Flora Waples - Founder at Restor Medical Spa

Welcome to another Founder Wisdom podcast. We have Dr. Flora Waples with us today. She's an MD. She's the founder of Restore Medical Spa. She's an Ivy League educated physician with 15 plus years of making aging optional. She's now in aesthetic and regenerative medicine. She's a public speaker. She was in ER for quite some time. So, Flora, welcome to the pod. Tell us a bit more about yourself and what you're up to.

Thank you so much for having me. Oh, about myself. I think you pretty much nailed it. I did emergency medicine trauma for 15 years, loved it, had a wonderful career, but started to want to intervene in a proactive way instead of a reactive way. So I opened my business about 15 years ago. So I am much older than I look, I think. And, um, and I've been doing regenerative wellness and aesthetic medicine ever since. And it's, it's been wonderful. It's been awesome.

Nice. And tell me about your time in ER. What did you learn there?

Oh, I learned that blood doesn't show up on black scrubs, so that's important. What I think— what I learned the most is that, you know, our medical system does everything 15 years too late. Like, if you come into the ER, unless you've been run over by a bus or shot, you know, but if you come into the ER, it's because someone failed to stop a dangerous or, you know, bad process 10 years ago. And that's why you end up in my ER. And I really want to change that about our medical system in my small capacity. I wanted to make it so that we could make that intervention 10 years early, 15 years early, so that you never develop that disease in the first place. That's kind of our goal.

What kind of stories, uh, did you have all your time there? How did, uh, that transfer in your current position? You must have learned to keep your, your cool together, right?

Um, you know, Yeah, I mean, of course, the ER is a chaotic, you know, very chaotic place to be. And I've seen it all. I've been attacked by 300-pound meth addicts. That's exciting. I've been, you know, I've had to wrestle down people who are on all kinds of drugs. And, you know, I think that— I actually think that aesthetics is more stressful in a really, really weird way, because if someone comes in the ER and they've been shot 6 times, right? And they die on my table. We did our best. You know, they were killed by the gunshots. If someone comes into aesthetic practice and something bad happens, that's entirely on me. So that bar of do no harm is higher. But yeah, no, I mean, you know, in the ER we've seen everything, foreign bodies in every possible orifice, every stupid decision that any human can make. We've seen it. It's, it's all there.

What led to the transfer to Restore, right? Like something that's more preventative as well. Like when was that official pivot? Yeah, that was—

I was, I think, 37, and I was 30 or 40 pounds overweight. I was pre-diabetic. Everybody in my family gets diabetes in their late 30s or early 40s. I was pre-diabetic. I was overweight. I was not healthy. I went to my physician, who's a bright lady, love her, know her personally. We trained at the same program, like good doc. And I was like, hey, you know, my hair's falling out. Joints hurt, I'm 30 pounds overweight, like everything's falling apart. And she was like, well, she's like, Flora, she's like, you know, you're a 35-year-old mother of 2. She's like, this is what it is. This is what your life is. And I was like, you know, I was like, I love you and I respect you, but that cannot be the answer. That can't be the answer for the rest of my life. It's just gonna go downhill from here. I was like, I can't accept that. And she was like, well, that's the answer I've got for you. And so at that point I was like, well, I know, you know. So I went back to school, I got my hormone certification, I learned about medical weight loss, I learned about peptides, I learned about all those things. Now I'm 48, I'm running ultramarathons, I'm in the best shape of my life, I can do, you know, sets of 21 pull-ups, and I am no longer pre-diabetic, and I will never take my kids on that ride. So it was really— it was running into my own limitations, then I didn't want to.

Yeah, I'm sorry about that. Okay, knocking on my door, some psycho. Interesting. And how was it at first when you launched a clinic? Was it, uh, pretty stressful? Was, uh, what was the mindset like launching a clinic with your sister from scratch?

So it was so, it was so lonely. It was so lonely, you know, because when you first start a business and we're, we're not an e-commerce business, so we're like a brick and mortar, obviously. And I remember when we first opened, Dominique and I, Dominique is my sister. I was the injector. I was the one doing medical procedures. She was working the front desk. Right. And I remember sitting at the front desk in our first location, which like in this little strip mall, you know, and sitting at the front desk and watching people just walk by on the sidewalk and not come in. You know, they were doing other errands or whatever, but every person that walked by, I had this like emotional visceral response of like, fuck you, why aren't you coming in? Like, why is no one walking in the door? And it was so lonely and so stressful. And, you know, starting a business is very, very, very hard. And there's no one else to talk to. There's no one you can share this experience with because everyone else is going to their regular job and coming home, you know. And it was very Very stressful. But, you know, we, we ground it out and now we have 6 locations and I no longer sit at the front desk, you know, worrying about why people aren't walking in. But it was, there was, there was, you know, that first year there was times we had to, you know, we didn't make payroll. You know, that happened. We had to go into personal savings to make payroll. Like all of the things that have happened to every founder, you know, happened to us. But we were able to, we were able to grow through it. So, that's good. But yeah, it was stressful. It was, you know, I would not recommend anyone do it unless you're really, really sure that that's what you want. Yeah.

And you said the growth was mostly organic and word of mouth. Like, did you invest in something in the first years to get clients through the door? Like, how did the business get to where it was today?

You want to hear it? So, in our first 5 years, 100% of our growth is organic. My sister's an attorney. I'm a physician. We don't know anything about marketing. The first marketing we did is we took out an ad, like a physical ad in a paper, like a newsprint paper. They still existed at that time, right? And it was like this little square ad that ran the back page of the paper. We knew nothing about marketing. And so almost all of our growth was word of mouth because, you know, we do good medicine and we have really awesome results. And so now, of course, we didn't even have a website at that point. So now, of course, we have website, we have SEO, we have all of those things. But originally, 100% organic word of mouth.

And what kind of clients were showing up back then to your door? And how did that change to today? Is it similar type of customers?

Oh, yes. You know, because aging hits everybody between the ages of 35 and 45, right? Like, that's when you're going to start having, you know, external signs of aging, like on your face. That's when your body is going to start feeling, you know, not the same way. Your capabilities are going to start slipping. And when people start losing things that they had, you know, losing their appearance, losing their function, losing the way they feel. When you start losing things, that's when you start seeking out people like me. And so our patients, yeah, between about 35 and 50 female professionals who have realized that things are starting to slip and who don't want that. And we exist to make that a choice. You know, if somebody is comfortable with that, you know, that way of aging, God bless, I wish them all the best. But if somebody's like, you know what, I'm gonna make a stand here, like, I don't wanna slip, I don't wanna lose these things. That's what we are here for. And, and those patients, yeah, that's what we had before. That's what we have now. I love working with those patients.

And have you seen people, um, being more accepting of, uh, of their health and, uh, welcoming health, uh, and being more preventative in their approach to health rather than, uh, 15 years ago? Yeah.

Oh, hugely. Like the, the concept of wellness, the concept of wellness as a proactive thing, not something that you hope for and take advantage of if you have it, but something that you can proactively choose for yourself. That concept didn't really exist 15 years ago. I mean, maybe it did in some communities, like really health-focused communities, but that concept has now sort of percolated into the general population. This idea that you can choose, you know, you can choose to age or not, you can choose to be healthy or not, that these things are now choices, not chance. That switch flipped, I think, probably about 5 years ago is I think when that really started flipping and people started coming in being like, I want to do something about this now. And I want to be proactive. I want to stop this. And that's been wonderful because there is so much suffering that can be avoided if you start early and you do the right things. There's so much suffering that can be avoided. And that's what I want for my patients. You know, I want them to feel and function optimally for as long as possible. And people are really embracing that. And it's been such an awesome journey.

And nowadays, I guess the biggest breakthrough is Ozempic, right? Like, what have you seen nowadays with that? Is it all good or should be Should we be a bit more worried, right? Like about drugs like that?

Well, you know, there are multiple ways of looking at this, and I will tell you my philosophy. Um, are there potential for unknown risks in the future? Always. You know, there's always the potential for something that you don't know to come back 15 years later and get you. But here's the thing, we know what obesity does to people, and we know what normal aging looks like, right? Normal aging looks like becoming more and more frail, losing more and more of your capacity until you die. That's what normal aging is. So even if there is some small thing that we're going to find, I mean, Ozempic's been used for like 30 years. It's not a new drug, but if there is some small thing that happens rarely to people, you know, 20 years in the future that we don't know about, it's still going to be vastly overmatched by the crushing burden that carrying extra fat creates in our body. So in my opinion, I think that GLP-1s should be in the water. I think that everyone should be on them. I think that, you know, Except for the people who are exceptionally healthy and fit, God bless them. But, um, you know, the benefit that comes from taking weight off of a patient outweighs anything else. Like my patients, I mean, this is the thing, they come into me because they want to look good in the swimsuit and have more sex. Cool, I can do that. I can give you a libido, I can make you look fantastic in a swimsuit. But what I get from the deal as a physician is I get to know that I am preventing horrible chronic diseases for the rest of your life. Diabetes, heart disease, strokes, Alzheimer's, we're preventing those things. So you wanna look good in the swimsuit? Cool. I get to know I'm preventing disease and we both win. I think they're fantastic drugs. And I think that, you know, 20 years from now, I think that probably most adults will be on them, at least in some capacity for some part of their life.

Right, right. And do you recommend to have a doctor watch them while they take these to be on a specific protocol, or can it, this type of thing, be like self-administered and self-managed?

Yeah. I think that it's a good idea to have a doctor, at least for your initial weight loss, because, you know, managing the titration when you're first starting to lose weight, there are nuances there. And I think that's a reasonable thing. I think that once you've been on it for a couple of months, you have a sense of where your dose is. You have a sense of how your body responds to different doses. I think managing your maintenance and microdosing on your own for, you know, sort of a reasonably, you know, reasonably competent, reasonably cautious individual, I think that's a totally reasonable thing. But I would say, During your initial ramp, because with these drugs, which is, you know, you ramp up over the course of whatever number of weeks, you stay at the max dose you're comfortable with until you get done with your active weight loss, and then you drop down to do your maintenance microdosing. And I think doing that initial ramp with some kind of provider who knows what they're doing will keep you out of the ER, you know, getting IV fluids for puking your guts out. After you get through that initial ramp and you kind of know your dosing, I think that most people can manage it on their own. Honestly, it's not a complicated medication, and it's a medication that has very clear physical effects. Like, you know, if you have too much. And you know, if you don't have enough, if you don't have enough, you eat. If you have too much, you vomit. It's not subtle. So I do think people can manage it on their own.

Right. And most women entering the clinic, is it for fat loss? Is that like the main thing, or is it health in general? What's the main cause of them stepping through the clinic?

You know, Charles, it breaks my heart to say this. Most women want beautiful skin, beautiful hair, and to be thin. And I would give my right arm if more women came in saying, I want to put on 5 pounds of muscle, you know, or I want to optimize my diet. I would, I would love those things. But the reality is most people want weight loss. And our goal is to kind of like take the weight loss and like wrap all the other stuff inside it. Like, yes, you can be on a GLP-1. Here it is. Let's also talk about exercise. Let's also talk about nutrition. That message lands with some people, not everyone, you know, but some. But the fact is people want to be beautiful and skinny. And have a lot of sex. That's basically what people want when they come in.

Interesting. Um, and these clients, is it, uh, one treatment? Is it like recurring? Is it on a weekly basis? What kind of packages you have for them?

Yeah, we— I mean, all this is ongoing because the aging process is ongoing, right? Like any intervention that we make to pause the aging process, like, you know, we set you back 5 years, the aging process is going to keep going. We have to continue. It's like, it's like mowing a lawn. You're never done. mowing a lawn, right? You continually— you're never done going to the gym. You have to continue to do these things. So we do all of our stuff with memberships where we basically write out a plan, say, what are your goals? How much time do you want to take to get to your goals? Cool. We make a plan, we give you a membership, and we see people generally once a month to kind of keep them on that path and get them to whatever their goal is, whether that's weight loss, muscle gain, performance, aesthetics, whatever it is. It's all ongoing. You're never done mowing your lawn. Never.

You also provide trainings, right? Like you provide trainings to other women founders that would love to launch their clinics. Tell us a bit more about that.

So yeah, we do. We absolutely do training. And that's one of the things I'm actually the most proud of. I mean, of course we built this business. I love that. We have also trained, oh gosh, hundreds, probably, probably not thousands, but hundreds of young women in the skills that they need to be able to do, you know, aesthetics and regenerative medicine. And I love that because, you know, these, these ladies come in and they leave with a skill that is something that puts them in exceptionally high demand in the medical field. These are, these are skills that are rare and desirable, and we really give them a foundation for a career. which is really cool and rewarding. So we do every other month we have trainings in-house and that's just, it's fun. Like these little ducklings, they follow us around, they watch the procedures, they learn. But that's something that we really enjoy to do. It's a way of giving back to the community and also it's a way of propagating this form of medicine. I believe that this type of medicine is important. I believe that this type of medicine makes people's lives better and I can only do so much. But if I can train other people It multiplies. And, uh, I really— I like, I like that idea. Yeah.

And how big is the team right now? How many employees? And what are roles? Is it customer care primarily, or—

Yeah, so, um, so we have 6 locations. Our team right now is, uh, 35 full-time, and then we have some, some virtual assistants and people who are doing, um, you know, especially offshore people who are doing a lot of logistics and admin work. Um, most of the people that we have, um, yeah, we don't hire for operations, really. We don't hire for admin because AI can do that. Um, we hire for people who are empathic, sociable, people pleasers. Like, that's, that's who we hire. And that's our— that's both managers, that's front desk, and that's clinical team. And then we train them in whatever skills they need, and then we give them the operational support from the AI. But, you know, the only thing— my opinion— the only thing that has sustainable value in our society right now is the ability to interact with other humans. And to change the behavior of other humans. And so we are specifically looking for people who do that, and then we train or outsource everything else.

You started selling supplements on the website, or creams at least? Like, tell me about that part of your business.

Well, I— oh, so we— yeah, we have, um, a full line of all of the, the prescription topicals. We have supplements, we have all of those things. They're, they're white-labeled, um, through other, you know, other companies like pharmacies and other companies. Um, because I have found that trying to sell retail, um, and again, in today's society, if you bring on a retail that's not white labeled, people are going to buy it once, they love it, they're going to find it on Amazon for half the price, you'll never see them again. Um, if it's white labeled, then you have a chance of keeping that person as a customer. So, so all of our, uh, home care, whether it's, you know, aesthetic, topical, prescription, or supplements, all white labeled. Um, and that's been a fight sometimes. Like, a lot of companies don't necessarily want to do that, but I think it's absolutely worth it because it's the only way you get any kind of loyalty. You know, for anything of that nature.

And is that like 10% of your revenue right now? Is it significant, or is it mostly still, uh, something, a loss leader, and you're hoping to make cash with that later on?

Yeah, it's about 8%. It's not a huge percentage, but it is a nice thing. And also, it, it, um, you know, it's— I— the analogy I use for my patients, I'm like, you know, you go to the dentist once every 6 months, you brush your teeth every day, you come see us every month. Here's the things you're going to use at home to optimize your results. It's, you know, you can go to the gym all day, but if you eat crap at home You won't see the full gains. This is the, the, the, you know, the equivalent of having a healthy diet while you're going to the gym. You use these things at home. Um, it's not a huge thing because frankly the stuff you can do at home doesn't have a huge impact unless you're talking about injectables like peptides or GLP-1s, which I would put that in a separate class. That's the medications. Those things have a huge impact at home. But supplements and topicals, some impact. You know, you're going to get that last 5-10% of benefit from those things, but really the real goods is, is the prescription stuff. That's the stuff, right?

You have 5 locations in Denver and 1 in Boulder. So, and you're not for the franchise model, right? Like, tell me a bit more for that.

Well, we may franchise in the future because there will come a point at which the, you know, the growth cannot remain fully organic. But we are blessed to be in a field with really healthy profit margins. Selling youth and beauty is very profitable, and because everyone wants it and people will pay astounding amounts of money to get it. So we have been lucky enough that we've been able to fund all of our growth internally with no VC, no loans, and not needing to franchise. How long that will go on, I don't know. I mean, I think that when we get above 15 locations, we'll probably need to start bringing in, you know, something like that model. Um, but right now we can do it on our own, and that means we own all of it and I make every decision, and I really like that.

Is there one manager per branch? Is that how it works? Uh, what's, what's the model?

Yeah, one manager per location on the admin side, and then on the clinical side, we have a clinical lead for every 2 locations. And so those are the sort of on-the-ground folks. And then, uh, yeah, one per.

And how do you select the manager? What skills are you looking for?

Same thing, no skills. I never hire for skills. I only hire for personality. So what we use, we use a system called Culture Index, which is like Predictive Index. So there's lots of these systems where you do personality tests on people and they're pretty similar. But the idea is it rates people on, are they autonomous or are they team members? Are they social or are they introverted? Are they— do they like repetitive tasks or do they seek novelty? And it ranks them on these different things. So what we're looking for is somebody who is moderately autonomous, so they can make some decisions on their own, but they like being part of a team. Somebody who's super highly social, so they can be interacting with humans all day and not get exhausted. Somebody who enjoys some, you know, slightly repetitive tasks, because let's face it, what happens day to day in the clinic, most of it is repetitive. You have to not get bored with that. And then people who are comfortable with change, who won't freak out when things change. And those are the traits we look for. And once we have those 4 traits, then, then we train everything else. But, but we are looking specifically for people who can function in the relationships inside the clinic and maintain the relationships with the patients, and then we'll take care of everything else.

Right, right. What's your protocol? What does your day-to-day look like as the CEO of that company?

I, I tell you, business or medical?

Both. Yeah, they're interrelated.

Well, medically, I do all the things. So I tell people I'm, I'm an alcoholic that opened Yeah. I am a significant user of my own services. So from a medical standpoint, again, I'm postmenopausal. I'm almost 50, right? So medically, I'm on estrogen, progesterone, testosterone, thyroid. I do growth hormone in 3-month pulses. I use CJC-IPA. There's lots of great growth hormone secretagogues, but that's what I personally use. I microdose GLP-1s for the anti-inflammatory effects and to keep the visceral fat down because visceral fat's the enemy. I do 3-month pulses of BPC-157 and then the copper peptide for the skin and hair, which is awesome. Um, and then, um, you know, so that's kind of like my medical regimen. I also take, you know, iron, B12, and magnesium as far as supplements. As far as like my medical day, I mean, I'll be honest, like, it is completely different from day to day. I don't see patients anymore. I'm only doing medical directorship and like management. So a lot of what I'm doing is, you know, interviewing, hiring, demoing new procedures, going to meetings, staying abreast of the state of the science, deciding what I'm going to bring into clinic, and then protocolling it and rolling it out. So I don't see patients anymore unless they are like friends or family. Like, I'll see— there's some people who are like my favorites I'll see, but I don't see patients anymore. That is now something that my staff does, and my job is to move the business forward, you know, as much as I can.

And how can you move the business forward this year? What are your top 3 objectives?

I want more people to be on peptides. That, I think, will make the biggest long-term difference in the health and wellness of my patients. Because, you know, there are things that we can do with peptides that we've never been able to do before. Like, in the past, if I want to regenerate someone's skin, I've got to take a laser, I burn off the top layer of the skin, they look like a burn victim for a week and a half, they peel, they're red, it hurts, they're at risk for infections, but it worked. Like, I laser resurfacing works. But now we've got this copper peptide and the copper peptide you do, it's a little tiny injection, feels like a bug bite, you know, 5 days a week, 2 days off. You do that for 3 months, you get the same benefits as a laser. But instead of like being, you know, all the risk of being a burn victim, all the pain of being— you get all the benefit. It's your whole body instead of just your face. It regenerates your hair too. I believe that we as an industry should be moving away from things like tox, filler, lasers, all these synthetic tools. We should be moving away from those and harnessing the body's regenerative capacity. because we have the ability to fully regenerate our bodies. And if we can really, really harness that, all the other stuff becomes unnecessary. And that is what's really cool and fun to me. And that's what I wanna do. I think that that would make the biggest difference.

I love it. Where can people find out more about you, Florin?

Absolutely. So, you know, anybody who wants to learn more about us, I would send them to our website, which is www.restormedicalspa.com. It's R-E-S-T-O-R. There's no E because we're very hip people. That's what I'm told. Restore Medical Spa. You can find out anything about any of the procedures we do, find our locations, learn about our people, and that would definitely be the first step. And then book a consult and come see us.