“If you want to chop trees, you have to go out into the woods. You can want to chop trees all day long, but if you’re sitting in a skyscraper, you’re not going to chop any trees.”

Hi. Welcome, everybody, to the podcast. Today is a very interesting episode about what medical wellness clinics do wrong. We’re going to talk about seven biggest mistakes and how they fail their patients while they're trying to scale the business.

Today, Cameron is our guest. I’ve known Cameron for a very long time, many years. He's someone who, who has set up a clinic from scratch, built it out, run a successful medical practice where he prioritizes medical first, where he prioritizes personalized care.

And I think those are big, huge things consumer likes. So we’re going to talk about all those things and let’s start with you, Cameron, start with you. Maybe you can introduce yourself and let us know how you started in this business. Yeah, absolutely. Like Alex said, I’ve known Alex for many years, but my name is Cameron Ackerson.

I live here in Asheville, North Carolina. I own a practice called Carolina Health and Wellness. We specialize in medical weight loss, men's hormone optimization, and peptide therapies. I got into this industry about 10 years ago now. After I finished graduate school, I got a job working for a small clinic, at the time, very small, and had a wonderful owner.

He really took me underneath his wing and taught me the ropes of how to get into this industry, how to run a successful practice. He gave me a lot of freedom, a lot of leeway, to kind of, cultivate patient care in the way that I thought was best. to add definitely more of that personalized approach.

And, after, working with him and for him for several years, we decided to jump ship, move to a different state and come up here to the mountains and try it on our own. Yeah, that’s kind of our, our little. Our little quick story.

Very good. So while you were, working at that clinic, you probably learned things that maybe didn’t sit well with you. And you say, you know what, when I open my practice, those are things, some of the things I’m going to take on is some I’m going to do different. What did you see that was problems in medical practices before you started your own?

Yeah, I think biting off more than you can chew, specifically with your service offerings. it's kind of the age old question of would you rather be a jack of all trades and master of none or really focus in on the things that you’re good at and the things that you’re passionate about? I learned a ton working at the previous practice, but they were more of a med spa approach.

They offered every service possibly imaginable, which isn't necessarily a bad thing. There are some people that can facilitate it. But that was one piece of advice that my mentor did give me. He encouraged me to pursue the things that I was genuinely interested in, and double down on those strengths.

And although it was a slower build for sure, when you have fewer offerings, there's just not as many revenue streams, so to speak. But I think in the long haul that definitely, number one, reduces the amount of stress that you have. It allows you to focus, it allows you to build and continue building on the things that you already, that you’re already good at.

That’s probably going to be the number one thing, is just making sure that you have a laser focus on what you’re really trying to accomplish. And then if you do want to do a separate endeavor with something down the road, then great. But just make sure that all of your ducks are in a row with your, with your previous activities first.

One of the things that really makes you stand out is you are an owner-operator. Right. And one thing I noticed in one of the previous podcasts we were interviewed, Carlton Washington, who, was co founder of Forever Young franchise.

And I, remember he told me, Alex, the clinics, well, the upper, the, the people who we sell our franchise to, the most successful ones are those who actually run their business. They are there. Yeah. And I see that you also in your business and I see the correlation, I see similarity in success.

So what do you say about a business owner involvement in the business? I honestly think that’s the only way to do it. If you are going to embark down the path of entrepreneurship, you do that because you have the vision. I was listening to a podcast one time and this gentleman was talking about how if you have the ability to close your eyes and envision something, whether it's a business, your dream house, your dream car, you can envision yourself driving down the interstate.

That’s a gift that a lot of people don’t actually have. And it sounds something so simple. And as an entrepreneur, that is your gift. You are the one that is taking on all the responsibility of your financial interest, your financial liabilities, but also your financial gain and the success of your practice.

And nothing is going to create a successful practice more than an invested business owner that is operating the business that does have skin in the game. It really shows a lot of passion. And I think that it gives you the opportunity to pass your passion onto your employees, which then pass it on to your patients.

And your patients will see it and they'll respect that. And it just creates a really positive environment. And we literally had a review this morning. Google review came in this morning. How, they mentioned in this long review that it's a family in that office and you can really feel that from the moment you walk in.

And that’s just, that’s goals. I noticed that. And this is something, my wife told me. She goes to those medical practices getting treatments done. And she told me, you know what I noticed? When I go to the medical practice and the owner is there, it is a totally different vibe when the owner is not there.

When I go there and owner is not there, you can, you can feel it. Like the team members, they are not so proactive. They're not on the top of the game. Yeah. And that’s, that’s something that I kind of make a rule for myself is I show up every day.

We’re open Monday through Friday. But I, I just know I have to at least show up whether I leave at noon. I’m there from 8 or 9 till noon. at least I show up and at least I show my face. And I think it also means a lot for our team too. Just knowing that, hey, I’m here with you guys.

I mean I could be here all the time, but, I, we actually had like a team meeting and I addressed that with, with some of my team members because I’ve been stepping away a bit more and more. Coming home, picking my daughter from daycare and coming home, working from home. And I just kind of wanted to give a, just open conversation, just a temperature check on are we okay with that?

Do we feel like the business is still operating the way that needs to with me, not there half the day? And they kind of looked at me like, dude, yeah, like, that’s awesome. That’s why you own a business, so you can have that freedom to do those things. And yeah, I think that’s, there's a lot of merit to an owner actually being involved and just caring, that that’s just.

Is showing that effort, for sure. Yeah. It also. It also shows in the revenue. I tell. It does. Every time you. Every time you leave the office at the end of the day, ask just one question, like, hey, how much.

How How many patients did we have today? What, was our revenue today? There's this just KPI numbers because, yeah, team members get used to, like, oh, shoot, like, they're gonna ask. They're gonna ask that we need. We need to perform. Yeah.

And I think, too, I can speak to this firsthand. there's a, There's. There's mornings, on Friday, we have a bit of a shorter day. We’re open from eight to two. But there's some Fridays where I have nothing on my schedule and I really don’t have to show up.

But it's almost like clockwork. Anytime I even show up for two hours, two and a half hours, three hours, whatever, an hour, there's always something. There's always a phone call. There's always something where I can see an opportunity, where I can be like, oh, hey, let me call this guy. Let me follow up with this guy. Putting yourself in that environment, in that if you want to chop trees, you got to go out into the woods.

you can want to chop trees all day long, but if you’re sitting in a skyscraper, you’re not going to chop any trees. So it's just sitting. You’re putting yourself in that right seat. Yeah. One thing also, I noticed differentiates clinics, and it's having a medical doctor at the clinic.

Oh, ever since. And I’m just going to share what I’ve seen in the industry. Ever since private equities came into this vertical, it just became a massive change in the business model. A lot of times you go to the clinic, you see a license on the wall, but there is really no medical.

No doctor in it. So. Yeah, I know you have actual medical doctor at the clinic, so. Yeah. Can you talk to us about that? Yeah, man. All right. I could. This is a soapbox I could be pretty passionate about. So the private equity people coming into these business models, what happened is they.

They saw, over the past decade that these business models, these med spas, for lack of a better term, we’re making some serious revenue. They're making. Generating a lot of income, especially with the growing popularity of hormone optimization with peptides and stuff like that. And so from, a corporate standpoint, they view that as, hey, here's a shareholder opportunity.

If we get into this sector, we can make a lot of money. And what they've done with these huge wallets, they stepped into this industry and they just make these pill mills, for lack of a better term, these shot clinics where they can essentially just hustle cheap drugs on razor thin margins and not provide any real actual care, any real medical care, but still churn a buck.

And because they can do that, they can advertise these low prices for GLP-1s us other small clinics are looking at this like, how are they even doing that? Because the reality is that these medications are expensive for sure. And if you want to try and play the price game and lower your prices, then that’s all you'll be known for.

You don’t want to be the cheapest clinic in town because it, if that’s what you’re doing, if you’re constantly running promotions, that’s all you'll ever be. People only buy from you when they know you’re running a promotion, running a sale. So what you have to do is you gotta figure out, how can I add more value to my offering? How can I make this worth, instead of, $200 a month, how can I make this worth $160 a week for a patient?

And that’s where again, being an owner-operator, being involved in the day to day operations, seeing it, hearing those conversations, and how do you add more value? And that’s through that personability, that’s through that human connection. whether it's a, weekly check in, in person, whether it's a, a weekly zoom call even or a phone call, providing that medical expertise and having a staff that can adequately answer those questions.

And not just be a company where, you have an online portal where you send a message, and maybe in a couple days you get a watered down response or so you have a problem with your medications that got delivered and then it just becomes this mess. So that’s, that’s really why I think one of the worst things that’s happened to med spas is these big giant companies for sure.

But if I have a message for any other small clinic owner out there is do your best to hold out. do not lower your price if you can, make sure it's appropriate with your market. But lowering your prices is very often not the right answer to do.

And sometimes when people get in this panic mode, that’s what they think they should do. But it's hold true, double down in your training, double down your staff, look at different product offerings that you can maybe, couple them with, adding in, tirzepatide. Well, hey, you can also do a B12 vitamin injection or glutathione.

Educating them on things that can actually help make a difference. with Peptides offering them an ancillary service, say they have, some tendinitis or something that they're dealing with. making sure that they know, like, hey, this thing that you’re looking up online, we also have that here. and again, I think it really boils down to like training your staff as well.

I forgot what the initial question was, but, this, this was really a mistake. Number one, that medical practices that do not have a chance, true medical provider at the clinic. And as a result, of course, when there is a patient come in and they have some kind of conditions, some kind of some underlying conditions, and they get prescribed a medication, of course, that’s what the problems happens.

That’s what I see one thing. Second thing is, yeah, you can’t retain patients for a long time because they don’t feel. But they don’t feel expertise. They just feel like the same medication gets mailed to me all the time. Like, what are we improving in my health? Yeah, no, it definitely, it shifts the whole perspective of the patient when there is real medical oversight and, like meeting one on one with a doctor for 30 to 45 minutes.

I mean, no one does that. We've had. One of the things I get commented the most on is, after a patient meets with our physician, gets cleared for medication, a lot of them joke and say, I have a primary care physician. I have spent less time with them over the last 15 years than I just did with your doctor.

And that’s really how you get people excited and hyped up. Also, having a medical doctor has its own benefits. They can actually appropriately prescribe these medications. we have seen so many people that have come in where they've been on semaglutide and they're just having these terrible, awful side effects from it.

And it's just sure they're losing weight, but at what cost? I just had a conversation with, one of my close friends, mom, the primary care physician, just gave them semaglutide and, didn’t even bother to follow up and ask like how it's working, oh, you have some nausea.

Well, maybe we should consider this dose of tirzepatide. tirzepatide is known to have fewer side effects, especially on the GI side of things, in the nausea. That’s where that medical oversight can be huge. But also these clinics that don’t have a real physician that’s overseeing all these things, man, they are doing the patient such a disservice because they are cranking up these doses.

these GLP-1s are wonderful, fantastic, amazing medications, but they are over prescribed way too often. The dosing is just completely negligent. you've got patients that are taking five times the amount of medication than they really should be, which ultimately is just going to desensitize them to it in the long run.

And they're not actually focused on the things that matter, the behavioral, side of things that are going to make that lasting change. So when you do have like a actual physician that’s saying, hey, yes, we can use this as a tool to certainly help, but here's the fundamentals you really have to double down on.

Let’s make sure we’re keeping that skeletal muscle mass high, our protein intake high, resistance training, making sure we’re getting adequate amounts of cardio. When you have a doctor that’s telling you that, and then you have a team behind them that’s reinforcing that week over week over week. That’s how you see real progress.

And that’s when you see real progress, that’s when you really start to establish real value. The referrals go up and you just create a happy business model. I mean, it's kind of all works together. If your prices are low, you have no revenue to get a real physician.

I mean. Yep. That expertise cost money. Yes. So now, okay, so now low prices, no medical oversight, then it leads to cookie cutter protocols. Sell, volume, and who knows what happens next.

Yeah, it's really interesting, with some of these people offering GLP-1s to look and see which ones are public, which ones. Do you have shareholder obligations to make more money? I, I do not. I strongly disagree with that.

Because when you’re talking about something like medicine, something so as impactful as, as weight loss, that can literally improve someone's quality of life pretty, pretty rapidly, but also extend their life expectancy. I mean, we should really be looking at this from more of a humanitarian standpoint, you know.

That brings me to the mistake number two. Cookie cutter protocols And I guess when you run a business that sales-driven and profit-driven, you don’t have a medical person whose license is on the line, then.

Yeah, that’s where we see cookie-cutter protocols. And you probably see more of that than anyone from people that come in from other clinics. Yeah, yeah, 1,000%. And that kind of goes back to, like, the people being on way too high of a dosing. it is so easy to just increase, like, patient says, oh, yeah, I had a little bit of a rough week.

All right, let’s just increase the dose versus actually diving in and talking to them. Okay, what was going on? Oh, it was my kid's, third birthday party. He had some cake before that, my mom was in the hospital for a little while. Okay, so you have a lot going on in your life.

Well, listen, that’s. That’s called. That’s what we call life. you've had a stressful few weeks, but having that someone to encourage them and talk them through it, like, hey, it's not the medication that’s off, and it's not even you that’s off. It's just you’re in a really challenging period of life right now. And it's, it's not always going to be like this.

But, hey, this week, let’s set a threshold. let’s. Let’s try to make sure we’re slamming back, 100 ounces of water daily. Let’s start there. Let’s maybe also focus on getting at least 120 grams of protein. And let’s include a green leafy veg with every single meal. Let’s focus on those three little micro goals this week.

And let’s see next week. with that, we, my team knows this. We have a standing rule where, if a patient is having a really tough time and say they are on the fence of borderline quitting, for whatever the reason may be, but specifically, like, if their progress is stalled out a little bit, what we do is we tell them, hey, here's a food log.

You fill this out entirely. And, we’re going to review it next week. And if you don’t lose weight, I will. We. It'll be a free week. We'll waive your entire charge for next week, but you have to fill this whole thing out. And guess how many free weeks of my 10 years of being a nutritionist that we have given out?

Absolutely zero. We've given out zero weeks because people just need that encouragement sometimes. And those cookie cutter protocols, they, they don’t, they don’t factor that in. Yep. Then you have people giving up on the, on the protocol entirely and they got no results. That leads me to the topic number three, which is poor follow up and patient monitoring.

Why do you think clinics struggle with long term patient care? It's tough. It's really hard. weight loss is relatively simple. if we’re, if we’re talking, through, through that lens. I suppose weight loss is pretty easy to get someone to drop, 10, 15, even £20 at times.

But in all reality, dieting isn't sexy, but what is sexy is having a team of support behind you and having different tools and you can draw upon different tools from that toolbox. So the way that we really try to focus on is educating our staff how and when to use certain types of tools.

When is it appropriate to make a judgment call, when, if there really is something wrong. When can we escalate this? How do we escalate this? But just giving them the care that they need. And again, it's so easy just to, to brush off because this is a tough job. That, that follow up, that of that patient care for weight loss specifically is arguably one of the toughest jobs because you have to be relentless.

You’re coming, you’re having a, patients that are coming to you that are, are not happy, that are, are broken in some ways and you’re there to kind of just help them fix themselves. And it's not you that’s fixing them, you’re trying to get them to fix themselves by, taking their health in their own hands and following the diet when they're not in there.

And that follow up care, the weekly, if you have a weekly type membership system, that works really well. But the follow up care is just, it gets challenging just due to the sheer volume of noise that you hear. So having a proper emr, a proper tracking system, whatever it is, just making sure that every single person is accounted for.

Yeah, that’s patient goes to, goes to patient retention. It's, it's difficult to get a patient, but if you lose them now, you have to go into more marketing to get more patients. So might as well establish good follow up and patient retention process.

What would, what would a good proper follow up look like? Something that’s, anything that’s systematized, anything that lays out a plan not just for your patients, but for your staff so that they know, hey, patient is week five into the program.

That means that they should be following this type of diet protocol. having something literally set in stone, whether it's written, printed, collateral, whatever. But a, I don’t say rigid system, but something that is set in place so that everybody knows where they're at in the journey.

Perfect. That brings me to shiny objects trends and peptides is being a huge trends you nowadays there's so many of them. It's interesting for me, since I in this industry since 2004, seeing how peptides came from being something concept and now it is finally something people love, they want, they're looking for it.

But the question comes with it is those are trends like peptides biohacking therapies, What mistakes clinics do when it comes to those trends. Yeah, well, I think the shiny object theory is absolutely perfect.

I get a new text message, a new email. I literally got one probably 30 minutes ago, about this new peptide that’s coming out. And I think here's the thing, when it comes to these peptides, you need to be, if it's something that you are offering, you need to be an expert on that peptide therapy, that specific peptide.

If it's something that you’re not really sure about, then you probably shouldn't be offering it. So like, for us, we have a very limited select peptide offering and it's because of the ones that we’re familiar with that we’re comfortable with, that we've used time and time again over the past decade and we've seen the results be favorable, over and over again.

I, I even talk people out of like certain peptide therapies, just because like it's, I kind of go break down the data with them and just explain like hey, it's, it could work but I mean, what's the risk worth? because ultimately peptides are safe and I think that’s kind of the silver lining is that realistically, I mean I, I would feel more comfortable with any peptide than really almost any other medication, like standard medication.

But I think going with what works and what has worked repeatedly over and over again like something like BPC-157, I mean you've, we've seen the results time and time again. things like Ipamorelin, cjc, sermorelin, nad, even tesamorelin.

Has gained a lot of traction, in recent years. The GLP-1s, and speaking of shiny object, I know a hot topic is retatrutide right now. And it seems like everyone's either offering or trying to offer it, but in reality, it's, it's.

If you do have a legitimate medical practice, and this is just my two cents, if you do have a medical, legitimate medical practice with a medical director's licenses on the line, you need to make sure if you are offering those things that everyone is on board. Because technically it's, it's not FDA approved, it's still very nuanced.

And could it be the next big thing? Sure, absolutely. could, could clinics make a lot of money by offering it now? Sure, absolutely. I’m not necessarily saying that you should or shouldn't, but you need to make sure that the whole team is on board. You need to make sure that you’re confident about that offering.

And I have a, I’ve got a personal rule. Any peptide that we offer in the clinic, I have used myself. And my medical director, he's used them personally too. So we can attest to these things that we’re recommending for other people. And besides that, we’re seeing a trend of people buying them online now.

Oh my gosh. Yeah, that’s that whole, the whole gray market, black market industry. I mean it's, it's really a shame. back in, I think it was October of 23 when they, switched up the categories. What that did is it just opened the door wide open for the black market.

They just, they stepped in. All of a sudden these, companies, 503A and 503B compounding pharmacies are no longer offering it. Well, someone's going to offer it. Especially when you can make a lot of money off of it. And now you got these peptides that are just selling for nothing. again, the corporate model where they're just selling, selling peptides, that’s it that they're probably getting from China.

they're not bothering to, work with a, a GMP, a legitimized facility that is US based, that has a team that does require medical supervision. a lot of people just don’t care, so thankfully like this.

Why One thing I will say about clinics out there that either do or are considering offering peptides, usually, those people that get in touch with you Those are the good eggs. Those are the ones that read an article about it that maybe did a little bit of dabbling reading online, looking at different black market sites, but decided that they do want a little bit more expertise on the topic.

And usually you can weed those ones out pretty, pretty quickly. The ones that are willing to go through the lab work, that are willing to pay for an exam with your doctor, to make sure that peptide therapy is appropriate for them. Those people you want, the people that are just that are looking for discounts, handouts, waiving fees, this and the other thing, they're going to be such a headache and pain in the ass down the road, it's just not even going to be worth it.

Yeah, very good. Another topic I want to talk about is scaling too fast. And we see it a lot in medical practices growing too fast. They have big capital injection and they just growing really fast.

And the things we've seen, the way the systems break, the team, team gets shift switched very often. New hires don’t get trained well enough. The founders, they just disconnect. Entirely focused and just sales, sales, sales, business grow, business grow.

And of course quality of care is now going down. Can you share some tips on company growth? Yeah. So, there's a book that I actually just met with a friend of mine as a guy that I got introduced.

He's a doctor here in town and actually an eye doctor. He's got a very large practice. I would imagine they probably do anywhere from like 5 to 7 or 8 million a year. But I was kind of confiding in him, just about like our business.

We've recently ourselves gone through kind of what you’re describing right now and he recommended a book called Traction by Gino Wickman. It's a pretty popular book. But Traction, like get a, get a grip on your business I think is what it's called. Yeah, yeah, the EOS system.

And it's, it really help as someone who is an owner-operator that we've recently personally kind of, we experienced that the whole growing too fast thing, and it wasn’t necessarily systems or operations at all. For us it was, we were growing out a good trajectory and we have a good mix of remote patients, that are in office and patients that are remote, that live, further out in North Carolina, with the remote protocol.

I had one person that was managing it and it just crept up to One day we realized, like, holy cow, Ellie, who is our nutritionist, she's overloaded. Like, this is a job for two, if not three people. And it wasn’t until things start breaking that we noticed that.

And what I’m saying, breaking, it's not necessarily the revenue, but it's more of the personal side of things. Employee burnout, that’s something that you really got to take seriously. Because when you’re a small office and if you’re in this space, odds are you don’t have, an endless team, of people that you can fill in.

Like a restaurant where you can just, oh, we got a waitress out. Let’s call so and so and see if they can come in. You feel that when one employee is out, I mean, it's tough. And then whenever you have employees that are dropping like flies left and right, it becomes almost impossible.

But that traction book, that kind of helped me go back to the core values and the fundamentals of what we’re actually doing, instead of focusing on necessarily, like, just the numbers and the sales, actually iron out what are our core values, what are our core beliefs, how do I make sure that I have the right people in the right roles, really caring more about the culture first and then the revenue second.

Because if you get a good culture, your revenue, I can almost guarantee you will come. Yeah. Employees burnout is a big thing because that’s when they start making mistakes, the morale goes down. Definitely.

Good point. In terms of eos, I can personally attest to that. We implemented it years ago and I saw the difference. We had a team members who said, okay, we’re going to step up, we’re going to lead the department, make sure the people in the right place.

They created all the SOPs. Yeah, like you said, burnouts. They created a process for what happens when one team member leaves. Who steps in? What does the process look like at the end of the day for a business owner? That’s the only way to operate.

Yeah, yeah, you really have to delegate. You really have to have someone in that chair that can be a director, that, your office manager, they need to be an office manager, not just someone that kind of, answers the phones and stuff like, no, they need to be the office manager.

They need to be the person in charge. They need to be autonomous to make decisions, and stand behind them. I recently had a conversation with my own office manager. We gave her, a well deserved Pay raise. But just emphasizing like, hey, I really want you to kind of take more of an office manager role.

I want to see you, make judgment calls. If the rest of the team has questions about this, that, and the other thing, make that judgment call. And, if you have to, at last. Last just reserved, you have to ask me or talk to me about it, then stand behind it.

If I know that you made the right decision or what you believe was the right decision, nine times out of ten is probably gonna be the right decision that one time that it may not be the most optimal decision. Great, let’s talk about it. I’m not gonna bite your head off. I’m not gonna be mad for the. The one bad thing out of 50 great things you did.

nothing's that serious. Nothing's that life ending. Yeah. One thing that made difference for us is when I told our team members that you are, an important person here. And as. And just because a client got upset, a client left, doesn’t mean that you’re fired.

And it gave them confidence to, be themselves, make mistakes, too, knowing that nobody's gonna, like you said, bite the head off just because they made a mistake. We’re all humans. Yeah, exactly. That’s just it. And I think that’s a big part of how you keep employees around.

For sure. Your culture, like you mentioned, that’s the one big one. What. What's our culture? What kind of people we’re hiring? What's our values? And yeah, once you hire people based on your values, that creates a really good culture.

Yeah, absolutely. Yeah. It's kind of funny. I, Every time I’ve, like, hired anybody serious, I always. We have an indeed, whatever, whatever reason. Indeed. LinkedIn for our job posting. If I see a good resume that I like, I’ll call them right away and just, hey, this is Cameron, founder from Carolina Health and Wellness.

do you have five minutes? I just want to kind of introduce myself and, meet you. And then usually within that first five minutes, I can tell if, hey, this is a potential good candidate, or what more likely happens is I end up being on phone with them for 15, 20 minutes and having just a great conversation, but, capping it at that five minutes.

So if it is something that doesn’t work, hey, no problems. Weren't from each other. Well, let me circle back with you. We got a couple of applicants, but, and the ones people that we have hired that Being wonderful hires. It's just been like this organic, natural conversation, I think that really sets the tone for employment as well.

For sure. I want to go back to patients and patient care, and importance of setting expectations of what are the patients going to experience when in hormone therapy on the weight loss? What's your experience with that?

Yeah, so weight loss is pretty self explanatory. obviously they're going to expect to lose weight. we, during those check ins we do tell people like, hey, you've gotten through the worst part of it. like the, the first 10 days is always the most challenging. say we switch them to like a low, low carb style of diet.

Hey, first three to five days, like you’re going to be feeling it, but don’t psych yourself out. You've already come this far, get through that and you’re going to have this clarity wash over you on day six. And by saying this like you’re almost kind of getting in their head a little bit because then like, you follow up with them the next week and they're like, oh, you were right man.

It was pretty tough for a couple days. But man, I feel really good this week. Like today I feel awesome. I just feel, I feel like my energy is high. I didn’t sleep in this morning, I didn’t hit my snooze button. I feel awesome. even with like, with from the hormone therapy side of things, when I meet with Dr.

Faki, telling them what they could expect, what they could expect. Also I think managing this is one area where I think a lot of testosterone clinics go wrong is relying too heavily on like the labs, like the data set of the labs.

if we tell a guy like, hey, optimal range we want to see is usually between about 7 to 1200. And then we got a guy that came in that at 200 feeling like trash. And then we run follow up labs and he's at 700, but he's feeling great.

awesome, man, that’s great. We've, that we've achieved what we’re trying to achieve. Oh, well, I want to be up at 1200. You said 1200 was the upper range. And it's having that patience, having that time to kind of talk them through and explain to them like, hey man, we’re not chasing that number. We really care about how you feel and from what you Just.

You just shared it sounds like you’re feeling great. But just, I think educating them on the expectation up front, and telling them, like, hey, here's what it's at. Here's what we maybe want it to be close to. But ultimately, everyone's different.

I think also as an owner-operator, anybody that’s been, in a nutritionist role or a patient care coordinator role, is use your past experiences. One thing that I think clinic owners can double down on is telling, their staff to use case studies.

When I say case study, I just mean, like, a patient experience. You don’t have to share, like, their name or any of their personal details at all. But, if you got a guy that, like, perfect example. I was just going over the. The whole number analogy with a patient, how he was feeling good, but he wanted it to, want to chase a little bit higher.

Hey, man, is there any chance we could to test dose just a little bit? And I kind of went through the same thing about, hey, higher is not better. In fact, one of our most fit patients. This is a true story, but, one of our most fit patients, you look at him and you would never guess that he's 55 years old, totally jacked, looks super young, handsome guy.

When he came to us, his Testosterone was, like, 93. He's still in pretty good shape. After starting testosterone. Even now, he takes a pretty low dose, I would say, actually a low dose of probably about 120 milligrams a week. And his testosterone sits about 400.

450 is total testosterone. And dude feels awesome and he looks insane. obviously he's got his own individual genetics that are playing for him. But just to emphasize the fact of, like, hey, we’re treating the patient, we’re treating the symptoms. We’re not chasing a number. But the point of sharing all that is telling people that are interacting with patients pull from that, pull from that prior experience that you had.

Because nothing can help a patient feel more validated than hearing the person across the tail from them saying, hey, I’ve heard this conversation before. I’ve had this conversation before several times. Here's what happened in the past. Here's what we can expect in the future or, potentially expect in the future. And that just gives people reassurance.

It's a good point. You brought up that genetics, one person could be with specific genetics, predisposition, specific way, and they would be absolutely amazing at 400 and take another person with a different set with different genetics.

They need more. Yeah, but if you don’t look at this data and, you just give everybody a, cookie cutter, hey, we’re gonna get you to 1200. Now. You’re just doing disservice to the person who doesn’t really need that much because that goes into other things.

Testosterone now converts to estrogen and all other problems they have to deal with 100. So on the flip side of that, I’ve got another guy that he does the same exact dose, probably around 120 milligrams a week. He's a thin guy. He's in his 50s.

But he's definitely not a bodybuilder by any stretch of the imagination. And we've slowly worked on his dose and got it dialed in. And his total testosterone usually sits around 12, 1300, a little bit higher than we'd like it to. But his estrogen's in check, his blood thickness is okay.

And that’s just where he seems to fit at the best. His dosing is actually slightly higher than, the other gentleman's. Which, like, if you looked at the two of them, you would very clearly think, like, oh, clearly this guy's on a crap ton of testosterone versus this guy.

He's probably not taking too much. But it's. That’s not the case. And unless you’re paying attention to the details, you wouldn't know that. unless you care about what you’re doing, the service that you’re providing, it'd be easy just to dismiss that patient, say, you’re fine.

maybe, maybe testosterone is not the right answer for you. I’m going to circle all the way back to, patient retention, back to all the points we talked about where a patient, receiving just a one-size-fits-all protocol, maybe taking on the 1200, and then they don’t feel very good.

Yeah. Wondering why. Yep. Yeah. And we, Yeah, and running. And another thing, too is like, just the panels that you’re testing. I cannot tell you how many times we've gotten, clinic transfers.

We get a lot of clinic transfers, where we ask them, do you have follow-up labs? And I say, oh, yeah, I just got them done a couple weeks ago. And we, we get a copy of them. And, dude, their labs are looking at nothing. Like, they're not even checking blood volume, Hemoglobin, hematocrit, they're not even looking at estrogen.

They're literally just running free and total testosterone. And it's like, okay, well, based off the symptomology you just shared with me, we really got to take a look at that estrogen. And then people are just like, oh, I had no idea. And that’s just kind of like, makes me like, you've been on testosterone for two years.

What, however, duration long. And you didn’t, you weren't aware that estrogen was also a factor in all this. So, yeah, it's. The stuff that you hear from, from other places is just absolutely bonkers. And I get. From a business operational standpoint, I get it. It's a lot cheaper to, test fewer things, to have a nurse practitioner or a PA sign off on them.

But again, you’re doing a disservice to the patient. Yeah. And that’s, that’s the follow up, ongoing follow up, ongoing optimization, why it's so important to continue giving them great experience. Yeah, I think we covered all the topics that I prepared for us.

Anything else you want to cover that we didn’t talk about? Yeah, I guess. Question for you. Who's the primary demographic that sees, these clips? Is it primarily business owners and doctors? This.

Yeah, for business owners, for sure. Plenty of them. That would be the. Yeah, that would be the primary. Yeah, I. The best, one of the best piece of advices that I’ve ever received specifically about running a business and just being a, owner-operator, entrepreneur, whatever label you want to put a pin on your chest.

I was down at another clinic, just, visiting, walking through, kind of seeing the operational side of things. And it just was this crazy, huge practice. I mean, they had, I mean, probably at least, a couple dozen staff members running around, patients everywhere, huge, beautiful facility.

And, like, I just, I looked at the clinic owner and I was like, dude, I was like, how did you do this? Like, how did you. I mean, this didn’t happen overnight, but like, how'd you get here? And he said, it's pretty simple, man. He said, number one, give a shit, he said, and make a promise and deliver on that promise.

And I just, that’s kind of been the motto that we've, we've lived by, is just care. Care about it. Care about your team, care about your employees. don’t be so fixated with the, the margins and the numbers and the total revenue and the next promotion and this and that and the other thing, care about your team, and that’s an investment that will not come back void.

And even at the end of the day, say something doesn’t work out. Well, guess what, like what's the age old saying? Hire slow, fire fast. So you got a bad egg in there, get them out. Yep, that, that’s something we, our mentor told us to hire us.

Yeah, fire fast. And don’t, don’t do like, hey, here's your two weeks. Nope. You pay them for two weeks and you let them go. Now you don’t care for the next two weeks. Being a cancer at the business. Yeah, exactly. Yeah. Thankfully, knock on wood, we've never had a position like that.

Well, at least as me being a business owner, we've had not being a business owner in the past about those situations. But I think the reason why we haven't experienced that is because we really do put a lot into that hiring process. Making sure people are the, are the right fit.

Yeah. Well, Cameron, one, one more thing I want to mention to everybody is that I think you offered consulting services for business, owners who are trying to grow the practice. Correct? Yeah, absolutely. I mean people that are, in this space, whether you’re looking to, onboard peptides, get in the hormone optimization space, even if you’re just, if you’re stuck at a bottleneck, definitely, more than happy brought on as a consultant, just reach out.

I know what it's like, I’ve been there myself. and I, it's, it's nice to go through it once yourself, see what works, see what doesn’t work. And also just working with like minded individuals, working with people that are in this industries that are masters of what they do, I know there's a lot of coaching groups out there, mentorships, but I think realistically working with good people like Alex, or having a good business coach, or just a consultant can do absolute wonders for your business.

Definitely. Well, thank you Cameron for all your shares and all your expertise. Yeah, of, course it was good.