With dementia you don't lose someone all at once. You lose them a little bit at a time.

Some days my mom knows exactly who I am. Some days I'm just a kind face sitting next to her. And that has forced me to sit with a kind of grief most people don't talk about, the grief that shows up while the person you love is still here.

In this episode I get personal about what my mom's dementia has taught me about loss, gratitude and how we choose to live while we're still losing someone. I've watched people handle grief in every possible way. Some go quiet and withdraw. Some stay busy so they never have to stand still. I've done both. And somewhere in the middle of it I stopped asking whether I was grieving the right way and started asking a better question. Am I honoring her with the way I'm choosing to live?

Because here's what I keep coming back to. The people who truly love us don't want our grief to stop our lives. They want their lives to continue through ours. The greatest tribute you can pay someone isn't the amount of sadness you carry after they're gone. It's how much of their life still lives through yours.

My mom taught me how to show up. How to be present. How to make everyone who walks through the door feel like they matter. I built companies with hundreds of people in them, and when I ask myself where I actually learned to care about people, it wasn't a business book or a seminar. It was her kitchen table.

This one is for anyone walking through loss right now, or watching a parent slip away, or bracing for grief they know is coming. Grief is real. Loss is real. But eventually grief has to become gratitude and sadness has to become purpose. And maybe a world-class life isn't about avoiding pain. Maybe it's about refusing to let grief have the final word.

Love doesn't require recognition. I don't show up so she'll remember me. I show up because I remember her.

CHAPTERS 00:00 My mom has dementia 00:59 The two ways people respond to grief 01:44 The question I stopped asking, and the one I started asking 02:35 What she poured into our family 03:55 How do you honor someone while you're still losing them 04:57 What would she want for my life 05:49 The greatest tribute you can pay someone 07:13 Refusing to let grief have the final word

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Can you say out loud right now exactly how much money is going to hit your account next month? Not a guess. Not "it depends on how busy we are." An actual number.

Most clinic owners can't. And that one blind spot is quietly costing them six figures a year.

I had a call in my medical mastermind with a clinic owner who had been open almost four years. Good clinician, steady patients, decent reviews, busy schedule. When I asked her what was hitting her account next month, she laughed. Not a nervous laugh, a real one, like the question was absurd. Four years in business and she had no idea. She was working just as hard in year four as she did in year one because every single month she was starting from zero again, hunting for the next round of patients to replace the ones who came and went the month before.

That is not a business. That is a treadmill that hopefully produces cash. And you cannot outwork it because the problem is not effort. It is structure.

The fix is recurring revenue. Memberships. Patients on auto billing, getting a service on a schedule, month after month, without you having to resell them every single time. But most clinic owners get memberships wrong before they ever touch a number and they burn months building something that was broken before it launched.

In this episode I walk through the eleven mistakes that quietly kill med spa and clinic memberships, why most owners get the model wrong before they touch a single number and how recurring revenue does not just smooth out your cash flow, it changes what your entire business is worth when you go to sell it. Buyers pay a premium for predictability and a clinic that knows what is coming next month is a completely different asset than one starting from scratch every thirty days.

If you run a med spa, aesthetics practice, wellness clinic or any medical business built on repeat patients, this one is about building the recurring revenue and membership model that finally lets you stop starting every month at zero.

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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.

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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

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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.

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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.

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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.

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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

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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.

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