that lesson is the exact framework most adults need to stop sabotaging themselves. Running businesses. Raising kids. Leading teams. Getting punched in the face by lawsuits, chaos, staff issues, market shifts, and pressure. I've lived all of it. And here's the hard truth: none of it is unique. Your market isn't special. Your schedule isn't special. Your stress isn't special. Your excuses definitely aren't special. The moment you stop arguing for your own exceptional suffering is the moment you stop hunting for magical answers and start executing on the boring fundamentals that actually work. This episode is about dropping the drama, killing the ego, and reclaiming momentum. Because you don't need a custom solution built in a lab. You already know what to do. You just don't want to do it. And that honesty? That's where progress starts. If you're ready to stop whining, stop romanticizing struggle, and get back to work, this one's for you.

In this episode of The Spinoso Podcast, I break down what it really means to be "unemployable" and why that's not an insult. It's a standard. It's the inability to tolerate mediocrity, the refusal to be comfortable, and the discipline to push past "good enough" in every area of life and business. We talk about the difference between being truly unemployable and being undisciplined, why the people who build systems rarely fit inside them, and why growth requires living in constant discomfort. I share stories from my dad, from building Genesis, from leading high-level teams, and from choosing the wild ride over the safe one every single time. We also get into generosity without optics, giving without expecting anything back, and why money doesn't change who you are, it just amplifies it. These are principles that apply whether you're building a business, leading a team, raising a family, or trying to live with more intention and integrity. If you're someone who feels out of place in average environments, gets restless when things get easy, and knows deep down you were meant for more, this episode will hit home.

There's a difference between being healthy and being alive, and most people confuse the two. In this episode, I break down why waiting to feel ready is the fastest way to waste your life. I tell the story of Carroll Shelby, a man who raced Le Mans with a failing heart, nitroglycerin under his tongue, and zero permission from the universe. Not because it was safe. Because it mattered. We talk about builders, founders, and creators who didn't wait for perfect conditions. Frida Kahlo creating from a hospital bed. Stephen Hawking rewriting physics with a body that was shutting down. People who moved anyway, even when fear was loud and the body wasn't cooperating. This isn't motivation. This is reality. The fear never goes away. The timing is never perfect. Your heart will always pound when it's time to move. That's not a warning sign. That's life telling you you're in the driver's seat. If you're building a business, carrying a vision, or standing at the edge of a decision you keep delaying, this episode is your reminder: you don't need to feel ready. You need to move. Don't wait to feel safe. Don't wait to feel steady. Don't sit at idle. Get in the car. Drive anyway.

In this episode of The Spinoso Podcast, I break down the five rules my dad taught me growing up. Not theory. Not feel-good advice. Real rules that shaped how I lead my family, my team, and a multi-state medical organization. We talk loyalty as a code, not a concept. Why disagreements belong behind closed doors. Why there are no fair fights in business, only fights won or lost. Why grit, suffering, and struggle early in life are not disadvantages but prerequisites for long-term success. And why complaining, venting online, or looking for external validation is one of the fastest ways to lose respect, leverage, and momentum. This episode is old-school, direct, and unapologetic. If you are a founder, leader, or entrepreneur who wants to build something real and keep it standing when things get hard, these are the rules you need to hear.

We are living in the most advanced, resource-rich era in human history. Better medicine. Better technology. Better data. Better tools than any generation before us. And yet more people than ever are drifting through life with no real direction. In this episode of The Spinoso Podcast, I break down a hard truth most people do not want to hear. Optimization is not purpose. Feeling better does not automatically tell you where you are going. And no amount of hormones, peptides, apps, wearables, or supplements will fix a life that lacks meaning. I walk through a real-world example I see every day in my clinics. People who are physically optimized, medically dialed in, and still deeply unfulfilled. Stronger bodies. Better labs. Longer lifespans. Empty marriages. Distant kids. Busy days with nothing that actually matters. We talk about the two questions that actually determine the quality of your life. What do you want? And are you disciplined enough to go after it? This episode is about responsibility. About character. About doing the boring, unglamorous work that no tool can do for you. Technology can raise your ceiling, but it cannot give you direction. It cannot build your values. And it cannot tell you what your life should mean. Use the tools. Take care of your body. Leverage science. Respect progress. But do not confuse resources with responsibility. Longevity without purpose is not a gift. It is just more time to avoid becoming who you are meant to be. Build the life first. Then use the tools to support it.

The rules of marketing have officially changed. If you're still trying to outsmart Meta, Google, or the algorithm with hyper-targeting, you're already losing. In this episode of The Spinoso Podcast, we break down why creative is the new targeting and how AI platforms like Meta's Andromeda are deciding who sees your ads long before you ever touch an audience filter. This isn't about hacks. It's not about tricks. And it's definitely not about running one ad for six months and hoping it works. We talk about why broad targeting now beats narrow targeting, why your ads are burning out faster than ever, and why raw, real, imperfect content is outperforming polished, cinematic nonsense. Selfie videos. UGC. Real conversations. Different hooks, angles, visuals, and formats. Not one version. Ten versions. If you're a clinic owner, business owner, or marketer who feels like ads "used to work" and now everything feels volatile, this episode will reset how you think about growth in 2026 and beyond. The algorithm isn't the enemy. Boring content is. All tools and resources mentioned in this episode are linked in the description so you can actually implement what we're talking about. Stay creative. Stay relevant. Or get left behind.

We built Genesis Lifestyle Medicine fast. Too fast. On paper, it looked perfect. Revenue up. Locations growing. Applause everywhere. But behind the scenes, the systems were brittle, the standards were fuzzy, and everything depended on me holding it together. In this episode, I talk about the moment every real leader hits. When fixing is not enough. When patching cracks only delays the collapse. This is about why growth eventually demands destruction. Not chaos. Discipline. From the Great Chicago Fire to Howard Schultz shutting down every Starbucks in America, I break down what rebuilding from zero actually looks like and why it is sometimes the only way forward. Not just in business. In your habits. Your routines. Your relationships. Your identity as a leader. If something in your world feels like it is burning right now, this episode will reframe it for you. The fire is not punishment. It is permission.