The Day I Stopped Being a Volume Doctor: Why Volume Was the Trap
13 Feb 2026 · 87 min
Dr. Ashu Goyal left high-volume insurance medicine to build a cash-pay practice around orthobiologics. He draws parallels between Grateful Dead improvisation, which he's followed to roughly 200-300 shows since 1990, and tailoring biologic protocols to each patient. Biologics prevent tissue breakdown and maintain spinal health.
Chapters
Yeah.
We don't have to find— normally what happens is I'm here, I've got this problem.
Yeah.
I'm in the present. I'm, I want to get to the future.
Yeah.
And I'm trying to think, I'm trying to solve where I want to get to the future with today's skill set.
Yeah.
Which is impossible.
Okay.
So what I've learned is, no, the future self can draw us to that. Now, as a doctor, doesn't that sound a little like—
Totally crazy.
But totally freaking crazy.
But at the same time, when you tell me that, I'm like, that's exactly what it is. Like, that, that, that is the key right there. is become your future self right now. That's the only way it's gonna happen.
Yeah. One of our favorite books, Be Your Future Self Now.
Yeah, exactly right.
You didn't build your clinic to feel like an employee in your own business. I'm Matthew Colobley, and on Out of the System hosted by Dr. Talks, we challenge the broken rules holding healthcare entrepreneurs back. Hear from clinic owners, rebels, and builders who are creating bold, profitable, patient-centered practices and doing it their way. Dude, I can't wait to have this conversation. Like we were just talking offline. Yeah. I mean, I know we can't talk numbers, but I am really looking forward because, you know, we work— we get a lot of pain, pain anesthesia, pain management anesthesia. I would say—
Yeah, yeah.
Anesthesia pain. Thank you. It's been a long day. I had a consulting day today, so I'm kind of, you know.
Okay.
But we get a lot. We're getting a lot in your industry that are contacting us. And I'm sitting here with Dr. Ashu Goyal, who is like the man. He did my back 2 years ago.
How are you doing? Phenomenal. One treatment.
One treatment.
Yeah, you can—
people always ask me what was going on, and we can talk about that. But like, Ash has made the journey. You still have an insurance practice, right?
Zero.
Oh, zero insurance?
100% insurance-free as of January 1st. There's no insurance. There's no UnitedHealthcare, no people telling me how to practice medicine, what I'm worth, what I'm going to get reimbursed, if I'm going to get reimbursed. None of that.
What's it like?
Liberating. Incredibly free, man. Like, I go to work every day. I've never seen you smile like this. Dude, no kidding. I've known you 4 years. No kidding. When you met me, I was a stressed out mofo, man. I was so stressed out because I didn't know what I was doing, and I didn't believe that I could get to the other side. You know, like, when we crossed paths, I believe that was in 2023 at IOF in February.
It was here. She got the book. She came back. She read. She being Nikki, your wife.
Exactly. So, yeah, I was there talking to Alicia. To Alicia. And Alicia said, oh, here's some books for free. I picked up the book. I'm like, what's this about? She's like, oh, you need to listen to him speak. He's amazing. I'm like, okay, when is it? It's Saturday afternoon. We had a wedding to go to, so I couldn't see you. I couldn't hear you speak. But I took the book home, gave it to Nikki. That was a Thursday night. She read the entire book overnight, and she's like, you have to meet this guy. You have to meet this guy. I'm like, well, he's speaking on Saturday. Maybe I'll see him Friday. I didn't run into you that Friday.
Right.
And then Saturday we had to go to a wedding, so I missed the conference. But I think that Monday she reached out to your team.
Yep.
And said, what's up? How do we make this happen? Like, we need help because we were so far in the insurance-based model and I was incorporating the biologics and the cash pay at the same time, but not doing it well and not doing it right.
Right.
And we had consultants who were insurance-based consultants. And they didn't understand the cash pay business, so they were kind of pushing us into their traditional pain management bucket, where it's like you know the way you want to do this is you want to have a nurse practitioner. He or she's going to see thirty to forty people a day. You're going to be in your room. You sit in that room and do shots. That's that's your MO. You do forty to fifty shots a day, five days a week, and then you have a urine lab. You have the nurse practitioner. He or she writes narcotics all day, so the patients pee in a cup. You get paid for every urine sample that you take, which is a requirement for people on narcotics, and you can make millions of dollars doing that. I was like, yeah, that's not me, man. Like, I don't resonate with making money off urine, especially writing narcotics all day, right? And making money off urine.
You trained in Cleveland at, um, Cleveland Clinic. You went to the— you were— you did your fellowship residency?
I did my residency there and my fellowship there.
Yeah. Yeah. Like, you're highly trained. Like, let's, let's go back. Okay.
So.
Med school, you come out, you go in pain, and you go to Cleveland Clinic. You come out and you went down a traditional path, didn't you?
I did, yes.
You were making bank.
Oh, yeah.
Right? Like in the traditional pain management, anesthesia pain. Right. Tell everybody.
Made a great lifestyle. Yeah. So I did my anesthesia residency, finished in 2006. That was at Cleveland Clinic. I stayed there from 2006 to 2007, did my pain fellowship. At the time, it was a top-ranked pain fellowship in the country, if not the world.
Okay.
Which was great.
So I left there with a great education. Yeah, so you're like, I got into this, I'm styling this. I got this. Yeah, I got this.
So I did a year of private practice in Columbus, Ohio. After not seeing the sun from November to April, I was like, I can't do Ohio because they offered me a partnership track, right? I'm like, if I become partners in this business, I'm married to Columbus, Ohio for 20 years. Nothing against Columbus, right? It was just cold, gray, and ugly from November to April. I was like, I can't do this. Like, this can't be my day in and day out life. So I moved to Arizona in 2008, joined Valley Anesthesia and Pain Consulting. It's a large anesthesia group. There's over 200 of us in the group. They had a small pain division, and I practiced traditional pain medicine. So this is epidural steroid injections, ablations, cortisone shots, medication management, spinal cord stimulators, intrathecal pumps. I was doing that to a very high level.
Right.
Right. I got, you know, I built a following here. I call them Goyle heads. So that's my referring docs and my patients. Yeah.
Do you have to shave their head? Do I have to shave my head? I just need to know.
Well, I had hair back then.
Okay. All right, good.
Down to my shoulders.
Yeah.
Okay. Yeah. This didn't happen until I turned 40. So—
Wait, before or after you met your wife?
It was after I met her.
Okay. All right. We'll blame it on the—
Well, she's the one who said it's got to go because like I had hair and there was like bald spots. Yeah. And she's like, huh-uh.
No, I'm not doing it.
It's not hot. It's like, take that off. All right.
So you got all these goyle heads, right?
Yeah. So I had a great practice thriving. In 2015, the senior partners talked us into selling to private equity. which was a great deal for them. For us junior partners, it was like, eh.
Yeah.
And so they got their golden parachute. We got stuck. So we're in this corporate medicine, private equity-backed model where it's volume, volume, volume. It's not about patient outcomes. There were no visionaries looking to see where we wanted to be in 5 years. It was like, let's just build this up and then sell it. But once we had sold initially, we all became employees.
So you're not going to get a bite of the apple when they sell again?
No, not at all. Right. We're stuck. Right. We still made a great living by anyone's standards. Made a great living.
Yeah, they're paying you really well.
But it was still very unfulfilling. Right, right, right. So we went from innovation, having a leader who was, you know, thinking, how do we become the premier practice not only in the Valley but in the state west of the Mississippi? I mean, that was, that was Dr. Aubrey Mays's vision, you know. We went from that to quarter-to-quarter budget. How far below budget can we get? Those are our business meetings. And it was so like soul sucking.
You know, that is just not like— they're obviously working with doctors for 11 years now, right?
Yeah.
That's like the last thing in the world you want to talk about is quarterly P&L statements.
It's important. But if you're running your own business, it's kind of important. But at the end of the day, there's a bigger picture involved, right? It's about taking care of legacy. It's about legacy, man. Exactly.
Yeah. It's not about— it's not about empire. It's about legacy.
Well, the legacy of that pain practice I left, so I left them in 2021 to open about my practice, my dream practice.
And you, you left a really good comped gig.
Oh yeah, we were good. Yeah, yeah, 2 months of vacation a year and a good salary, benefits, all the good stuff.
You left all that behind to go up to debt in your eyeballs. Freaking—
dude, you have no idea. Like, Nikki and I—
No, I do. I've seen your P&Ls. Yeah, I've seen the balance sheet.
Oh my gosh, in October 20— so yeah, so okay, so I opened up the practice June 21st. Heavily insurance-based. It's terrifying, right? Because, I mean, I'm not the guy who hangs up a shingle and says, come see me. I'm like, I was blending in, just doing my thing.
You weren't like a— you didn't have a lemonade stand as a kid?
No. You're an entrepreneur? My dad was.
Your dad's an entrepreneur?
Oh yeah, yeah, yeah. He started his own business in the early '90s and, I mean, did really well for himself. Yeah. But it was kind of necessity is the mother of invention. And so he kind of got forced into creating his own business. And that's how it happened for me, too. I was so miserable in my corporate medicine-backed job that I just couldn't do it anymore. So once my contract was up, I'm like, I'm jumping ship. But everyone I talked to in the Valley who was doing their own pain thing was doing very traditional pain management. There was no healing. I didn't feel like there was soul involved. I'm not telling you— I'm not saying that these guys are doing epidurals, right?
Just masking the pain, not really fixing it.
You got it. You got it. And I was like, I've been doing that for 14 years. And it's so unfulfilling. It's like episodic care. I do a shot, you get better for 3 months, and you're back. We do it again, and we just keep on doing this. Then 5 years later, your spine is so degenerated, your only option is a fusion. That's not gonna work because that's not the issue.
Right.
It's not a stability issue.
Right. There's, yeah, there's not, you're not fixing anything.
Exactly. We're not fixing anything. So I opened up my practice in 2021 with the hopes to build something where people could come and actually heal their bodies, heal their spine, heal their joints.
Right.
And have longevity. But I started off in insurance-based medicine and I got sucked into that for like the first 2 years until I met you.
Yes, it was '21. Yes.
June of '21.
God, it was that short? You were drowning when I met you.
Oh yeah. Oh yeah, it was, dude, it's so bad. Like, this is where I wish Nikki was here to tell you how bad it really was because she's like, you don't even know how bad it was because she was running the business side of things.
No, I remember having conversations with her like Yeah, like it was you guys without— I mean, you had a crap ton of debt.
We had a crap ton of debt and we're burning through our savings because we weren't collecting on insurance.
Yep.
So, and that's the thing people don't understand. Like when you start your own medical practice, the money comes out of our own pocket. Yeah. I mean, whether we borrow it or it's our savings, like we have to pay for the care that we're giving.
Yep.
Someone's got to pay for it.
You're paying in advance for it.
We are.
Right, exactly. The patient comes in, you get paid Whatever, 45, 30, 45, 60 days. Maybe, maybe you get underpaid.
We just got paid $134 from UnitedHealthcare for a consult I did in May of last year, May of 2025. We just got the check yesterday. Those bastards are fucking cashed it. I'm like, are you kidding me? Like, that's almost a year later to get paid $134 for an office visit. How is that even sustainable?
You know, it'd be great if they clawed back in 60 days.
They could, they could, they could. You know, we actually closed the clawback account. So there you go.
Yeah, yeah. Good for you.
There's a whole process involved there that, oh man, it's such a dirty business. It really is, the insurance game. And they devalue us. So anyway, they did that for a long time. I was hardcore into orthobiologics. I got turned on to the—
When did you start doing orthobiology?
2017.
So you were doing it in the big practice?
I was trying to, but the problem was I knew too much about it and they wouldn't invest in the materials I needed to deliver high-quality PRP.
You're a perfectionist.
Exactly. It was like, I can't do this to people. Like, Yeah, sure. You're going to give me a $40 PRP kit, test tube PRP. I just learned that that's crap. And this is all the way back in 2017, 2018. I'm like, I can't do that to people.
So maybe, maybe you got a billion cells if you got lucky.
If you're lucky. Yeah, I did a couple of cases. They all went well. But inside the back of my head, I'm thinking George Chang Chang is like, well, what are you doing, man? That's not how you do PRP. That's crap. You know, you need to, you need to get a nice volume of blood. You need to get the right platelet count, platelet dosing. I mean, this is— gosh, that was almost 10 years ago, right?
Yeah.
So in 2021, started my own practice and I got in— I could start focusing on orthobiologics the right way. The problem was I just didn't know how to do it. Like, I had no mentorship in that field, right? Because going through medical school, going through residency, joining a practice, you don't learn the business side of things at all, you know? So I relied heavily on these consultants who were really good at the insurance game.
But don't know a thing about the cash side.
About the cash.
That's like me going into the insurance game.
Yeah. All our meetings, like, they just didn't get it. They weren't getting it. Like, Nikki was banging her head against the wall. They're like, look, we're not trying to do what your traditional pain management people are doing. They're killing it. Like, they've got really successful pain practices in the Valley, actually all over the country.
Good for them.
They're doing really well.
Good for them.
Yeah.
Yeah.
It's just, that's not my— that's not what I resonated with. Like, that's— there, to me, there's no soul in that.
Well, you said, like, you just said something, like, when I think about you and I talk about you and Nikki a lot, right? and with our prospects or just telling the story. To me, you— what you helped me understand, because I was coming at it from a bit of a, hey, let's grow these things and sell them off, right? You and Nikki really helped me understand that this is about legacy. When you and I were in your house, I can't remember what time. I've been in the house so many times, right? When we were over there, I don't know, there's a bunch of us over there.
Yeah.
And we were having— back then when you and I drank, when we were having some really Ash has got a great wine—
He's got a killer wine collection.
It's probably not getting any smaller because I know you don't drink that much anymore.
We don't drink anymore.
Yeah. And you were saying, you said something when you told me that you left the high-paying gig and you gave me a range of what you were making. Your house is gorgeous. He's like, yeah, you think I afforded this house because of this, that work, not because of this work. We're just starting with this. And then you said something of, I don't want to stop seeing my patients. Yeah, I give them my personal cell phone.
Yeah.
And it hit me, bam, right then and there. I'm like, this is about legacy and healing.
Yeah.
Like, it really changed me because I admittedly at that time was probably like, oh yeah, you can exit the business. And I realized for doctors, for a lot of 'em, an exit means only seeing 4 patients and spending like 2 hours with 'em or an hour with 'em and giving 'em their cell phone if they have any questions.
100%.
Like, to me, that's what, that's what healthcare should be.
That's what I feel it should be. I mean, that's what works for me. Like, Matt, you know, when I was, when I was leaving the private equity group and I was talking to my friends who were killing it in pain and they're like, dude, you come, come to our practice. Like, you'd fit in really well and you'll have great opportunities. We want to sell in 5 years. You'll make bank. In my head, I was thinking, imagine building something you don't want to get rid of.
I could never imagine selling something that I built.
That's what— that's where I am. Like, I'm building something I don't want to get rid of, right? Like, I love—
like, especially now, imagine raising your kid and getting them through college and selling them off.
Yeah, exactly. Kind of. Yeah. I mean, I mean, you know, but if you build, if you build something you love, right? Yeah. And that's what Nikki and I have been able to do. Like, we've got a practice we love. Like, I can't tell you how many times people come in there, they rave about our staff. They're like, you guys have the best team. And we do.
You have a great team, including the dogs.
Yeah. And the puppies. Yeah. So we have Da Vinci and Lucina. Yeah. They're with us at the office all the time and they're a big hit. Yeah. I tell you what, like after procedures, they'll come to recovery and sit in patients' laps and they just pet them. Like, oh, you imagine doing that with a venture capitalist group? What are you doing? No. Some guy in from New York.
Where's the slide? Where's Yeah, we should charge for that.
We're so not VC, man. But I was like, you know, for me it was always about building something I don't want to get rid of.
Yeah.
You know, and that way if it ever comes to selling it, like, you're gonna have to give me a lot of money to make me want to not— to want to want to part with it.
I could see you and Nikki doing this till like you're 80.
I, I don't think Nikki would want to do that.
Well, yeah, you are older than her, so you'll be 80, she'll be whatever.
Well, I don't think she would want to do that, but, um, for me, yeah, because I love the patient care. I mean, like, like yesterday I saw 4 people. You know, which is amazing.
That's a full day though. Seeing 4 people is a full day.
Yeah, I spent almost an hour to 2 hours with each patient, you know. So yeah, it was—
Profitable day?
It was a good day.
Yeah, I know you're not going to talk numbers. We're not— yeah, that's, that's fine.
It was a good day. Yeah.
Um, is it safe to say that you did better that day than you would probably do in a week and a half of insurance care?
Oh yeah, 2 weeks easily. Yeah, easily. Yeah.
And the patients are happy?
They're happy. But you know what, Matt, you said something to me In the very beginning, once I finally started jumping on the calls. So we connected in February of '23.
Took you what, 6 months to get on the calls?
No, a couple months. I think it was May. I think it was like April or May. Oh yeah. Remember you and Shakhtar threatened to like tie me up and beat me or some crap?
Yeah. That's pretty much, it was something like that. Yeah. Yeah.
It got, it got violent. So I'm like, maybe I should jump on a call. So I did. But you said something during one of the first few calls that really struck a chord with me in a positive way and really kind of made me reframe what I was doing and how I was building. You're like, build a practice around the outcome, not the procedures, not the methodology, but around the outcome. And that really resonated with me. I mean, that was some— that's so profound. And I listened. I don't think I got it, but I listened and it stuck with me. And now I look back over the last 2 and a half years, and that's exactly what we did.
Yeah.
We built the practice around an outcome. It's not about the procedures. It's about where, where does this person, where's this person gonna be in 6 months to a year from now?
Yeah.
Like, it's about that outcome.
Right.
And then we work backwards. Yep. And that's how we built the practice.
When you focus on the outcome and, and so the problem with medicine today is it's because it's been overrun by venture capitalists. It's not about the outcome at all. It's, it's like you said, it's about the 90-day numbers. It's about the metrics.
Yeah.
And if I could go back in time, so I've been, I've owned, I've been involved in the medical space for 11 years now. God, no, 12. Shoot, it's 12 years now. And I've been working with doctors since, like, growing their businesses since 2018. If I could go back, I made a lot of mistakes for, like, the first 3 to 4 years because I just assumed that doctors wanted to sell. And I spent way too much emphasis on P&Ls and balance sheets and all of that today. So I had a client in today. She's anesthesia pain. She's in Tampa. She's starting from the ground up. left the group, right? That kind of thing. Leaving behind all the stuff you were doing.
Yeah.
And she's scared out of her wits, right? And I realized not to talk numbers with her because it scares her. And what we did is we talked— we spent 2 hours today talking about the outcomes and the vision and like where— like, and she's like, well, I don't, I don't want to sell. I— she goes, Maybe I'd like to have a couple of locations. She said, but I just, I want to be able to use the money from this to do some work in Alzheimer's.
I'm like, yeah, right on.
Let's use the business. Let's run a profitable business so that you can go fund the thing that you want to fix.
Exactly. Yeah.
Right.
Beautiful.
You know what I mean?
Yeah, I do.
Like, it's, it's been such a revelation in these last, well, these last 15 months, really. Like, we'll talk some about that. But it's just been so much fun, like, to, to realize your brothers and sisters in the medical space really don't give a shit about golden parachutes and all that. They really care about the patient.
Yeah, most do. Yeah, most do. At least our circle. Yeah.
And they're incredibly frustrated, right?
Wouldn't you say? Oh, for sure.
Yeah.
Because, I mean, insurance is like a ball and chain. It shackles you. You can't help people the way you want to. Like, I'll give you an example. Today I saw a really nice woman. She's been with me for a long time. She's been with me since my Valley, my, my previous gig.
Mm-hmm.
And followed me to this place. She's got a UnitedHealthcare Medicare Advantage plan.
Mm-hmm.
And, you know, she gets one epidural a year. You know, she's like, we talk about biologics, but she's like, you know, the epidural works. I do great. I, I'm working out. I eat well. I'm super fit for— she's like 78 now. I think she's in great shape. And we would have to play this stupid game every year, once a year. So, okay, I think you need an epidural. Have you done physical therapy? I've done it for 10 years. Like, well, you got to go back because your epidural got denied because there's no documentation of 6 weeks of physical therapy within the last 3 months. She's like, I do my exercises every day. She's like, and when I go, I've got to pay a $75 copay every visit. I'm like, you gotta do it. So anyway, that was a protocol, physical therapy for 6 weeks while she's in pain. And we got, we got it down to the point where like by last year, her last epidural was almost a year ago. She would come to me after the 6 weeks of physical therapy. She's like, my primary care sent me to physical therapy. Here I am. She's like, can we try to get the epidural approved? It would still take 2 to 4 weeks to get it approved. It was a process. We do her shot. Well, she came in today. Now I'm insurance-free. She still has that UnitedHealthcare Advantage plan now, but I'm insurance-free. She came in, she's like, my back pain's back. I'm like, I'll get you in Wednesday for your shot. And she's like, yes. Yeah, yeah, yeah. It's amazing.
Yeah. You know, and she had— instead of her spending like an additional $1,400 on like physical therapy, right? And she's going to the gym every day, right? It, it is really— and we'll talk about this transition because I think I think that's the hardest thing, isn't it? The hard— is that the hardest thing for doctors to understand is that people will pay out of pocket?
So, or what?
Let me rephrase that. What was the biggest turn?
Like, let me tell you about it. So, you know, throughout med school, med school is all insurance-based. I didn't get exposed to any cash pay services throughout medical school. Did an internship through university hospitals, Case Western in Cleveland. Didn't get exposed to any cash pay services. It's all hospital-based medicine. All my rotations were inpatient. I get to Cleveland Clinic, it's anesthesia. All our billing, all our reimbursement is cash pay except for the plastic surgery side of it.
Right.
We didn't really get taught the business side of that, but we do rotations through plastics. We learn how to, you know, take care of people on an outpatient basis for that, for those types of surgeries. All insurance-based otherwise. Get to pain fellowship. Everything we're doing is insurance-based, right? There's no, there's not this notion of cash pay and that people will actually pay cash for their services. The ones at the Cleveland Clinic would do it were like the royal family would fly in and pay for a liver transplant and they'd get, they'd go right to the top of the list and pay for a liver transplant. So that one in my head would, oh, that's what cash pay is for. That's what cash pay is. Yeah.
It's the royal family.
It's not for an epidural. It's not for a stimulator. It's not for This procedure is not for an office visit. So fast forward, what, 14 years later, 2007? Yeah, till about 2017 when I started learning about orthobiologics. And those are cash pay services. I got introduced to physicians who were doing this at a very high level, who were charging cash and getting paid for it. It was still so foreign to me. I tell people it's like they get us addicted to insurance like an addict would get addicted to heroin. Yeah, right.
That's exactly what they do.
And so the The challenge I had when I met you was you were trying to like cut the cord. I'm like, dude, this is a slow wean, man. For me anyway.
Yeah. Because I don't have to— For most it is. It's a 24-month run.
Yeah.
24.
Exactly.
Yeah. And I try not to even tell 'em, 'cause if I tell 'em it's 18 to 24 months, they like, no, no. And then once they make, I always tell 'em, once you make your first $50,000, you'll understand. Like it's 18 to 24 months. But yeah, keep going.
Right, right. Exactly. I, I liken it to, I tell, I tell clients, I tell other docs, it's like weaning off of heroin, I imagine. You know, it's, it's, it's hard. And you go through withdrawals, you're like, whoa, I'm charging people money. Like, like, that's a mindset shift. And that's where your work is foundational, man.
Oh, thank you.
Like, I tell you about this all the time. Like, really, we wouldn't be here where we are today without you.
Oh, thank you.
And your— and the work you did. And a lot of it was mindset, you know, like understanding, like, our worth, because we get so devalued as physicians because our value is determined by CMS, the Centers for Medicare and Medicaid Services. They decide what we get paid, and insurance companies. base their payment off what Medicare says we should get paid. It doesn't take into consideration any risk, our overhead, the quality of care we deliver. It's like, this is what it is.
Yeah.
For a high-risk procedure, here's your $300.
Yeah.
Well, that doesn't cover my nursing staff, my— all my equipment, my, my supplies, my salary, my malpractice, all of that. Like, we've done the math. It doesn't cover it. That's why you have to make it up in volume. And that's why all these docs are doing 50 shots a day.
Yeah.
It's like, dude, that's not good care. No, you think you're really slick and really good at what you do. Like, I was, I was in that world. I did that for a while, you know. I did that for almost 12 years, you know. I was in that high-volume, you know, acute care. Just, man, needle jockeys. We called ourselves needle jockeys.
You're really good with a needle. I mean, you did my back, 21 shots.
I mean, you know, without sedation too.
Without sedation.
But, but, you know, getting back to your question though, it's It's a whole different concept. It's a whole different world. It's like being addicted to heroin and trying to come off of it. Mm-hmm.
Right.
Mm-hmm. It's, it's just gotta be a slow wean for some of us. Some people can cut the cord and they do great. I wasn't that way. For me, it was like, I have to understand the process here.
I have to see it.
And we, and you know, we did it right. And you coached us along with this, you know, in October of '23, that's when you eviscerated our financials in front of all, it was a group of strangers in San Diego.
I remember San Diego.
Yeah. Who now become really close friends of ours.
They're all your very close friends. Yeah.
Amazing. Yeah. And like, I look at that room like, wow, there's some pretty amazing people in that room. But they were all so supportive. Yeah, I was like, dude, I don't care. We need help. Yeah, like, here you go, man. Just do it. I'll take it.
I remember when I saw how much debt you guys had.
I went, oh yeah. Yeah, I couldn't, dude.
So— And I saw the debt service. I was like, oh my God, they're never gonna get out of this.
I'll never forget, man. Like, you're like, Ash, your practice is in the ICU. You're on full life support. They're doing chest compressions. You're swirling the drain. If you don't turn this around, they're gonna take your house, your life insurance policy, your cars, all your assets because you can't pay your loans.
Yeah.
I'm like, yeah, not only that, I can't pay payroll. Yeah.
And you haven't paid yourselves in God knows how long.
We hadn't paid ourselves for like 4 months.
Yeah.
Yeah, we couldn't. Yeah. It's like either pay my staff or I pay us. We couldn't do both. Yeah. Yeah, it was that bad. Yeah. And then you were like, listen, your options are listen to what the consultants are doing and do a traditional pain practice and see 50,000 people a day and burning churn and put them all on drugs and have them pee in cups or drop insurance.
Raise your prices. Because at that time, what were you charging for back?
Oh, gosh.
$2,500? $3,500?
No, I lost so much money on all those cases. Yeah, lots.
Ballpark, what are you charging now? Give everybody an idea, whatever you feel comfortable saying. Like, I, you know, I know, I mean, I know you're private.
So here's the thing is I don't charge for a procedure now. It's, it's about a package and a program. Yeah, right. So, and you helped me understand that, right? Because I mean, I didn't understand what programs were. I didn't under— and that whole concept isn't— we're not taught that, right? You know, and I met you in 2023. How old was I then? I was 40. I was 40, uh, 49 when I met— yeah, I was 49, right? And so, I mean, you're talking about some serious reconditioning there, right? I mean, there's some—
yeah, there's some years. Yeah, 15, 20 years of the system.
Exactly.
Yeah.
So to change that was really, really hard. I lost my train of thought.
That's okay.
But yeah.
Yeah, like, so now how, how many procedures are you doing a month on approximately?
Oh, oh, great question. Oh, I remember, we're talking about programs. Yeah, yeah, yeah, yeah. Yeah, so really getting back to the programs. So People aren't buying the procedure, they're buying the program. I just got off the phone on the way here with a young woman who's— she's trying to understand like what it all entails. She's like, I'm 100% on board with the procedure. What happens afterwards? She's like, am I just going to be left alone? I'm like, dude, no way. You got my cell phone.
Yep.
Like you get— we're going to be doing adjunctive modalities, laser treatments. I can— I communicate with your concierge physical therapist weekly. Like we're in this together. Like I go on this journey with each client together over the next 6 months, even up to a year for some people, you know? I'm as invested as you are in this, you know, because I want your success. I'm not doing— I tell people, look, your thousands of bucks ain't going to change my life. Like, that's not life-changing equity for me.
Right.
You know, but what is in 6 months when you're like, oh my God, I haven't felt this good in years. And then you send me your friends. Yeah. Yeah. That's what's going on.
You primarily grow is through referrals.
Yeah, it's mostly referrals. Like I have a, I have a handful of concierge physicians, physical therapists and chiropractors and naturopaths who send me people.
Yep.
But a lot of what we're seeing since we dropped insurance since January has all been this person has such a great outcome and they're just sending their, their friends and family to me. And that's what's been going on.
And that's the way it should be in this to me. Like, I mean, I'm fine. Like, I have clients that run Facebook ads to webinars and it works great, right? Yeah. But really, if you're getting great outcomes, to me, we call it the 7-star experience, right? Like, you know, exactly. How do you become highly referable?
Yeah.
Well, you become highly referable by giving them yourself. That's an option. It's not the requirement. No, no, of course.
I like communicating with my clients. So, you know, I've got really fascinating people. Like, my phone is like— I get text messages.
Didn't you treat one of the guys in Bruce Springsteen?
We can't talk about that.
Oh, wait, it's not? But it's on your Instagram. It's on your Instagram.
I know. I know some people.
Okay. Yeah, we—
yeah, yeah, yeah, yeah. You know, but I mean, it's great. Like, I'll see a text message pop up. I'm like, that's pretty cool. Like, yeah, I mean, it's just— it's an honor. It's a privilege. You know, it's humbling. At the same time, but I'm very confident in the programs that I've created, you know, and I know people will get better. They just have to, they've got to do the work. You know, like with orthobiologics, it's not only is it a procedure, but it's also participatory.
Right.
Like, you know, we stress this all the time. It's not just, I tell people when you're considering biologic therapies, you're the pharmacy that's making this stuff I'm going to be injecting back into your body. So make it good, but you also have to make the environment good.
So what are some of the things you have people do? I know you have them do HBOT.
That's a big deal. I love hyperbaric oxygen therapy. Not everyone, not everyone can do that. It's a nice to do. It's not a need to do. But I would say about 90% of my clients are able to do it and they love it. Some, some keep on doing it. Like, I'll— I do hyperbaric every weekend. I'm at the, the Venice Air facility. I'll pop in there and I'll see like 3 or 4 of my clients that morning, you know? And it's great. It's like, it's great because they're still committed.
So you don't have the HBOT in the office. You're outsourcing it to somebody else.
Yeah. So, yeah, that's a big thing for people to understand.
It's like, no, you don't have to go I don't have all this equipment.
No, no, you don't. And, you know, and for me, I love collaboration. Yeah. You know, and I look at, so there's one person I refer to for hyperbaric in this town, Dr. Carrie Burdinko, Benisair Health. She's extraordinary. She's just an absolute, she's wonderful. But she's also a master at hyperbaric oxygen therapy. Like she's an expert in the field. She understands the dynamics. She understands safety. She's got 2 technicians in the room at all times. There's always a physician on staff as well.
And, uh, I love going into that room. It looks like something from 10,000— from whatever, Space Odyssey.
Exactly.
There's like 6 of them lined up, the tube. Yeah, metal tubes.
But she's got 4 of them there. And for me, it's like, look, if I, if I can't do something as good as someone else, I'm just gonna refer them there. As an anesthesiologist, you know, at Cleveland Clinic, we had a ketamine clinic. Like, I could run a ketamine clinic, but there's another group in town that has it so dialed in. Like, I've met with the doctor, he's phenomenal. He's deep, he's soulful, he understands the whole process, what's happening on a deeper level, not just the chemical level, but also a deep spiritual level. And they've got the whole facility set up to support you when you do that. So it's not just pain management, it's like mind-body medicine at the same time.
Wow.
And I'm like, I'm too busy to do it that way. Like, for me, it'd literally be, you're going to be in a room and you're going to be getting ketamine. You're going to be tripping your balls off in there. Like, that's not cool. So, because we were talking about that and entertaining that because It would be an easy thing to do, but if I can't do it as well as those guys, right, I'm just gonna refer out, right? So that's what I believe in. So the people who are listening who are thinking, oh, I want to do this, I want to do this and this, if you can't be the best at what you do in each one of those things, then I, I don't recommend doing it.
And you, you have them do physical therapy, are you still doing IVs and things like that? Yeah, yeah, we do lasers.
Exactly. Yeah, yeah, we have an MLS laser. So that thing's crazy. That thing is amazing.
Freaking— I look, I don't know much about the machines, but like I hear what all of our— and I've used it, obviously. I hear what all of our clients say. Oh yeah, it's a great machine. We're seeing from CE Lasers, it's the M7 or whatever.
Yeah, we have the M7. Yeah.
It's a freaking— like 80% of our clients. Oh yeah, have it.
Oh yeah. Like it's a game changer with the biologics. I mean, so I just did a webinar with Colin Rigney and Ryan Martin, and it was all on the MLS laser and photobiomodulation. And, you know, as I was preparing for it, I'm like, this device in and of itself is regenerative.
Yes.
Even without shots. And what's great is like, I explained that to people. I'm like, look, you could do these biologic therapies, or you could do laser and do all the other protocols without the needles. Because some people don't like needles. Yeah. And so I'm like, you don't have to do needles. Like, we don't have to do shots.
It's great.
But here's— here are tools that you can use, but you have to invest in them. You got to be committed to doing this.
Yeah.
Our laser is book, Matt. Like today I had, uh, saw 4 people today too, but they all signed up for lasers and my team was like, we can't get them in till for 2 weeks. Wow. Like, yeah. And we were on the laser from 7 to 4:30 Monday, Tuesday, Wednesday, Thursday, and then half a day on Friday. And I mean that in their 15-minute session, it runs all day long.
How far out are you booking for biologics procedures?
Middle of March. Yeah, because we should—
okay, so to put everything in perspective, we're recording this for the beginning of February.
Oh, yeah. Yeah. So 6 weeks, about 4 to 6 weeks.
You are booked out 4 to 6 weeks.
Oh, yeah. I got no room. Yeah, there's no room.
Yeah. And for the record, I want everybody to understand, again, he's not charging $1,000. So this isn't because of volume. You're, you're charging higher prices than that. Yeah, significantly.
Yeah. I mean, I'm in Scottsdale, it's a premium, but I'm also delivering a premium service.
Yeah.
This isn't a shot. You're not paying for a shot. You're paying for—
Yeah, your outcomes. But Look, you're structuring what a lot of our other clients do and they're charging this. I have some that charge more that are not in places like Scottsdale, like rural towns.
Oh, right, right, right. Exactly. Yeah, for sure.
And that's what's comfortable for you. And that's, you know, that's what you feel is good and you're making a good living with it.
Yeah, we're good. Yeah, we're good. Yeah. I mean, I think that people have the potential to make a lot more money in insurance-based medicine, but I think that comes at a cost.
I don't think so anymore. I mean, it has gotten so bad.
Maybe it has.
Like, so it's been really fascinating for us. So something's happened in the last year in the medical industry. I think last year when the head of UnitedHealthcare got assassinated in Manhattan. So to put this in perspective, this year at A4M, there were 10,000 attendees. The year before that, I think there were 5,000 to 6,000. This is what I was told. Okay, so in the functional space, if you start to look like we maybe used to get 10% of our inquiries were people that were in the large group or in the hospital looking to leave. Today it's over 50% of our discovery calls.
Oh, wow.
Are people that are— yeah, I'm making $500,000, $700,000.
Yeah.
I'm working for the large group in the hospital and I need to leave because I can't do it anymore.
Yeah, right. Yeah.
And I'm either going to leave medicine and they're all late 40s.
Yeah.
Early 50s. We have a couple that are like 65 that are like, I need to leave now. Like, I'm going to leave. It used to be all people like you that had an insurance-based practice were transitioning. Now, 50— the consult, the Dominion Day, as we call it, that I had in the office today was startup. I mean, just starting from square one, 1,000 square feet, no list. Let's go. How do we do this?
Right on, man. Burnout's real, man.
It's real.
It's real. Suicide rate's real.
The divorce rate's real.
I get it. 2017, I mean, I hit rock bottom. I was so depressed. I was so miserable. I was so unhappy with the corporate medicine gig. Like, I mean, it was challenging. Like, it was really challenging. I didn't know where to turn, you know? I mean, luckily I did some intense psychotherapy and found the right coaches to really help me hone in on what I wanted, right? Because I mean, like I said, I wasn't the guy who goes and hangs up a shingle, so that wasn't even my realm of possibility in 2018, 2019.
You're trying to make it work in the system.
Yeah, trying to make it work in the system. Exactly. But the system is so messed up. Like everywhere I turned, the people who were in it, I'm just like, I talked to them. I found great people. They're like, we'd love to have you on board. I'm like, awesome. We, we have similar personalities. We believe in really taking care of people. Like these are good guys and, and women too. And, but they were like, oh, but we're going to be joining HonorHealth, which is a big healthcare organization here. And so I started interviewing with those organizations. I'm like, wait, this is, look, this is This looks and smells like— Yeah, just exactly what I'm trying to leave.
Yeah.
I was like, this isn't going to work. I'm like, so what do I do? And yeah, then the right people kind of gave me, helped me find the confidence to say, just go do your own thing.
How did— okay, so it's '23, you're in, you're in our program for 4 months or something like that. Nikki's on the call, right? And then you finally jump on. You, I remember you, I use your, again, I use your story a lot. Matt, you don't understand. My patients are not going to pay cash. I've already tried. They won't pay $500 for a PRP injection. Right. What changed for you? Because it was a big— I really was wondering whether or not you were going to make it.
I know. I know. I was like, okay, what really changed? I mean, Nikki, living with Nikki, my wife, because she saw the bigger picture. She saw where we are right now. She saw that in 2023. I didn't see that. Right. That's number one.
Hold on a second. You've always been a guy that understands the power of your thoughts. Sure. Like, and we're going to talk about like your meditation journey and stuff like that.
Yeah, for sure.
But it's not like you weren't exposed to the power of your thoughts or manifesting, the concept and the concept of the quantum field and things like that.
Right.
But you were like unbelievably blocked. And it really rattled me because I'm like, I don't know Ash really well, but I can tell like he's a spiritual dude and not from the standpoint of hanging out at church and stuff.
Right.
You know what I mean?
Like, yeah.
But so you had a massive block. How did you get through it?
A lot of work. So, you know, and part of that was fear, you know, like, um, talk about that.
What were you afraid of?
You know, I think a lot of it, it goes back to us being conditioned that we're not worth it. You know, it's that deep. It's that deep.
They hammer you that bad.
Oh, they hammer you that bad. It's like, no, your epidural should be $300. Your office visit should be $60. Like, that's what we're like, wait, I'm now supposed to charge $500 for an office? Like, I can't do that. No one's going to come to the door and I'm going to—
Yeah, exactly.
I'm going to freak out. Like, I got to make a living. Like, I need these insurance. Like, so that was the, that was the thought process I was stuck in. That was a mental loop I was stuck in. It's like, I need insurance to make a living. Someone I talked to recently, I'm trying to get them to join your mastermind, but he's like, I don't want to pay the money. And he's like, he's in the same— he's exactly who I was, man, in 2023. I told Nikki, I'm like, I'm like, I won't say his name.
Don't embarrass him. No, I'm kidding.
No, no, I know.
I don't.
But dude, there's hope for you. Just like join Mavericks. Join Mavericks. But you know, so you asked me about the breakthrough. So let me tell you about this. It was you, you know, being in that group with Josh Schachter, Ariana DeMers, Deb Matthews, Amy Duffy. I mean, those Tracy Gappin, like, freaking amazing. It was like the golden age.
It's like the golden age, dude. Now we've got a new gen. We've had like, we have new generations that come in all the time, but with OG, man, that was, that was a pretty Powerful group.
Powerful group.
Yeah, that group is like, we're all still really tight. Oh yeah, we are all in check.
Timeless Trevor. Yeah, uh, Mark Petropoli. Dr. P was in that group.
It was a pretty great crew.
Yeah, what a great group, man. And Buford was a part of it for a little while. Yep. Yeah, I mean, that was a really cool group, but it was just being around all of us, you know, together, and, you know, that mastermind mindset, you know, we're sharing ideas as a collective, you know, we're, we're getting together And you were a great coach, a great leader, man. Like, that had a lot to do with it too, like making us realize that we're worth it. You said— I mean, you're the one who hammered in, they undervalue you. They, you know, they're undermining your intelligence and all the hard work you've put in. You're worth more than that.
Yes.
Look at what you guys do. Look what you're doing for people. It's like, dude, no shit. Like, yeah, man. Yeah.
No offense, I couldn't make it through med school if you gave me the answer to the test.
I couldn't probably even want it.
Yeah. I mean, you gotta want it, right? There's no There's no there's no way in a million years I could even consider trying to take the entrance exams.
Like right, right.
I have I am so impressed by your by by doctors' intelligence, and when I say you know doctors mean all it like how what you have to learn and what you have to go through.
It's a language. You know I tell people it's beyond a language. Yeah, probably. I mean there's you know there's a lot of intuition that comes into this too. Like especially when you're doing biologics because it's not a protocol. Like I do not believe in a protocol for for biologic therapy.
Because it's jazz.
It's jazz. It's all improvised.
It's jazz. It's jazz.
Exactly.
Jazz has boundaries.
Yeah.
But what jazz is, because, you know, my brother— you haven't met my brother, Dan, but he's a professional musician, right? And he plays a lot of jazz.
Oh, yeah, I did meet him. He was here.
That's right. Yeah, he was here. Oh, that's right. Yeah.
You came to see Ben Asser.
Jazz has boundaries, and inside of it, there's 3 to 4 dudes playing 4 different ways.
Yeah.
But it all sounds the same. It sounds beautiful.
Yeah.
Yeah, it's jazz.
Exactly. It's Grateful Dead music. Same thing. Exactly.
It's exactly— it's the Grateful Dead.
6 people on stage, virtuosos at their instruments, and they're all creating— their own thing together. It's so incredible.
That's exactly what biologics is.
But that's— it's exactly what biologics is. Because listen, you know, I'll give people a pre-procedure protocol, but I tailor it for them. I mean, your biology is different than Sally's biology, which is different than Mary's biology, which is different than Joe's biology, right? And so the therapies can't be the exact same treatment for each individual person. So you got to take that into consideration when you're doing these. Like, All these studies that are being done, level 1 studies, this and that. I'm like, they're missing a key component of what biologic therapies are, and that's personalization.
Yes.
Right?
Yes.
Great. You have protocol standardization. This is a different field of medicine. This is. And I think that everyone's like, oh, we have to have standardization with PRP and this. I'm like, yeah, but you also have— you have to have individualization and personalization. Like, you have to have that. It's not standardization by itself. It's like, it's not one size fits all. It's just not that way.
I don't think medicine is that way. Medicine's Marketing's not that way. The law is.
Okay. Sure.
But marketing's not that way.
Exactly.
Playing golf's not that way.
Right, right.
Playing football— like, you have to understand, like, there is a— I'll relate it to golf, right? Because as a former golfer—
Yeah, yeah.
Like, you can go— the tour event is here in town. You could go to the driving range and you'll see the top 30 players in the world and they'll all have different swings.
Exactly.
But their impact point is exactly the same.
Yeah.
And the impact point, for those that don't know, is when the club hits the clubhead.
Okay.
So this space and the foot and a half of that impact point is all pretty much the same to get the kind of result. But they all wind up there different ways. That, to me, is how I view functional. This is how I view medicine. We've tried to make medicine like you're baking a cake, and it's not that. Because the problem is that the ingredients, the human body, are completely different.
Exactly.
Like, I just had my blood panel done, right? Like, Will Haas is my doctor. You know Will. You know, he was laughing. He goes, you just got bad genes on the lipid profile. I don't drink, I don't eat fried food. Like, yeah, I eat clean like you do, right? And my lipids and tris are slightly high. And he goes, you just got bad genes, man. Like, that's just— but if you're just trying to fit me in a box, you'd be pumping me full of statins.
Exactly.
Killing my leg muscles.
Right, right. You know, exactly.
So yeah, like, it is— it's jazz, man.
Like, it is totally.
And it's—
yeah.
And I think that's really hard for doctors because they want— we get doctors that come in, I want to know what the exact protocol is. Okay, go to IOF, get some training.
Exactly.
Let's learn the basic fundamentals, and then let's— let me teach you how to free yourself so that you can free your intelligence and this gift. When that sperm crossed the egg barrier and you were created, you were created to be a healer.
Yeah.
Okay, that's what the Creator made you to be. What has happened is they've turned you into a drone.
Yeah.
And let's make you a healer again. But to do that, let me get you some baseline. Let me free your confidence.
Right.
And then let me show you how to play some jazz.
Yeah. You know, right on.
Like, let's do this.
That's exactly what it is.
And they look at me like I'm—
what the fuck are you talking about? It's okay. They'll get it eventually.
They'll get it. They get it. It takes about 4 months.
It does.
And I can see when the light goes on, they go, yeah. Oh, okay.
Yeah.
Now I understand why it's a year-long program. I'm like, yeah.
Yeah.
Yeah, that's, that's because most people, they stay with us for years.
Well, yeah, we did 2 years.
You did 2 years.
Yeah. And that's what we needed. And it was perfect because, you know, what shifted for me was the kick in the ass you gave us in October.
Which was about 6 months in or 5 months in.
It was from February to October, almost 7 months in.
Yeah, almost 7 months.
Yeah, about 7 months in the program because, and that's not your fault, that was me. Like my stubborn wall. Like I apologize to Nikki all the time. I'm like, I get it. I now I get what you were trying to get me to do.
And look, you think I haven't dealt with this before? It's common, man.
Oh yeah. Oh yeah.
You know, then you get the rare ones like Schachter that goes, "Okay, let's do it." Schachter is an extraordinary human being, man.
I love that guy so much.
Same thing with Donnie. Donnie's like, "Matt's telling me to double my prices. I'm gonna go double my price." Like he gets it right.
As he should. He's one of the world's experts in this stuff. Like yeah, I mean, you know, if you're gonna go see a world expert, took Roddy five months for him to really get it.
Five to six months.
Yeah.
It took Petropoli.
8.
Yeah, 8 to 9.
But he listened to you, man.
I remember when he, when he sent me the text coming back from surgery, he goes, oh yeah, oh my God, I just spent 9 hours in surgery and yeah, I'd have to do a week of this to make what I'm gonna make tomorrow.
Yeah, exactly, exactly, man. It's a game changer. And then meditation was a big part of that.
Okay, yeah, let's dive into that. Okay, yeah, so you've done a lot of work with I have, yeah.
You know, I started, I started meditating. I started in high school, like, I started dabbling in high school, dabbled in college, a little bit in med school, not too much during residency. And then in 2016, Nikki and I went and learned Transcendental Meditation. So we did TM.
Okay.
I did that pretty fairly regularly, but then, um, let me look here. I'm gonna, Excuse me for just one sec. Yeah, yeah, yeah. So I log all my, my sessions.
Really?
I do. There's an app called the Insight Timer, and I just use it for— yeah, it's fantastic. It's got hundreds of thousands of guided meditations. It's got courses, all that kind of stuff. It's free, which is amazing. I use it for a timer, but I'm on 1,092 days straight of not missing one day of meditation.
1,092 days straight. Okay.
And my—
and how long are you doing these for and how many times a day?
Anywhere from a low of 20 minutes up to 45 in the morning if I have time. And then at night it's about another 15 to 20 minutes.
All right.
Yeah.
Let's talk about this because this is— all right. So this is an area that, like many people with meditation, I was probably first exposed to it in, I don't know, my 30s. Right. Did a little bit of it. Didn't think I was very good at it, you know, because I'd get distracted. My mind would be running. Didn't have apps back then either.
Like, you had to pop a pop a CD in or something like that. Yeah.
And then off and on. So in the last, in the last, so somebody somehow some way a video about Dr. Zelen, the Russian physicist who talks about the quantum field and pendulums and all of that. I have no idea how this got in my box. It was one of those things like it got there and all of a sudden I started watching it and like thirty minutes later I'm like. Oh, I finally get it. So probably about four months now, consistently five to six days a week. The thing I've noticed is we look at business and I look at goal setting completely differently. I don't look at ninety-day project. I don't look at ninety. I don't look at quarterly sprints. I don't. I don't really worry about the revenue numbers. I'm tapping into the coherence of the quantum field. Like I'm tapping. Into the feeling of my future self. Yeah, right. And it is a game changer. I want to hear about like what you have been experiencing, because what I'm experiencing is like things out of the blue are showing up and I'm all into serendipity. Like, yeah, but it's coming at a completely different level, right? Yeah. Because I'm surrendering to my future self.
Exactly.
So what's it like? I want to learn more. Like, what's this been like for you? What are the changes that you've seen in your life and your business? Like, let's dive into this because this is something I think is I'm seriously contemplating creating meditation course and event and things like that for doctors.
Yes, it's on the list. And combine it with what you're doing with Mavericks. Yes, that could be incredibly powerful.
I've done some teaching in the quantum field, which is really cool.
Yeah, yeah. You know, we talked about Joe Dispenza. For those of you who don't know, he's a chiropractor who I think in the late '80s or sometime in the '80s was running a triathlon, got hit by a A, a vehicle, shattered his spine, was told that he's never gonna walk again. He has to have this big spine surgery. He's gonna be fused from his neck to his pelvis, and he still won't be able to walk even if he has the surgery. And he said, screw it, I'm not gonna do that. So I'm gonna know what I know as a chiropractor, or my knowledge of anatomy. He was into yoga at the time too, my knowledge of yoga, and I'm gonna tap into my innate healing intelligence to try to heal myself.
Mm-hmm.
Well, he did. He walked out of the hospital, I think, 6 weeks later.
Yeah.
Yeah. And healed his spine. And he's like, made a commitment that if I can do this, I'm going to share this with the rest of the world. And he did it through meditation. That's what he does now. He basically demystifies the mystic, the mysticism, right?
And he backs it up with a crap ton of science.
It's all science.
It's all science. Unbelievable, the science.
He's doing incredible research at his events. He has people who volunteer. They'll do blood mark. They'll take blood before the event, after the event, see how it's things change, the blood markers change. They'll analyze breast milk, saliva, EEG activity, heart coherence, like the energy in the room, and everything shifts in 7 days. Like, it's tremendous. He's like, the blood chemistry changes so much at the end of 7 days, you're a different person.
Yeah.
Yeah, it's that powerful. And it's just breathwork and meditate— it's just sitting and connecting to yourself.
Yeah.
You know, and you mentioned like when you were in your 30s, your mind was racing. In meditation, that's just fine, right?
I used to think that was the wrong way to do it.
No, you just let it happen, right? It happens to me all the time. I think today I was— when during my meditation, what did I think? I thought about the podcast. I'm like, I haven't seen Matt in so long. I'm really happy to see him. It's been a while. And all these things started going through my head. I was thinking, I only have 4 people on the schedule. How am I gonna make a living? Like, like, it's still there. It's still there.
It's still there. It's deep-seated, isn't it?
It just goes, but it just goes. It's like Like, it didn't affect my day. I didn't go into my day thinking, oh, I only have 4 people. It was a thought that popped in my head while I was meditating. But that's what meditation, I think, allows us to do. You can have those, those intrusive thoughts or those self-doubting, self-limiting thoughts, but you let them go.
Mm-hmm.
And that's, I think that's what happens when you practice regularly. Like, that's why I don't miss a day, because I know it's the most valuable thing that I do. Obviously, there's a physical component, the exercise, lifting weights. That's a passion of mine too. But meditation, like, 1,092 days straight. Haven't missed one day.
What's different? What's different for you?
Oh, man, a lot's different. I mean, I'm a totally different person than I was even 2 years ago. You're way calmer. Yeah, way calmer for sure.
You've lost a lot of weight.
And happier too. Oh, yeah, dude.
How much have you lost in the last—
Oh, I only lost like 7 pounds.
But yeah, it's redistributed.
It's redistributed. Yeah, I've got more muscle mass now. Thank you. Thank you. A lot of that was because I was in an insurance-based practice and I was like, I'm not living the life I want to live. I'm not doing the things I want to do. You know, I was, I mean, insurance, man, like we're forced to do destructive procedures, right? The epidural steroid shots we do, the ablations we do, those are destructive procedures. They're great at masking pain and some people need those and that's great, but it doesn't resonate with me, right?
Yeah.
It's not what I feel. It's not who I am. It's like, I know better. Yeah, like there's a better option than what you're doing. Yeah, yeah, it's gonna cost money, but I tell people, look, if you want your insurance-based care, like, you don't need me. There's a, there's a literally, there's a hundred pain docs in this town who take insurance.
Turn a dead cat and find one.
Yeah, like, come to me when you want an alternative, right? So meditation has helped me become, come at peace with that.
So, yeah, so was that really hard? Like, for you to come free?
It was, for sure.
I mean, right, because your identity was locked up in high volume, because you all talk about high volume numbers and how many patients you see.
And I love my patients. Yeah. You know, I mean, all the people who put their trust in me. I mean, I tell people, when you're doing spine shots, that's incredibly intimate.
Yeah.
And the person on the table is putting their utmost trust in you that you're not going to fuck them up, right?
That was me.
Exactly.
When I was awake.
Exactly. I know, while you were awake. Exactly. It's like, I got this. I know I'm good at what I do, but I have to— I always honor and respect the person on this table that chose me to be the guy to do it, you know? And so there's so much love there. And so even when I was doing 50 shots, like, I loved all my patients. You know, and leaving that world was really hard, you know, because it was that letting go.
Did you tap in? You know, this depends on a lot of other people. They talk about the outcome that you want. Yeah, right. And then tapping into the feeling and the emotions.
Exactly.
How has that been for you?
I'm working on that every day. So when I meditate, I'm like, tapping into the future self. Exactly.
Yeah. So talk about that. Like, yeah, I look at— like, I tell people in the company, like, our future self already has the answer.
Yeah.
We don't have to find— normally what happens is I'm here, I've got this problem in the present. I want to get to the future and I'm trying to think, I'm trying to solve where I want to get to the future with today's skill set, which is impossible.
Okay.
So what I've learned is, no, the future self can draw us to that. Now, as a doctor, doesn't that sound a little like—
Totally crazy. But at the same time, when you tell me that, I'm like, that's exactly what it is. Like, that is the key right there, is become your future self. Right now.
Yeah.
That's the only way it's going to happen.
Yeah. One of our favorite books, Be Your Future Self Now.
Exactly right.
What is— do you remember any of the science that Joe talked— Joe's talked— Joe talks— Dr. Dispenza talks about this with regard— because you were really impressed with how deep he went into the science.
Oh yeah. I mean, it was fascinating, but to me, I don't really need that. You know, I mean, if you're— if you're—
yeah.
For— I mean, it's cool.
Yeah.
But I'm way beyond that. You know, I'm more about a— I'm about the feeling.
Yeah.
Yeah. Like, I love the feeling, like being in that room for those 7 days. Man, I got deep and like I had breakthroughs. Like, I— okay, in that one week I changed so much. When I got home, Nikki didn't even believe it.
Really?
Yeah. She's like, she's like, no, she's like, that's not who you are. I'm like, honey, I'm telling you, like—
She didn't go with?
She was there.
Oh, she was there?
Oh, she was there with me. But when we came back, the conversations we were having, like, I'm not gonna get too personal, but we had some intense conversations and I'm like, I'm telling you, this is how I feel. Like, and she was like, I don't believe it. I don't believe it. Like, because it was such— so the opposite of where I was before this week.
Yeah, you had changed.
I changed, transformed. Yeah. And then things started happening. Like, because I stayed with the meditations. Like, I, I, I mean, 1,092 days. I mean, that was, uh, July of '24. Hey, I'm just logging it. I think it's cool.
Like, no, it's very cool. Yeah, it's very impressive.
I want to keep it going. And it's like, But it's also, it motivates me, right? And it's my commitment to myself. Like, I'm not going to miss a day. Like, if I'm traveling, I find time to do it. You know, if I get up, if I'm traveling, I get up early. I'll find time throughout the day or when I get back to the room, I'll find time to do it.
It's 20 minutes.
It's easy.
I mean, I blow that on Instagram. Exactly.
No kidding. No kidding. Yeah.
And it's way better than Instagram.
It's way better than Instagram.
Yeah. I think the most fascinating thing for me in the whole process of meditation Is so I I can't remember this was it was over Christmas or something like that, and there was some Gaia training center was had some dispensary thing on sale, and I bought it because I've been following Joe. And the first time you listen to his meditations, you're like, what the?
I know his voice, and yeah, bar bar right whatever. Exactly. I'm like, dude, you sound like the Wizard of Oz. I'm like, dude, what is this?
Seriously? Yeah, but I understand why now because like it changed. It's a It's a different bucket for your brain. Your brain can't put it into the same bucket.
And that's the ego that's getting in the way there. That's your default mode network that's taking that signal in, and you don't want to listen to it. You start making fun of him.
I'm listening to him, and I say, he talks about this whole thing that 90% of our actions today were replays from yesterday.
Yeah.
Okay, that makes sense, because I've done a lot of work in that, of all that. And then he started sharing the science. About how people's blood panels change and their immune cells get boosted.
Yeah. They fight infections. Yeah.
And I'm like, okay, this has me intrigued. And then I think for me, what really hit it is I was doing a meditation and I was always like, fuck, 30 minutes. And I start the meditation and all of a sudden he's like, and now come back. And I'm like, there it goes.
Yeah.
That was a minute. And Christine's like, how was meditation? I go, I thought and felt it was like 5 minutes. And it's just amazing how things change in such a positive way when you can tap into that future self. You really— people have no idea how much they replay yesterday.
Oh, yeah. Well, it's a familiar past. He talks about that all the time. Like, we're stuck in the familiar past, and that's why we're stuck where we are, because we're reliving the past over and over and over again every day.
Yeah.
I mean, I'm surrounded by that. I mean, we're all surrounded by that society, right? You know, there, there are few, there are, well, I mean, there's a lot actually. I have a lot of clients who've escaped that and they're living in their future self in the present every single day. And it's extraordinary. Yeah. That's inspirational. But we're so stuck. I mean, we're so conditioned from our past. That's all we know. And it's comforting. It's like, it's safe.
Yeah. It's like, it's, I liken it to Why does the woman who was abused by her husband go back to him?
Yeah, because it's familiar.
It's familiar. It's not necessarily it's safe, but it's safe. And at least we, at least we know how bad it's going to be.
Exactly right.
Yeah.
We don't know what's on the other side.
We could, we could find somebody worse. So he can't be that— maybe he's just not that bad.
Right. Oh, he really does love me.
Yeah. He just happens to break my nose every 6 weeks. Yeah. And my jaw.
Yeah.
It's really, it is. We really don't understand. And this has helped me a lot with the doctors to help help them understand the insurance relationship is an abusive relationship.
It is, for sure.
Like in my book, I talk about this. When the book comes out, I'll bring that up.
We're the modern spouses.
I call it, it's the modern medical plantation. You're the sharecropper.
Yeah, right, right.
Right? And the insurance companies and the hospital system are the rich white plantation owners. Right? And you think this is the year you're going to finally make money. You're like, sorry, you still owe us money. You got to do it again next year.
Yeah, exactly.
And we just get— it's interesting how we just get conditioned to think Well, it's really not that bad. Yeah. Did you ever think that when you were in the insurance space, that it was really just not that bad?
Oh, yeah, for sure. Yeah, for sure. I mean, I was, I was in it. Like, I was so excited in 2021 to get the insurance contracts. I mean, literally, Cigna was giving me 74% of Medicare. I was like, yes, I got a Cigna contract. UnitedHealthcare gave me like 84% of Medicare. Yes. Like, no one gave me Medicare rates. Like, Medicare was my best payer. Which, if anyone knows, the whole system of Medicare is designed for you to break even. It's not designed for you to be profitable. Oh God, that's not what Medicare is. It's designed for you to break even. It's a socialized system. Exactly.
So yeah, that's worked well in the rest of the world.
Yeah, right.
Not.
But these insurance companies are paying us— well, at least me, because I was a solo private practitioner. I didn't have the negotiating power that like a large Banner Health or HonorHealth or these other paying groups that have like 12 offices, 15 doctors, they've got negotiation power. So they're like, hey, look, we're taking care of this 100,000 people that are on your plan. We want a better rate or else they're going to have no place to go. Right. And so they bump up the rates.
They don't bump it up that much anymore.
I have no idea. I'm so out of it. I don't give a shit.
What has been happening? I can't— we're not— let me rephrase this. What appears to be happening?
Yeah.
is the insurance companies have figured out that they actually still have all the power.
Yeah.
So with these large groups, what they're doing is they— let's say the medium-sized groups, not the large groups, the medium-sized groups and the smaller groups that come to negotiate, they'll be like, no, we're going to actually lower your rate. Because what they figured out is they can bankrupt them and then they buy them for pennies on the dollar. So the insurance companies are now going out and buying these insolvent groups.
Sure.
So they now, in some of the Some of the situations like UnitedHealthcare owns 11 distribute— 11 different revenue points in the medical customer journey. Oh yeah. 11.
Yeah.
Right.
Like they own the pharmacy, they own the PBM, they own the physicians.
When Rockefeller and Standard Oil did this and they owned the refineries, the oil wells, the trains, the, the gas, the, the, where the, the production house, all of it. When they did that, it was called a monopoly and they broke it up.
Exactly.
Right?
Yeah.
I mean, they tried to do it to Microsoft. Yeah. And that's exactly what has happened. It's not a monopoly because it's not one. Right. But whatever that other phrase is, I fell asleep that day in business school. But I mean, that's what they've done. I mean, it's— that's what I would do if I owned them. It's just— it's bad. It's just— I can't even— it disgusts me on a regular basis.
That's why it's so liberating to be out of it, man.
Yeah.
And yeah, I'm so grateful.
What was it like to get rid of your first The first, first, it was scary.
It was really scary. I'm not gonna lie. Um, you know, you helped us with that. What we did is we looked at the lowest lying fruit. Like, we did it volume based. Like, okay, we have this insurance. How many people are we seeing per quarter with this insurance?
10.
Okay, well, I can live without those 10 people.
Yeah.
So let's get rid of that insurance. So we did that. Then we went on to the next one. Okay. What's the next in line? Well, you see about 50 people a quarter from from this insurance. Okay, let's drop that. But what happened was the volume didn't change. More people showed up.
And remember I told you that?
I know.
And what did you think when I told you that? That you've gone crazy.
Doesn't make any fun.
Nature bores a vacuum.
Yeah, right.
So going back to the work of Dispenza, right? Nature, it can't. Yeah. Everybody do this. Go home tonight. Take all your clothes in your closet, give them away. I guarantee you, no matter how dead broke you are, you will have a full closet in 6 weeks.
Okay. Yeah, exactly.
Like, I do it all the time. Yeah, right. Like, I just got rid of a bunch of clothes. I'm like, fuck. And what— yesterday I was at Lululemon, almost bought stuff. I'm like, what am I doing? Oh yeah, I don't need any more gray pants.
Yeah, yeah.
So, okay, so you get— then the volume increased, or the volume stayed the same, right?
So October 20— October 23 is when you scared the shit out of me and really opened my eyes and made me see how bad it really was. And if I didn't change things, like, we're gonna lose everything. Like, Nikki and I, we were burning through our savings.
Mm-hmm.
And so literally 6 months later, we started— we said, well, we started weaning off insurance before that, but 6 months later, our better-paying insurance patients were flooding us. So we actually had revenue and I could start paying the loans back. So we met with the bank, we said, hey, listen, this is our situation. We're gonna turn it around. Just be cool. They jacked up our interest rates, which sucks. I mean, always, I know, which is— but they were cool. They give us 6 months of deferment though. It was interest-only payments, which we could do. But then 6 months later, it was like March, March of '24 was when— oh my gosh.
I remember. I— oh, you've shared the numbers. Yeah. And I use it. I've done it in the presentation.
Exactly.
Yeah.
Yeah.
You went from like 20 to 40 to 80. Exactly. Something like that.
Yeah, exactly. So Matt, it's happening.
Yep. It's happening. Always does.
Yeah. Like, The cash pay is increasing and the insurance patients are starting to drop off, but the volume is still the same. And so that went on through— we weaned off all insurance July 1st, 2025. So from—
That includes Medicare?
No, except for Medicare. I don't consider Medicare insurance, but all private insurance. Right. And then from July to December last year, what happened was Medicare was 70% of my, my patient volume. It was less than 10 to 15% of my revenue.
Yeah.
Yeah.
But those Medicare patients were buying your cash-based services.
A lot of them were.
A lot of them.
Yeah. And I was like, this is—
Medicare is a great— it's a, it's a great lead gen.
It is for sure. For sure. Yeah. A lot of my high net worth people saw me through their Medicare for their consults. Not that they needed to. Because now they're still seeing me and then they're not going through Medicare. But 70% of my volume was Medicare, but it was less than 10 to 15% of my revenue, of my insurance revenue. And so—
That's amazing.
Amazing, dude.
I'm like— Freaking 80/20 at its finest, isn't it? Exactly.
Yeah, yeah. Which you drilled into our heads. I mean, you know.
So 30% of your clients were generate— 30% of your patients were generating 90% of your revenue.
Exactly. Yeah.
As it should be, by the way.
Oh yeah. So by like October, I was like, I can't wait to get rid of Medicare because I want to have a better schedule. I'm going to have time. Well, so we dropped Medicare January 1st, and man, I saw a lot of people in January.
We had a great month, didn't you?
It was great. Best month ever. Yeah, better than any insurance month, better than any insurance and cash pay month combined. Yeah, best ever. Like 10x. That's why.
And that's continuing. That's why I texted you.
I was like, Nikki was like, you got to text Matt. And I was like, 10x.
See, and that's, you know, it's really fascinating to me because, you know, nature never changes.
Yeah.
Nature is the same because it's based on science and creation, right? Like whether you believe in creation or not, right? But like, there's a reason why. There's a reason why 20% of the people control 80% of the wealth.
For sure.
And 10% of the people control 90% of the wealth. Because it's scientific. Because 20% of the sunflower head has 80% of the seeds. Like, you can go through nature over and over and over again. And what we try to do as humans is we try to make everything equal. It's impossible.
It's impossible.
Because when we do that, like, 20% of the dead shows have 80% of the positive reviews, whatever, right? Like, you can keep going on and on and on. And when I can get someone like you that gets it, when you and Nikki got it.
Yeah.
You know what? You take it. You took as long as anybody else. Yeah, exactly.
Yeah, sure.
When people get it, their business just goes bam, right? Like that. Their stress goes down. And it's just— it's the most satisfying thing in the world for me. I imagine it's kind of like when you feel when you have a really hard case.
Yeah.
And somebody can now have— be pain-free.
It's incredible. Like today I had only 4 people, but there were follow-ups and You know, one guy is 6 weeks out of his procedure we did in December, and he's like, I'm 80% better. It's only been 6 weeks.
You did my back 2 years ago. It is— I had Ryan, uh, yeah, do it when we were at OrthoZone. I'm like, dude, my left side gets tight. I'm like, can you double-check and make sure that I got— he's like, no, you're just— you got to stretch more.
It's tight.
Can you— I know it's just all— I know it's just ultrasound.
Yeah.
Like, can you check my right side? He goes, you look great.
Yeah, because that's where that facet was.
Remember that? So what was the deal? Everybody asks, so I gotta get it on record. Like, would you remember? Yeah, you got that golfer's back, you got that rotation.
Rotation. And so you're— you have facet joints in the spine. That's where the vertebrae articulate with each other.
Okay.
And when you rotate in golf, you stress out L4-5. That's where the most common rotation point is in golfers. And you, with your swing, you're loading that right L4-5. So that right L4-5— because you got the MRI right before we did your procedure, and that right L4-5 facet was lit up.
Yeah.
Yeah. Because I remember I did— so I do a comprehensive spine treatment because I don't believe in treating just one spot. That's a stupid insurance-based modality. That's a mentality which And this is the whole functional spinal unit, ligaments, muscles, the levels above, levels below, the joints, capsules, all of it, right? The fascia. But I did all that stuff, but when I hit that one spot and I started injecting, you're like, oh God, that's it, that's it right there, that's the spot, that's the spot. And you had me stop. I was like, you just tell me when. Like, okay, go. Because you were not sedated for this.
No, I was— everybody, this was a Sunday, right?
This is Sunday night.
It was a Sunday night and I'm not sedated. So it probably took twice as long as it normally would.
Okay. Yeah, but it was a lot of fun, dude. It was really cool. But what was amazing is when I did that last shot in that joint and I was injecting the PRP into it, you were like, I felt the pain leave my body.
So you injected the dye? Yeah, I think. Yeah. And I felt the dye cool and go around it. Yeah. And then you go, okay, now I'm gonna push the PRP. And you push the PRP, and what happened is it went—
I've—
it was like the PRP went to the bottom.
Yeah.
And as it pulled itself up and I felt the pain leaving my hip, it's never been back.
I know.
It's never been—
It went away that day. I mean, it's insane.
I used to not be able to hit balls back-to-back days. Yeah, I used not to be able to play 2, 3 days in a row. I mean, I took a trip in a year and a half, but I mean, it was in July. I played like 4 days in a row.
I still have the video you sent me. So you, you left on Monday morning, you sent me the video on Tuesday, and you're like, Dude, I just got to tell you this. Like, I sat on that plane, my back did not hurt at all. Not at all. And you're like, normally that 6-hour flight, I'm up and down, switching positions, walking up and down the aisles.
Yeah.
I felt like that's great. That's not normal.
Felt great.
Not normal, but I'm glad.
How important is it? Do you, are you doing anything with regards to like HRT and things like that?
I'm not personally because a lot of my referring providers are concierge medical docs who have functional medicine training.
You think it's important to get the right, the better outcomes? 100%.
You think like if somebody's on HRT and they got their gut health or we get Absolutely. The healthier you are metabolically, the healthier your procedure is going to be, the better the outcome is going to be.
You know, um, how important is it, do you think, for somebody to be doing meditation on a regular basis before they go?
Would that improve whatever— Works for them? Prayer, you know, whatever, breathwork, whatever works for you.
But you think that'll improve it metabolically? Absolutely.
Yeah, absolutely. I mean, Joe Dispenza's got data that shows that, right? We change our blood chemistry. I'm sure it's doing something to our stem cells, our growth factors. I'm sure all of that's getting activated on some level. But I feel like it could be prayer, it could be what we call meditation, it could be breathwork. It's all the same. It's all the same bucket, right?
Yeah.
Call it what you want, do what works for you. But as long as you're taking those moments of stillness to connect with yourself, you know, or connect with a higher power, whatever that is, it's all the same. Yeah. But I think there's shifts that happen there. I mean, we know from the TM studies that people who do TM, low blood pressure, transcendental meditation. Yeah. Yeah, they have lower blood pressure, lower risks of heart disease. I mean, that's well documented. I mean, that's scientific. That's been out for decades, even before Dispenza. So now Dispenza is taking it to the next level.
Well, he's even showing in his studies that it is reducing cellular age.
Yeah, right, right.
Exactly. Telomeres and all of that.
Right, right. Which is remarkable. I mean, we can, we can do that all with our minds.
It's really fascinating how little we know about the mind.
Yeah. I mean, because what we're taught is what we— I mean, medical is our brain and we don't learn about thoughts, right? It's a field of psychology.
They tell you to focus on your brain and they cut out your heart.
Yeah, right. That's what they do.
Exactly. It's nasty.
So true. So true.
When I can get a doctor's heart reconnected, yeah, it's game over. Like, literally, like, we do work on that now.
Yeah. When I can get their heart and head coherence together, I know, like, you know, Even when I was back with Bali, like, I was giving my cell phone out to my clients back then, my patients back then. Remember my circle of friends here? A lot of them are doctors. They're like, you're too exposed, man. You, you, you're too close to your patients. I'm like, these guys have no connection to them.
No, it isn't that what you're supposed to be.
That's exactly what I thought. I'm like, kind of what I want as a patient. Take care of them. And like, they would never understand, like, what I told you about, like, these intimate spine procedures, right? And how much trust that people are putting into us. You know, it's like, I honor and I respect that. Plus, if you want to get deep, there's energy and all that kind of stuff, and I'm tapping into that. That's a sacred space. Absolutely.
Talk about that. Like, you know, um, well, so, because I think I find it fascinating, and I mean, like, you know, go as far as you want if you don't want to.
Yeah, not to get too woo-woo, but, you know, if you are, if you come from that school of thought where we have this Kundalini energy, which is— And what is that? It's like the energy of our chakra systems, right? So we have 7 chakras and And they all have the center where there's motion happening, right? There's energy. And it's, it's, you can think of it as a cerebrospinal fluid, the flow of the CSF. I'm a DO. I trained in osteopathic medicine. I spent extensive time training with 2 of the masters in craniosacral therapy and tapping into it, being able to feel it. Yep. Right. And when you connect with it and you can manipulate it, healing can happen. Like, we saw remarkable things just with craniosacral therapy.
Yeah.
Maybe it's just a parasympathetic nervous system reset. Whatever it is, it's pretty powerful. But that Kundalini energy flows through our spinal canal.
Mm-hmm.
Right? And when we're putting needles in there, right? We're tapping into that energy. That's another reason why I don't wanna put steroids in there because it's so toxic.
Because it's a— because it's a toxic and you're gonna block the energy flow.
Exactly. You're gonna block the energy flow. Like now when I do these biologics, I'm putting people's own stem cells in there. I'm putting their own blood growth factors, their own anti-inflammatory proteins. It's like I'm feeding that energy, right? Absolutely. We're creating space. We're creating that flow back, which is so incredibly important for healing, right?
Yeah.
That's what's going on now. But anyway, yeah, I love that.
Look, I think it's, you know, we know as much as we know about the body, we know so little about the body.
100%. I mean, yeah.
Remember when we told, we were told margarine was good for us?
I mean, like, I loved margarine back in the day, man.
It's like, I'm not going to die.
Yes, you are.
You got Alzheimer's. You got plastic in your body.
American cheese and margarine.
Oh my God, yes. Single-wrapped Kraft cheese, right? Remember those things? Like, that wasn't bad for you at all.
I lived off—
Jesus, you know? Yeah, but we know so little about the body. And that's one of the things that's happened for me. One, working with doctors for the last 12 years, I used to get queasy like driving by a Walgreens, right? Now I'm like, oh, you're gonna do surgery? Can I, can I sit in? Can I, can I watch?
Right.
But then the other thing is I'm realizing we know so little about the energy flow of the body. We know so little about how— what you were just saying, like, you're injecting steroids into the spinal column. Yeah, that's disrupting the energetic flow. When we use our own biologics, it's enhancing it.
Exactly. Exactly. Yeah.
It's fascinating.
It's a whole mindset shift, right? I mean, I've always thought about that, but it really— I mean, at least entering that space, but I didn't really think about how toxic these shots were because I look at it like a bigger picture. Like, hey, I'm giving— I'm helping this person get back to who they are, right? Because they've been in so much pain that they can't play golf, they can't play with their grandkids, they can't go on a vacation, you know. So even if I do this shot, they get back to who they are for the next 3 months. Yeah, right. And so there's definitely a reward in that.
Yeah.
And it's felt fulfilling.
Yes.
But, you know, after 10 years of that, I was like, shit, people, they're not getting any better. They're not getting any better.
No, they're getting worse. Yeah.
10 years later, it's like, oh crap. Yeah.
Like Yeah.
I mean, especially with ablations, like it's a great tool that we burn some nerves in the back. You can get rid of back pain for 6 months up to 2 years. But I didn't learn until 2017, because they didn't teach us this at Cleveland Clinic, that the medial branch nerve innervates the multifidi muscle, which is the main stabilizing muscle of the spine. And if you ablate that nerve, that muscle will atrophy.
Oh, Jesus.
Because that's not— it doesn't matter. We're pain management. Well, that's a side effect. but we're managing the pain, so nice job, you know? And in 2017, these regenerative medicine people were putting up MRI studies and showing us, oh, this is a spine 2 years after an ablation. And I'm like, oh, that's not good. And I learned to read spines in a completely different way in 2017. So I look at the multifidi muscle and now I understand, like, when people have gone through epidurals, ablations, All kinds of treatments, physical therapy, everything, chiropractic, and they're just not getting any better.
Yeah.
And no one can figure it out. You look at the MRI, you'll see that muscle atrophy almost because you have no support in the spine. And the problem with that is they get sent to a surgeon who fuses the spine, but motion wasn't the issue. It's the lack of the muscle.
It's the lack of muscle.
Exactly. And then you just create dysfunction above and below the fusion. Yeah. And that's our system.
Where— 2-part question. Is the American healthcare system fixable? And if so, where's it going? What do you think's going to happen?
Well, I grapple with this because I don't think the system is broken per se. I see flaws in it, but it's working exactly like it's meant to work.
Well, no, it is. You're right.
It's working. It's a well-oiled machine.
It's working exactly as it's designed.
Insurance companies are making billions and billions of American people.
I'm talking about the outcomes for the patient. Like, is it—
I think, I think people got to go back to the basics. Clean up your food. Clean up— start with food as foundation.
Yeah.
Eat nutrient-dense food. Think about what you're putting in your mouth. That's where it starts.
Yep.
You got to move your body.
Yeah.
Being sedentary is just as bad as smoking 2 packs a day. You got to move.
What if I smoke a pack and a half a day? Is that okay? No, I'm just kidding.
But you know what I mean?
Yeah, the food supply.
I think, I think we have to start there and not become reliant upon the medical system. Yeah, I mean, I think that should be the focus and that should be our goal. And then the things that I'm doing should be like luxury items for people.
Would you go to medical school again today?
Yeah, man, I would.
Would you still do it?
I would, for sure. Yeah, for sure. Because I love— I mean, now that I am where I am today, 100%. Like, yeah, what would you tell somebody who—
what would you tell someone if you were— if you were your younger— talking to your younger self, 22 years old?
Oh yeah.
What would you tell them to do?
I can tell you exactly because I have this great student, Sebastian. Hey dude, he's— I think he's a second-year med student now, but he came to me his senior year of, uh, college at ASU and he was really interested in going to medical school. So he shadowed me off and on for a year and saw everything I was doing with the biologics and, and all that stuff, how I interacted with my clients And, uh, when he finished, uh, I was his thesis, uh, director for his senior thesis. He graduated with honors, got into med school, and when he got into med school, he's like, Dr. Goyle, he's like, listen, man, he's like, you taught me the 3 most important things and foundational for me going into med school. Number 1, the body can heal itself, so support it.
Yep.
Number 2, patients come first, always treat them with dignity and respect.
Yep.
And it's okay to be close to them. It's okay to connect. I'm like, yeah. Number 3, he's like, fuck insurance. I was like, my mission has been accomplished.
You're like San Diego.
Yes, exactly. Yeah, that was like, okay, that's what I would have told my younger self back when, uh, 23 years old when I started medical school.
Okay.
Yeah, beautiful. That was the advice I gave it to him. So thinking of me as my younger self, I wish someone would have told me that.
Yeah.
You know?
Well, my goal is to I just, I want a medical school where I can teach a semester of business.
Yeah.
That's my goal. I figure if I can get one, then I can get 2 semesters, and then we can put it— if we can get 2 semesters, 2 classes in 2 semesters on business and cash-based services, I believe that in the next 40 years we can change healthcare big time in America.
You know who I think— so this just made me think about one of the Walton children, the daughter. The daughter.
She started the medical school. She started the medical school at University of Arkansas.
Like, her philosophy, what she's doing with this, all nutrition-based. It's, it's heart-centered. I mean, she's doing— she's radically changing.
I love that.
This group of doctors, if you can connect with her and incorporate the business side of it.
And it's all free. They're paying for it.
Like, they don't— Exactly. It's scholarship only. Um, yeah, it's in Oklahoma or something?
No, they're in Arkansas.
In Arkansas.
It's in, uh, University of Arkansas. And then, um, Bloomberg, Michael Bloomberg, who was the mayor of New York.
Yeah.
Um, he's now it up through— because he's worth $50 billion, right? And at Johns Hopkins, you no longer have to pay for medical school.
Oh, I didn't know that.
Yeah, yeah, yeah. Like, he's got it set and he thinks he's looking at— because when you come out with that much debt, yeah, you're enslaved to the system.
Stupid. Yeah, that's ridiculous.
Go ahead.
Yeah, I was gonna say that might be a good person for you to reach out to. Okay, I'll put it on the list. Yeah, yeah.
So here's the ultimate question I want to ask you before we end. Yeah, what's gonna happen with the Grateful Dead.
Oh dude, okay.
Are they? I mean, okay, so they had Dead and Company.
Backstory: my first Dead show was Deer Creek, 1990.
Okay.
And, uh, I mean, I was hooked. I was like, these guys have something truly special going on, you know? Like the— and I was a musician at the time. I started playing guitar when I was 13, so 1987, and I was getting really good. I was playing all the time. Like, that's what I did. I quit wrestling, I quit sports to really play guitar. It's easier to pick up It's way easier to pick up chicks for sure, for sure. Although being a stud wrestler was pretty—
not too bad.
It wasn't too bad either. Yeah, I wasn't really a chick magnet back then though, dude. But music was everything to me, and I didn't like the Grateful Dead until I went to the show.
Yeah, that's usually how it goes.
Because I had no idea, like, what they do on stage and how they interact with the crowd. That's magic. Yeah, like, no one is doing that. Yeah, on that level. Like, they literally feed off the crowd. Like, they'll play a song. Oh, shit, that was a train wreck. Let's, let's go. Let's go this way. Because they had no setlists. Yep. They would just get up there, you know, 5 minutes, you're just noodling around trying to figure out what they're going to play next. And they just go into a song and see what happens. And that's kind of how they set it up. And it was such a unique experience. I was like, there's something about this that I'm really into. Yeah. And so I probably saw Grateful Dead with Jerry Garcia.
How many times?
Like 20 times. Yeah. I didn't travel all over the country. I wasn't doing tours or anything like that. like that, but I'd go to like 2 or 3 night runs, um, you know, a few times a year. So between '90 and '95, something about 20 times. And then Jerry passed away. And then Bob Weir, who's the other— what, other main member of the Dead? I mean, they're all main members, but he was the other lead singer-songwriter. I saw him and his, uh, you know, variations of Dead and Company and all that stuff until he passed away just last month, at least 200 or 300 times. Like, no joke. Like, I saw them—
You saw them at the Sphere a lot, didn't you?
I saw 24 Dead and Company shows at the Sphere. Yeah. I mean, that venue is, is just a cool venue to begin with. You get 2 shows. I tell people, you're paying a ticket. Yeah, the tickets are kind of inflated, but you have music and then you have this thing.
It's amazing.
It's amazing.
It's freaking amazing.
There's nothing like it.
It's so good.
It's so cool. And with the Dead shows, the thing about the Dead and why you could go see them 24 times is it's a different show every night. The energy is different. The feel is different. I had a buddy of mine, um, who's not a Deadhead who went with his wife, who's a really good friend of mine, and he was like, dude, I had no idea the Dead were like this. Yeah, he's like, I thought it was funny hippie music. He's like, they killed it.
I saw him in Madison Square Garden like 3 times.
Oh, right on. It was—
yeah, it was in the '90s with Jerry. Yeah, yeah, right before Jerry died.
Yeah. But what's gonna happen to them, you know? So with Bob Weir passing away, the, the storyteller's gone. He's a storyteller. He was the last storyteller. Phil Lesh passed away a year before. He was the bass He was the other storyteller because he sang a few songs. But now they're gone. Now there's just 2 drummers, you know? So what do you do with that? I don't know. I mean, Bob Weir envisioned this music lasting 300 years.
Mm-hmm.
And, you know, there was an interview with him where he had an out-of-body experience at one of the big stadium shows, baseball field shows he was doing, where he's like, I was playing, we were in a jam, and he's like, all of a sudden I was 10 feet behind the stage. And he was like looking. He's like, there was a guy standing there who was in my place, but he's like, it wasn't me. John Mayer was over here, gray hair. O'Toole, the bass player, was over here. He looked pretty old. He's like, and there was 2 different drummers there, young kids. He's like, that's my vision for the Dead and Company.
Beautiful.
Just to go on, new people, just keep the music alive.
When they go back to the Sphere, we're gonna go.
Oh yeah, definitely.
When you find— because you'll know before I I do.
Just count me in, brother. Okay, you got it. You got it.
Yeah, we'll leave the wives at home.
Right on.
Okay, it'll just be you.
I don't think Christine will go either. It'll just be you and I. Right on.
Ash, I can't thank you enough for your friendship.
Yeah, likewise.
I really, like, seriously, like, I just love you and Nikki, your wife.
Love you too, brother.
Like, yeah, you guys have really helped me, and, uh, we wouldn't be where we are without you.
Oh, feelings mutual, man. For your mentorship, your friendship, your brotherhood, all of it, man.
Thanks, man.
Yeah.
And thanks for fixing my back.
Oh yeah, right on. Anytime, man. Anytime.
I hope it's not for a long time.
Yeah, but you know, it's gonna come back. Well, not even if it doesn't come back, you know, the nice thing about these biologics is they prevent the breakdown of your tissue. They keep the environment of the spine healthy. Yeah.
Yeah. All right. So if somebody's listening, they want to get treated, what's the, what's the name of your practice?
Integrated Spine Pain and Wellness in Scottsdale, Arizona. It's ispwscottsdale.com. Our phone number is 480-660-8823, and you can reach us online. Oh yeah, I said that, ispwscottsdale.com.
Yeah.
And we're off, uh, Scottsdale and Shea. Yeah.
Yeah. Thanks for coming in, Nash. I appreciate it.
Love you very much, brother. Yeah, I love you too, man.
You got it, bro.
Awesome. Thanks. Appreciate it. Yep.
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