Ep #77 - He Coded His Own Friend in the ER — Then Built a 7-Figure Practice

What if you were running the code on your best friend's husband — and didn't even realize it until the room went quiet?

That's the moment that changed everything for Dr. Jeffrey Galvin. After 20 years as a board-certified emergency medicine and obesity medicine physician — including time at Boston City Hospital during the height of the AIDS epidemic and crack wars, and a stint as a military trauma specialist — Dr. Galvin walked into an ER room, looked at a patient he'd just called time of death on, and realized he knew him. That night sent him down a rabbit hole that ended with him walking away from a secure ER paycheck to build something from nothing: a single, uninsulated office inside a CrossFit gym.

Sixteen years later, that CrossFit closet is Vitality Medical Wellness Institute — a state-of-the-art concierge longevity practice in Charlotte, North Carolina, serving executives, high performers, and (surprisingly) a growing roster of physicians as patients. In this episode, Jody sits down with Dr. Galvin to talk about what it actually takes to bet on yourself, why "relational medicine" is his real superpower, and how he built a nearly referral-only practice without ever really marketing it.

They also get into the harder stuff: how to say no to patients who aren't ready, why he thinks most functional medicine certifications are "kind of a racket," why he refuses to compete on price, and the one sentence a frustrated patient's wife said that talked him back into treatment six months later.

Topics covered:

- The ER moment that changed the entire trajectory of his career
- Why he calls his diagnostic process "cheating" (and how you can too)
- Walmart vs. Nordstrom's: owning your pricing without apology
- How to fire a patient who isn't going to be compliant — and why that protects your reputation
- Building a staff and mentorship pipeline when you're one of the only practices doing what you do
- The most dangerous trend in longevity medicine right now

Connect with Dr. Jeffrey Galvin:
Website: https://www.vitalitymwi.com/ 
Instagram: https://www.instagram.com/vitalitymwi/

This podcast is powered by Accelerated Medical Practices, where we believe hormone and wellness care should be both life-changing and profitable.  If you own or run a clinic and are interested in being a guest on the show, please complete the form here and let's connect!  Or email Jody at Jody@AcceleratedMedicalPractices.com.

 🚀 Grow your clinic with proven systems at AcceleratedMedicalPractices.com

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Transcript

SPEAKER_02 0:37

And here's what I can do. Home screen should be available to everyone who wants it. And while providers know the land, many struggle with the defense of their kind of practice. And that's what I promote. Today's podcast is here to share real strategies, real stories. Things you can implement in your practice right away. So I am so glad you're here. Come on, let's go. Okay, everybody, welcome back to the Beyond Formulance podcast. I am Jodie Lane, your host, and today's guest has to be created the security of a 20-year emergency medicine career and a study here paycheck for a single room in a crossfit gym. And yes, that sounds very strange, but we're gonna get into it today and find out why he did that and how he turned that crossfit gym office into an incredible clinic. I'm with Dr. Jeffrey Galvin, who is the founder and medical director of Vitality Medical Bellness Institute in Charlotte, North Carolina. And after a long and established career as an AR physician, he moved away from the traditional model and built something from scratch. Something a lot of you out there can probably relate to or are thinking about doing. He built a couple years of longevity practice that serves high performers who demand more from their health as well as their physician. Today we're not gonna talk about the medicine, although we could do that for hours because Dr. Galvin's one of the best. But instead, we're going to talk about what it really takes to take a bet on yourself, build a business from nothing, and break every rule in the process. Dr. Galvin, welcome to the podcast.

SPEAKER_00 2:13

Thanks, Jody. Thanks for having me.

SPEAKER_02 2:15

Absolutely. All right, we're gonna dive right in because your origin story is one of the most unique out of all the providers I've met in my 10-year journey. Tell us about how you started in that gym.

SPEAKER_00 2:29

Yeah, so this goes back probably 20 years ago. And, you know, I was on board certified in emergency medicine as well as obesity medicine, but um trained in in emergency medicine at Boston City Hospital, which is like, you know, trauma gun knife and gun club Mecca in the in a time in the middle of the AIDS epidemic and the crack wars, and so you know, saw quite a bit of emergency stuff, and then was in the military as an emergency physician, trauma specialist for a number of years. And then when I separated from the military, got recruited at Concord, North Carolina, because a bunch of it was an emergency department there that was staffed with all ex military guys and a guy that I worked with recruited me down and beautiful, nice little town. We had moved around quite a bit. We had three little kids, and it was the first time we were gonna actually get to sort of settle and put down roots. And um, you know, a very interesting contrast between kind of what I had been doing in a community emergency department, not you know, a busy emergency department, but community, right? And so a majority of what we were seeing was largely chronic disease related, right? So, you know, things that have been longstanding, ongoing, you know, managed by their primary care doctors. And many of those people, you know, you could walk into the room and say, you know, I think if this person made different choices five, 10 years ago, we would we wouldn't be here. And we were treating symptoms and and we were just see, you know, treating the end result of treating those symptoms and not dealing with the core root of it. And you know, there's really very little interest in the primary care doctors to get into the root of it and honestly of the patients either. Like they just want that pill. And you know, so it got you know a little frustrating. And then, you know, in the course of so also personally at the time, you know, went from this sort of high-paced, like active and had suddenly had three little kids working, you know, trying to establish my career, working a lot of shifts. Um, and and because I wanted to be around for the kids, I worked nights primarily, and so I was always sleep deprived. Um, I was working way too much, stressed out, ended up putting on a bunch of weight, developing hypertension and you know, high cholesterol and and not feeling good. And honestly, what one of the things I was finding was I was coming home and just you know, the kids would want to play, and I just was like, you know, had no energy to do that and didn't really recognize that honestly at all. But what happened was there was about a three-month period of time, sorry, where I had three cases come in, all young men under 40 that had sudden cardiac events, you know, in the field, all of whom passed away. So there were probably sudden, you know, undiagnosed heart disease, including, you know, a case of who was a friend of mine. Um and my one of my wife's best friend's husband, who was an athletic, fit-looking guy, had worked out that day, was pumping gas and collapsed, and had a sudden cardiac event, and I was the attending. And, you know, if you don't work in the emergency department, you um this may sound a little crass or or like uncaring, but like when you have a code like that, you don't really care who it is, or you don't even know who it is, you don't have a name, you know, there's and you're essentially orchestrating all these different people, you're intubating the patient, you're ordering meds, you're looking at the monitor, you know, you're not really, you know, you're directing CPR, but you're not really looking at the person, you don't have any, you know, you the EMS might say, hey, he has a history or whatever, but you know, you have you have no idea who the person is. And and honestly, you're not really looking at them. And and after the ran the code for quite a while because he was so young and finally had to call it. And I I looked at him then, and you're like, you know, now they look weird, they're they're intubated, and and you know, they don't look the same. But the guy looked familiar. I'm like, and I looked at the chart, yeah, I go, what's his name? And the the name didn't ring a bell. So I'm like, okay, maybe it's okay. Set down a dick document, and the nurse came up and said, Hey, you know, the patient's wife is here and she she knows your wife really well. And I remembered the different last names. And this is a guy who, you know, I saw socially, you know, at a lot, and Paula was really good friends with his wife. And I'll never forget walking into that room and to tell her what had happened and and her looking at me going, I heard he fell at the gas station. What did that idiot do this time? And I had to tell her he was dead, and you know, it kind of was, you know, and unfortunately in my profession, you see, you know, you have to deal with that situation quite a bit. But this really hit me. And I and I'm like, crap, that could be me. Like, what would happen if it was me? And you know, I wasn't feeling good. And so I went to my primary care doctor, who's a friend of mine, and I told him that story. And he's like, you know, I said, I really want a full workup. I want to know if I have and he's like, you know, we don't really do that, just eat less, work out more. And I'm like, and you know, and here's some medicine for your blood pressure. And I'm like, it pissed me off, honestly. Um and I was like, this is ridiculous. This is like ridiculous advice to give somebody. And it sent me down the rabbit hole. I started reading and started, you know, kind of going to conferences and realizing very quickly that all the things we've been telling people to do were were nonsense. Like even the nutrition. And in a very short period of time, like within about six months, I completely turned my own health around. Paula had, we started doing CrossFit, we got our nutrition right, had some advanced labs done, realized there were some hormonal issues and other things going on. And the CrossFit gym that we were working out at was owned by this X ex-marine guy who we became pretty good friends with. And um, after every class, I would be kind of surrounded by people asking me medical questions. And Steve came up to me one day and said, Doc, you know, we got an empty office upstairs. You guys should open some clinics. And that was 16 years ago. And our very first clinic was in this like room in this CrossFit box with no heat in the winter, no um air conditioning in the summer allowed. And then we we were there for a short period of time, and then we moved to a different gym. It was like a more of an athletic center with like a nice internal office, and then we opened an office near the hospital, and then about eight or nine years ago, we built a state-of-the-art facility. You've been here, you know what I have, yeah. Super nice, and you know, and what we started doing was you know, essentially what they call functional medicine today, where we were doing detailed evaluations and identifying these root causes, and we started, you know, reversing diabetes and all this stuff. And before long, we realized that we were getting a lot of physicians as patients because I would fix you know, somebody and they would call me up and like, How did you fix this person's diabetes? And you know, kind of tell them like what we're doing, like, you know, I don't feel that good. And so to this day, like our staff is like, why do we have so many doctors as patients? And you know, and not only from all over the country. And um, so that evolved from sort of a functional medicine clinic to then we started really focusing on these sort of higher-end evaluations. We work with tons of executives, and our ideal is we want to give people certainty, clarity, and direction. So certainty about their health, which entails very detailed, as you know, evaluations, multi-day, and like all types of modalities, and then a really um personalized one-on-one sort of sit-down with me that typically lasts six hours or more. And that's clarity, like what all this stuff, you know, these are the findings, this is what it means to you based on your symptoms, on your family history, and on the results, and then directions. What do we want to do about it? And, you know, we're always, you know, trying to redefinitively want to answer as a yes or no five questions. And we're able to do that. One is do you have heart disease? Two, do you have any evidence of metabolic disease, even pre-pre-diabetes? You know, evidence of insulin resistance that shows up a decade before it really is going to reel its head. Um, three, do we have cancer? Four, do we have any of the risks, either genetic or um you know, lifestyle related? Or do we have any evidence based on your cognitive testing and quantitative EGs and things like that of cognitive decline or Alzheimer's? And finally, like, how quickly are we aging and how are we performing compared to our peers and our competitors? And um, we get that from these extensive evaluations we do. We look at advanced labs, genetics, epigenetics, advanced cardiac testing, scans, carotid ultrasounds, BO2 max testing, we have a DEXA scanner, we look at everything. And then from that, we formulate these very detailed plans and we and we have you know incredibly high success rates. And you know, and you know, I know you do marketing, but as you know, we don't really market, it's all kind of word of mouth because we do is a little bit unique. And um that being said, you know, we still you know, like we're doing a whole set of videos right now because we get these really incredible results. And like, you know, a lot of times physicians call me up a little bit shocked and like, how did you do that? You know, like um, or them for themselves, like, how did you figure that? And they're like, Listen, the secret is I cheat. And I have such a deep.

SPEAKER_02 11:44

Wait, wait, wait, say that again, because I'm not sure everybody heard that. The secret is you cheat, yeah.

SPEAKER_00 11:48

And I cheat, but you know, I have all the information, so I'm not guessing. I like I and I have a new PA who just started, and he's like, What I do with them when I'm kind of training him, I said, Well, we and we get like these detailed questionnaires and and all this stuff, but uh what I do is I I said, Well, let's before we look at the questionnaire and find out what the patient's coming for, let's just look at the lab work and we'll go through the lab work, and I'm like, this is what this patient's coming for. And then we look at the at the thing. And he's like, How do you know that? I'm like, because you know, you do this long enough. I know if these labs look like this, these are the things the patient's gonna have problems with. And and you know, it's probably I'm probably right 80% of the time. You know, there's always sometimes like a particular issue, but you can I can look at you know that because we have such a detailed panel of labs, I know, you know, with great certainty what probable things people have. And you know, I speak all over the country, I work with a lot of executive groups, and you know, what what I describe is not that we don't do functional medicine or hormone therapy or or whatever, although all of our things are we always look at nutrition, fitness, sleep, stress, hormones, metabolic health. We use a lot of technology, wearables, and things like that to kind of track things. But what I think my superpower is, is that I practice relational medicine and I spend so much time with patients is that and it changes the relationship. And that relationship drives success. And you know, the average primary care doctor spends five minutes a year with their physician. I spend, you know, an average of probably eight to twelve yearly with me, and then with our coaches and other staff, probably in double that. And so it becomes a very different relationship. And as you know, we do retreats out of the country. It's not unusual for our local patients to um, I'm I'm available to them 24-7, but we get them so healthy. I rarely get medical um related calls and texts. But unusually, like we go out to dinner with our patients. We have like a social relationship with a lot of them. And so very often then people are like, hey, we're you know, we got this thing, you want to come? Or and so it's a weird, you know, it's a very strange relationship that we didn't set out to do this, it just sort of evolved and morphed over the years. And, you know, the stuff that we're doing, a lot of people are trying to get into. Um, but we've been doing it for 16 years, and so there's a little bit of credibility with that. Um, yeah, and we really do get transformational change. As a matter of fact, the series of videos we're doing, I think really, and I might it's not live yet, but maybe I can give you a link to a video that we just filmed for one of our executive patients. That oh, that'd be awesome. That feels pretty much. Yeah, yeah.

SPEAKER_02 14:38

So I what you said something that I mean, you said a lot of things that I want to dive into, but there's something that you said that I want to highlight because I work with a lot of providers that are in that dude, a variety of different ways of treating their patients from very, very low end to very high end. But you said, I'm available 24-7, but I don't get contacted about their health because I make them healthy. All of those providers out there that are so worried about giving concierge support because you're afraid that you're going to be bombarded with questions and just take care of them. You just take care of your patients and make and eliminate that need for questions. That's brilliant. Yeah.

SPEAKER_00 15:18

Now, you know, we um uh every once in a while I get, you know, someone who's like texting you every two minutes. And so what we do is we sort of gently like have the coaches say, hey, listen, you know, like a really good example is like refills and stuff like that. And I I tell my staff, throw me under the bus, it's okay, because like I only have limited bandwidth. And like if someone texts me for a refill on a Friday night, I'm not gonna remember. So I'll do it. And then like I have my staff literally call them and say, Hey, listen, you know, Dr. Galvin has all the all the you know, will do anything for his patients, but he really sometimes can't. And so stuff like this, if you would just text me instead, sure, it will guarantee a great approach. Yeah, that's a great approach because as much as good as his intentions are, um, if you text him about a refill, it may only get done of the time.

SPEAKER_02 16:10

That makes sense.

SPEAKER_00 16:11

Because, and so they, you know, they kind of um, and we're you know, we're just honest with people like, you know, but anything else, and you know, and we manage people like I've literally taken care of somebody remotely who is on a mountain uh via a satellite phone filming a television show where they got altitude sickness, and the on-site paramedic wanted them to continue, and they clearly had altitude sickness. And I had to like explain to this mountain paramedic that I thought she was an expert that, like, yeah, that you gotta get this guy off the mountain or he's gonna die. Wow, and um, so you know, we've had some, and you know, our patients can they try a lot of our patients travel over the world, and so we've had, you know, we've had to coordinate care in in like different countries and in the third world and things like that. And so we can provide that support. And a lot of our patients are like, you know, they want my opinion about that stuff. And I've got you know, I've got a skill set that lends to treating anything. Um, you know, and so you know, it's it's a little bit of a unique aspect of our practice.

SPEAKER_02 17:17

So, you know, I've seen a more and more of a surgence of ER physicians or people or providers that work in the ER becoming more functional medicine hormone kind of providers. When you as you stated, you didn't intend to go out and become what you know is trending right now called longevity medicine. Like, because you you were the original, like you were doing all the tests and all that years and years before this became something that people are talking about. But for somebody that is like in the ER right now and has that same epiphany, like if I could take care of the patient before they came into the ER, they'd have a much better quality of life. What advice would you give them in terms of how to pick what lane to stay in? Because there's a variety of different ways that you can service people, right? There's like a straight-on hormone clinic, there's a little more functional medicine, and then there's going really deep down, like you mentioned, relation uh medicine. How do you help? What would you say to somebody who's trying to figure that out for themselves?

SPEAKER_00 18:20

I I think that you know it's a pretty individualized question. I think one of the reasons for emergency medicine is that for the first, you know, probably five years we were open. I I was working in the ER and my clinic both. And so emergency medicine, you know, you can, you know, I work primarily night, so I could uh there was a way to sort of do both, right? It sucked because I was, you know, working a huge amount of time doing it. I think you got to be realistic. I think that a lot of people think I can just like do this without any training. And like you really need to get, you really need to know what you're doing, right? And do I think you need to like be like functionally medicine certified? I don't. I think that those are kind of a lot of those companies, like A4M and things like that, I think it's kind of a racket, you know. Like I'm obesity, I'm board certified in obesity medicine. Let's face it, that's a BS.

SPEAKER_02 19:14

It's your experience that gives you the knowledge, is what you're saying, right?

SPEAKER_00 19:17

Right. But also like it's not like it's a it's not uh there's no national, there's a national board, but it's like you know, it's like a certification. It looks nice on a shingle, physician to physician, or like, you know, that emergency medicine like is a real like it's a residency, it's you know, it's exams, whereas obesity medicine is just like a test. Um it does indicate training, but like if I had to pick two people, somebody who's been doing it for 20 years versus somebody who just came out with like a shiny piece of paper, I'd go to the 20-year person. So I think that like the training is is really important. Um and I and I th and those those organizations do give good, you know, good training. And it's important to get that training. I do I think the piece of paper is important. I don't. I do think that you know, sometimes people think it's it's simple and it's easy and they and they don't understand um that it's not. And like we see a lot of um people that like come to us that have been seen at other clinics, and I and I just I'm aghast at like the care they're getting. And like you're like, oh, you know, maybe we shouldn't be blocking your we should maybe not be giving you estrogen blockade because we kind of don't want you to have a heart attack or develop demand. Right. But like that's just my personal opinion. If that's what you want, then yeah, we should definitely block your estrogen or power to you.

SPEAKER_02 20:45

I think it's because it because you can't necessarily just go get a job in this industry as easily as you could in traditional medicine, that there's this pull toward entrepreneurship, and you think I have to open my own clinic, and so therefore you're not getting all that experience of working under somebody as experienced as you before you go and try to do it on your own.

SPEAKER_00 21:05

Yeah, I I do. Yeah, and I think that's one of the things we're looking at is like, you know, we're starting to do a mentorship type thing where you can train with me and and you know, I I think we have like a you know, we also, if you come to us, it's a very experiential thing. As you know, like we really focus on food and like you know, we we cook with our patients and we like you know, there's a whole experience part of it, you know. So as you know, our office is beautiful, and like our patients come, we like even when they get their lab initial labs, we do labs and we do a beautiful breakfast for them. Right. We do things like you know, we have different monitors that we use and we kind of have them wearing those prior to their evaluation. And after a couple of days here, we kind of pull up and we say, Hey, look at your readings the week before you were here, and look at your readings over the last two days, and they're radically different. And I could say, so you see what a huge change you can make. With just two days. And I said, you know, you had breakfast and lunch here for those two days. Did we feed you anything that didn't look amazing and taste amazing? And they're like, no, like it was incredible. So could you eat like that every day? Yeah. And look at what it did to you metabolically. You know, we it's like, and it's it's a radical difference. And so you kind of you leverage that experience and you say, hey, look at there's some method to the madness, and that's why we did it this way. And it instantly establishes a little bit of credibility and things like that. And so utilizing those advanced tools at the same time incorporating it into an experience is important. And um, you know, and you know, we're expensive, you know, like they're like, well, I could go, you know, up the street and get hormone therapy for a hundred bucks a month or whatever. I'm like, awesome, you should definitely do that if you want, you know, but like some you know, unfortunately, some undertrained person or an extender or somebody who you know is gonna provide that level of service. We we're providing this level of service, and and there's nothing wrong with Walmart. You know, we all all shop at Walmart, however, um Nord Stream's better. And if we have the resources, we're gonna go to Nordstrom's or some other high-end place. There's nothing wrong. Like the shirt I buy at Walmart provides the exact same function as you know, some high-end shop on Rodeo Drive, but they're they're different, right? Like um, they still cover my skin. Right. There's a functional difference, but there's some, you know, it just really depends. And and um, I you know, that's what I tell people like if they push back, I said, I get it, it's cool, like it's absolutely fine if you don't and very rarely do we get people say, no, I really want more. Um so you just have to sort of understand that and not undervalue yourself. And I think there's this like race to the bottom, and it's stupid. Like if you know, your your time is valuable. When they come to us, they're not just getting like a a medicine, you know, a functional medicine protocol, they're getting access to 25 years of experience and someone who who's made those changes themselves and does the same things every day, and um, and also deeply kind of understands the executive mindset and the mindset of high performers. And also, you know, one of the things we do is like I could tell you um Jody, all you need to do to live to 100 is eat sticks and rocks every day. Um, and that may be true, however, what's the likelihood of you doing that? It's zero, right? So if I tell people like you need to do this 100% of the time, like it's a fool's game, right? And you know, perfection is the enemy of success. And and so we kind of teach people, let's be pragmatic about it and understand that we can't be a hundred percent, nor do we want to, because you know, like a good example is the holidays, you know, and we see people after the holidays, and they're like, it's like the Spanish Inquisition around here. People come in, that's so bad, you know, every kind of four four bad dinners, and you know, and one thing, like what we find is our patients actually do remarkably well over the holidays, and even if they have like a little bit of slippage, you know, I always tell them, I said, listen, you know, we survived. And I said, but I've got some bad news for you because I just read in the paper they're gonna have Christmas again next year and anniversaries and birthdays. Like, how do we be pragmatic about it and understand that we have to, it's okay to not be perfect. And honestly, the the lunch and breakfast that you have during the work week, um, where you're alone and you're you're likely to grab a bagel or something unhealthy or you know, get some, order some fast food in or whatever. People come in and they're like, Oh, we were really bad. We went out for my anniversary on Friday night. And I'm like, Yeah, okay, who cares? How many of those happen a month? How many workday lunches and breakfasts do you have? There's 40 of them. So 40, if you have 40 bad meals out of 90, you're gonna have a hard time overcoming that. If you have three bad meals out of 90, it's nothing, right? So we try to give this perspective, especially when we're working with like higher-end people that are doing travel and things like that. And how do you, you know, I've got a patient that has a huge alcohol beer and wine distributor, and he's you know, he travels into for these wine tastings and things with clients. Like, how do you take that person and like get them not to be drinking seven drinks a day? And you know, how like so we work with people in relation to their life, like what their lives are to provide a really personalized strategy. Okay, this is what we're gonna do to sort of deal with this because we've got to kind of level that playing field. We can't have a self-sabotaging, but we can probably hack it. So, you know, and like you can eat out pretty cleanly, and no one has to know, but just by understanding menus and things like that, and maybe using a little technology to kind of help us. And so there's a way of doing that. And I think that's important when you're dealing with sort of higher performers to give them a lifestyle that works with their lives.

SPEAKER_02 27:37

Hey listeners, whether this is your first episode of Beyond Hormones or your 50th, I hope you can tell by now how much I love working in the hormone industry and sharing my tips, experience, and guest stories to help you succeed. Your success is truly my personal joy. So if you don't mind, I want to take a quick moment to share a product of ours that I know will truly help many of you build the clinic you have been dreaming of. It's called Practice Automation System. Now, here's something that most of the clinics I've spoken with that have scaled past seven figures have quietly figured out. Most marketing doesn't fail trying to get leads, it fails after you've already reached them. According to studies, up to 87% of people don't pick up unknown calls anymore. Isn't that crazy? But deep down, I bet you realize it's true. I know I don't answer unknown phone calls, do you? So that means even if your front desk is being incredible and calling them as soon as they come in, there's a good chance they're not gonna reach them. And if that's all you try, your marketing dollars just vanished. Not because your advertising didn't produce, it's because your message didn't get through. The practice automation system is what we built so that doesn't happen. To reach someone these days, you need to nurture them. They used to say it took five to seven touches to reach someone. Now it can be as high as 20, 30, or even more. We help you text them within five minutes, nurture them automatically for weeks and months. The pipeline keeps moving even when your front desk is busy. I spent years running and growing a hormone clinic in Orlando where we grew to over a thousand patients, four providers, and 23 staff members. So we know this works. You know why? Because we used it ourselves, well before we turned this into a product. We're not guessing what hormone patients need because we experienced it. To find out if Practice Automation System is the solution you've been looking for, go to accelerated medical practices.com slash automation. That's acceleratedmedicalpractices.com slash automation. All right, let's get back to the show. Yeah. Well, and you know, something I want to just kind of highlight is you've chosen very specifically who what your lane is and who you're targeting and how you're between those people. We talked about you mentioned the Walmart versus the Nordstroms. And, you know, you're right, there's really nothing wrong with choosing to be the Walmart if that's if you're especially if you're well trained and you're providing a great service and you're just limiting your service and you're limiting your time and all of that. But it's knowing and being conscious of who you are, what you're doing, and what you're charging, and then being okay with a patient saying no. It's no is a perfectly fine answer if you know they go through the whole process. And I'm imagining too, you don't let your patients show up without any idea of price or commitment because you're not asking them just to pay a premium price. You're asking them to make pay a premium commitment to what you tell them to do, that they need to do it. You don't probably don't keep people who are not compliant, correct?

SPEAKER_00 30:59

And I I think that you know, that's another thing over the years that I've learned to say no to people. Like, you know, sometimes you just sit down with with people and you just know from that initial consultation that they're just not gonna be compliant. And, you know, and you know, sometimes I'll just say, listen, you know, I have a very limited number of patients I can see, and I understand what you want, but I don't I don't think you're in the right headspace for us. And I don't want you to drop $30,000, $40,000 and be unhappy. And you know, we're we may not be the best choice for you. And I, you know, I have a great story of a guy who came and did this initial consultation, and really the entire consultation basically him was him telling me all the things he was not going to do. And you know, hey, and he had been like a lot of our stuff, it's almost all word of mouth, right? He's like, I know you know these three guys that have done really, really well with you, and I know he's doing this, well, I'm not gonna do that. And he's this other guy's doing it. And I'm like, Well, you hear more. Um, I you know, he said, Well, I go, well, listen, thanks for coming in. And he's like, Well, what are the next steps? I said, Well, you know what, I'm not gonna take you on as a patient. He's like, Well, what do you mean? I'm like, listen, you're you're not, you're not, you're not there. I go, you you know, you just you spent the entire time telling me that you're not gonna do any of the things I'm gonna tell you to do. And so you're gonna spend this money and you're gonna be pissed off and you're gonna badmouth me around town. And and like, and I I will try, I'll do everything to make you well, but if you're gonna fight me with it, and I I said, I just I don't I don't want that. And and honestly, you don't want that. And so he went home and apparently called one of my patients, and the guy called me up and I said, Yeah, I go, you know, he's and they're like, you know, it's probably the right decision because the guy's kind of fast, you know. And I'm like, okay, well, six months later, the guy shows up at the office again, and uh, and I'm like, Oh, hey man, you know, what's going on? He's like, I'm ready. He goes, I'm ready. And I'm like, Well, what changed? He goes, Well, I gotta tell you what happened. I went home, I was so pissed. I called my friend up. I'm like, Oh, yeah, I know, because he called me. He goes, then I I went off to my wife and I, you know, told him on, and then um, like about a month later, I was still complaining about you. Uh and my wife, you know, had never really responded. And he's like, What what you don't care about any of this stuff? She's like, You've been complaining about this guy for a month. She goes, A, that's weird. And B, all the things he told you are completely true. You know, so I didn't talk to her for two weeks. And then he goes, I started thinking about it. And um, I still wasn't feeling well. I'm seeing my friends were doing great. And I I realized that you know what you told me was right. I did, I went in there and I told you all the things I wouldn't do. And I kept thinking about it. And I kept saying to myself, why do I keep thinking about this asshole? Um, and finally it just dawned on me, it's like you were being very brutally honest with me. And he goes, I'm this huge company, nobody ever talks to me like that. And he and I and he goes, I realized that was what I was pissed about. And I thought about it like if I were in your shoes, I would have done exactly the same thing. And he goes, I'm really ready now. And so this was years ago, and he did, and to his word, he did all this stuff, did incredibly well. And I probably have more referrals from that one guy than anybody else on our practice. And we still to this day joke about like remember when they kicked me out of your office? I'm like, I wasn't, I didn't kick you out of my office, but yeah.

SPEAKER_02 34:26

Highly recommended that you leave.

SPEAKER_00 34:27

Yeah, and so you have to kind of understand that like you've got to be like true to like you've got to be ethically sound and true to yourself and true to your goal is the patient to do well. And if they're not gonna do well, then you gotta be honest with that. If they want to proceed despite that, you know, I you know I might relent and I might say, listen, okay, we'll give you a month and sort of see how you're doing. But luckily, you know, we don't have to deal with that as much now. Most of our patients, like I never speak money with anybody, but I I'll do a 15-minute phone call, or honestly, most of the time I speak an event or something like that, and they call and they talk to you know our our uh our uh practice manager, and like they sign up for the whole thing, sight and scene, and and pay the money and and like oh yeah, whatever.

SPEAKER_02 35:17

Yeah, your reputation speaks ahead of you.

SPEAKER_00 35:19

Yeah, and you know, very often we're also dealing with like I want to bring my wife too, or my husband too. So we do a lot of the couples, and so that's like a little bit, you know, and that just sort of you know evolved, and that's like you know what we do. And again, I don't if you just you know, if you come and you're like, I can get this, there's a nurse practitioner down the road that does this for nothing. I'm like, uh awesome. But you're gonna get kind of what you pay for. You probably don't have the the depth of experience, the training, they don't have the equipment. You know, we always, you know, we measure. We have all the equipment to do high-end, you know, DEXA and all that stuff. And so even our hormone therapy people, we're measuring things that you're not measuring in a you know, a men's health clinic or game day health or whatever. Like they're not doing, they're not, you know, they're not getting the objective measurements what they're that we do. Like, we're not just doing labs, we're doing performance measures. And like we want to our at three months, um, our average delta on the DEXA for a male is 15 pounds, meaning the delta is pounds of fat loss plus pounds of muscle gain.

SPEAKER_02 36:25

Wow.

SPEAKER_00 36:25

Um, so that that could mean they have no weight change at all.

SPEAKER_02 36:28

Right.

SPEAKER_00 36:28

You know, they might have lost seven and a half pounds of fat and gained seven and a half pounds of muscle. And the if you don't have that technology, which is you know quite expensive to have, then people are gonna be like, well, I like this, but I'm not losing any weight. Well, when I can show you on your DEX of that, like, yeah, you're not losing any weight because this is what happened, and you dropped your body fat like this much, and then they're like, Yeah, my clothes fit way better. And then, like, oh, and you can teach them the scale is not your friend, and using an in-body, they're all those companies say, Oh, they're just like DEX. They're not. I have both, and I can show you that absolutely they're not the same. And so having that investment in technology and also having the other things that we do elevate our level of care. And also, that's that cheat, right? I don't have to argue, um, I don't have to push back about weight when I have data. Like, you know, look at what you're doing. I had a guy just this morning, he's at his three months, and he's up, he's 10 pounds heavier after three months, and he's he's gained 15 pounds of muscle and lost five pounds of fat. And he's like, and his comment was like, I don't know how things going. He's like, Great, I feel great. My brain is so much clearer, I'm killing it at the gym. I'm wearing pants that are two sizes smaller. And I said, you know, are you having any any concerns that? Yeah, but I'm gaining weight. And we looked at the decks, I'm like, well, here you go. He's like, Oh, that makes so much sense. Yeah, I shouldn't even weigh myself. I'm like, yeah, I don't disagree. But again, if you don't have that, like it's hard to kind of explain that away.

SPEAKER_02 38:02

Yeah. Let me ask you a very different question, just because as people are listening, one of the things, there's two main things that people always listen to this podcast and listen for marketing and staff. And marketing we're not going to talk about with you because it's more word of mouth, but how do you hire and maintain a staff that has the intelligence and the commitment and the integrity and the excellence that you and Paula do so that you can provide that level of service?

SPEAKER_00 38:31

Yeah, it's a we struggle with it, honestly. It's hard to find good people and like it's so, you know, especially with like CMA level, like it's so transient. Like they just, and like, you know, in a primary care doctor, when they've got 20 CMAs, like I've got a lot of doctors that, you know, like they they lose a CMA, you know, a couple every month, you know, they're like churning, but like you don't notice it because you know, you just but here we have one or two, and like they notice when when you know people change. And we honestly struggle with that sometimes. We try to find people who are passionate, um, who are personable. Um, and we try to provide good training and try to get people invested in lifestyle. We want people to be kind of living the lifestyle we're promoting.

SPEAKER_01 39:18

Yeah.

SPEAKER_00 39:19

Um, but I think everybody you talk to has staffing problems. You know, like it's really hard to find really good people and we have pretty high standards. And like, you know, so we've got a pretty good crew right now. We're looking for a new, another coach, but we have a kind of a process that we go through, but you know, we sometimes kiss a lot of frogs before we find a price.

SPEAKER_02 39:42

Well, I like what you said that you provide training. I think a lot of times, and I actually just did a video about this uh for social media. A lot of business owners or providers don't want to provide training because there's this fear that I invest in training in you and then you're gonna leave me and you're gonna take that training someplace else. But my the alternative question is what if you don't? Like what if they don't leave? Then now you have an untrained person. So being willing to put the effort into somebody, I think is the answer there.

SPEAKER_00 40:11

Yeah, and like and plus, where do how do I list for that this position? Like, where are they gonna come from? There aren't, we're one of the few places in the whole world. Absolutely, you know, and so um, and so that becomes problematic. But you know, when we hire extenders, it's like a mentorship program, you know, where we have like a defined sort of onboarding training over the course of you know six months or so, and it gives us a chance to find out like, are they aligned? Um and you know, the fact is sometimes people have all the best intentions and you know, and there's nothing wrong with them as a say a provider, but they just don't get it, or they just sometimes don't have what we need. And so we do kind of look at that and try to figure out if someone's gonna work long term or not.

SPEAKER_02 41:06

Yeah. Yeah, well, I mean, it's actually kind of refreshing for people that are listening that you have a highly successful 20-year business and you still struggle on a day-to-day basis basis with the same things that everybody struggles with. And you know, you're working through it.

SPEAKER_00 41:21

Yeah, and like you know, we work like we have a lot of business owners in all fields, right? Um and medicine, we we we have a huge population of like orthodontic people, doctors, lawyers, business owners. Um, I spend a lot of time with people, and you know, very often we sit down for an hour and we talk about their medical stuff for five minutes, and we we talk about other things for the rest of the time. And everybody has the same staff. Like it's not just medical, it's everybody, it's a struggle for everybody, and um you just have to realize that it's hard. Yeah.

SPEAKER_02 42:04

Well, this has been an amazing conversation. I don't know if you know this, but I finished every episode with something that I completely stole from another podcast. It's uh Steve Bartlett's diary of CEO, where he asks his current guest a question from a past guest, and you don't know who that is. And so I have a final question for you from my last guest. And that question is what do you think is the most scary or detrimental thing in the longevity and wellness space right now that could jeopardize its credibility?

SPEAKER_00 42:39

Oh, I I think for sure it's these clueless influencers that are pushing unproven treatments. You know, peptides are a great example. We've used peptides for a dozen years. I get probably two emails a day of some fly by night company that wants to sell me peptides that you know who knows where they're sourced from. You have no idea. You know, certainly a setback when we could not get compounded peptides any longer. We have been fortunate that we've been able to use the same source our compounder used, but like people are buying stuff from and you know they have no idea. A oh, well, there's a certificate of of purity or whatever. Like I could Photoshop that. If you look at those websites, there's no guarantee of sterility. You have no idea where it's coming from. Are you gonna put that in your body? It's it's crazy. And also, you know, a lot of these things are being, they're what I call 1% things, right? And there's a lecture that I give where um, you know, I've got the the slide is like this sort of pool of water like in the Arctic, filled with water with ice and snow around it. And the caption says, What happens if I put a 300 pound diabetic in a coal plunge? And the next slide is this obese, pissed off looking guy. And the cut the slide says a wet 300-pound diabetic. Like I haven't fixed anything. And like those are a cold plunge, is a 1% thing. Yeah.

SPEAKER_02 44:13

That makes sense.

SPEAKER_00 44:13

If you're performing at the 20th percentile, 21 ain't helping you, right? Right. You need to get you to 90. And then that 1%. And people gravitate towards these shiny things because like I saw this podcast and I get all this stuff. Like, I want to try the supplement. Like, you know, how many people have just a drugstore worth of BS supplements that they bought based on some internet thing that are sitting half used in your like and also, you know, is there a way to measure the effects? Right. And so, you know, that's, I think, my my feeling is like that does great disservice because people are kind of biohacking themselves with no data. It's like it doesn't make it's like it's like trying to tinker with your airplane engine while you're flying. Oops, you know.

SPEAKER_02 44:59

It's funny. 10, 12 years ago, you know, you couldn't convince someone to put testosterone, biodental testosterone in their body. And now we have gotten to a place where it is kind of the wild, wild west. It's crazy.

SPEAKER_00 45:12

So again, if you don't measure, like, you know, but there's a lot of people that like are taking shortcuts and it's dangerous, you know. And you know, we don't really know the harm assuming because it's like kind of exploded. Now, as much as I disagree with almost everything Kennedy's done, I it does sound like the FDA is gonna lift that compounding band. And then, you know, if you have a legitimate compounder that you've used for a decade, then you know, if I can get my peptide from them, then I'm convinced that I've got this relationship with this company and I know I can trust them, and that then that's helpful. But again, those are not that's not step one, right? Right? It's step five or six, and we don't treat with buzzwords, we treat the root cause of problems. And I always tell people the the secret to six, if you want to be a healthy, vibrant, vital 95-year-old, the secret isn't all the boring stuff. It's consistency over time doing the boring stuff. A peptide's not gonna get you there. You got to do the boring day-to-day stuff in and out. We can certainly we and we do lots of biohacking. We you know, we do things, you know, we send people to other countries for stem cell therapy and things like that. Like we supervise everything, but again, we get people dialed in first. And then once we get them dialed in, then we kind of turn to biohacking. We do a lot of really advanced stuff, but we don't do it until people are at that 90th percentile. And then we start layering that other stuff in and we're measuring to make sure we're not doing any harm.

unknown 46:48

Yeah.

SPEAKER_00 46:48

And that we're getting the results that we expect.

SPEAKER_02 46:51

Yeah, that and I love that that little sound bite. You know, if you want to live in 95, start with the boring stuff because it's true. I think we live in a an instant gratification society. And between the social media influence and the desire to cut corners and be comfortable, but yet still have great outcomes. We've just kind of bought into this ridiculousness that's out there. So thank you for saying that out loud and you know, letting people hear that. It's been so wonderful to see you. We worked together, just everyone knows, we worked together, what, like three or four years ago.

SPEAKER_00 47:23

Yeah, a while ago, yeah.

SPEAKER_02 47:24

Yeah, I came back to North Carolina a couple of times. I got to work with the staff and we had a great experience with Jody.

SPEAKER_00 47:29

So I think appreciate that.

SPEAKER_02 47:32

Yeah, it was wonderful to work with you and your team and your family because it was at that time there was a number of family members that were working in the practice. So yeah, that's awesome. All right. Well, thank you so much, Dr. Galvin. I really appreciate your time. I know it's very precious, and uh all the wisdom that you've provided today has been just incredible. Thank you.

SPEAKER_00 47:50

Well, thank you for having me. Absolutely.

SPEAKER_02 47:54

Thank you for listening to Beyond Hormones, the business of wellness. I hope that you're walking away with fresh ideas and real strategies you can use to grow your practice with profit and purpose. If you enjoyed today's episode, be sure to follow the show so you never miss a conversation. And if something you heard today resonated with you, do me a favor, share this episode with a friend or a colleague. It's one of the best ways you can support the show, and it might be exactly what they need to hear right now. If you want even more tools and support, go ahead and head over to accelerated medical practices.com. Until next time, keep doing the work that matters. Your patients need you, and I am cheering you along every step of the way.