Medical Empires

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.