Empire is a monthly mentorship for owners of medical practices at seven and eight figures. Your one-on-one work is with Vaughn Kohler, who co-hosted The MFCEO Project with Andy Frisella for five years. I assess where your business leaks in your first month.
I run the Genesis Lifestyle Medicine clinics and eight companies doing $200M+ a year. I teach what I run.
$3,500/mo
Want to talk it through first? Book the call. Your one-on-one time is with Vaughn.
1:1
monthly coaching with Vaughn
Month 1
business assessment with Alex
Monthly
Empire-only Q&A with Alex
3
in-person events a year, included
Dr. Alex Spinoso, MD, MBA, is a family medicine physician and serial entrepreneur based in Dallas. He started in 2017 as a prison doctor in a 150 sq ft room. Today he runs 15+ Genesis Lifestyle Medicine clinics and eight companies doing $200M+ a year, and his first company hit eight figures in 16 months. He earned his undergraduate degree at Dartmouth and his MD at St. George’s University School of Medicine. He also owns companies you may already buy from: Rush Pharmacy (co-founder), LifePRP and DEFCON1. He founded Spinoso Medical Empires, hosts the Medical Empires podcast, and wrote How to Conquer What You Can Control (And Let Go of What You Can’t). In Empire, he leads your month one assessment, the monthly Q&A, the in-person events and the Empire space.
Vaughn Kohler is your one-on-one coach and co-founded Charismedx with Alex. He has logged more than 1,000 hours coaching physicians, PAs, NPs and clinic owners. He was a pastor from 2002 to 2011. He then co-hosted The MFCEO Project with Andy Frisella for five years and returned to the relaunched show in 2025. He wrote Overcoming Overwhelm and Over-Availability Syndrome. In Empire, he runs your monthly coaching, keeps you on your to-do list, and tells you straight when something belongs in front of Alex.
At seven figures you already know the general answer. What you don’t have is someone who knows your numbers and will tell you the fourth location is a mistake.
I’ve made those mistakes. A partnership of mine unwound at a loss, and I once signed a lease I couldn’t exit. One second opinion would’ve cost me less.
Empire puts that second opinion on your calendar every month. A structure sits behind it, so the advice turns into finished work.
“Prior to our in person meeting I was questioning the value of this group… NOW after the meeting, the leadership from Vaughn Kohler and Alex Spinoso along with the inspiring members have changed my entire mindset… I am taking myself out of the business 80% to working on the business 80% in May.”
Danielle Wilderman, Revive Aesthetics & Wellness, April 1, 2025
Alone, the advice you get is general. Your next decision is a seven-figure one, and nobody who has done it is looking at your numbers. Your team can’t tell you no, because they work for you.
Inside Empire, the same business gets Vaughn working it with you every month and holding you to a to-do list. You get my read in month one and a Q&A built only from Empire questions. You also get everything in Elite.
Four steps, and you choose how the first one happens.
01
Buy your seat and you’re in. Want a second view on the right level? Book a call with Vaughn. When Elite is the better fit right now, he’ll say so.
02
We complete the Business Assessment together. Vaughn and I compare notes and hand you a joint to-do list.
03
Vaughn works through the list with you month by month.
04
Submit your questions ahead of each Empire Q&A. Post in the Empire space and tag me. Come to the three in-person events. Those are where the work happens.
01
Empire has six parts, and the first five are Empire only. Vaughn builds monthly coaching around four questions: who you are, what you want, what you’re afraid of, and the next most important thing to do. He keeps you on pace with the to-do list.
02
A focused, one-time session in your first month. I look at your clinic and name the bottlenecks. The first fix is usually the money: a clean twelve-month P&L, your utilization number, and margin by service line.
03
A full session dedicated to Empire members. Questions go in ahead of time so I can prepare real answers.
04
A private space inside the community for Empire members only. Post your questions there and tag me directly. Post publicly, not by DM, because my answer to your question usually helps the room.
05
Three in-person events a year, with me and the group. Your membership covers the event itself. Travel and lodging are on you.
06
You get both monthly live calls: Call 1 with me, Call 2 with Vaughn. You also get the private community, the member resource library of worksheets, calculators and playbooks, and the recorded call library. Empire members also get Empire gear.
Empire is not private time on my calendar, and I want you to know that before you pay. Your one-on-one coaching is with Vaughn. My time comes through the assessment, the Q&A, the in-person events and the Empire space. Expecting weekly calls or texts with me is the wrong expectation, and I want to correct it now.
Empire is not done-for-you. Nobody here logs into your books or your EMR. We tell you exactly what data you need, why you need it, and how to read it. Then we hold you to getting it.
Empire is not a tactical hotline. Vaughn won’t pretend to have the expertise on dosing protocols, staffing ratios, or a service-line P&L. He gets those questions in front of me, in the Q&A or the Empire space.
“At the last conclave, I took on one clear mission: free up my time and quit one of my jobs. Well… mission accomplished. I officially turned in my resignation to A Plus Healthcare today.”
Amy Fowers, August 5, 2025
“The strategic advice has been excellent. It’s opened my eyes to opportunities, systems, and priorities I hadn’t considered before.”
Traci Carnette, Empire All Access member, June 27, 2026
“I had no idea the impact this group would have on me personally and professionally… Thank you Alex and Vaughn for having a vision and stepping into it to help us all evolve.”
Amy Flynn, Empire member, April 2, 2025
One price covers everything above: $3,500 / month
You cover your own airfare and lodging for the in-person events.
No. I own companies many clinics already buy from, including Rush Pharmacy, the compounding pharmacy I co-founded. I also tell you up front what you don’t get, and the list is in “What Empire is not.”
No. You can join at checkout and we confirm your seat. A call with Vaughn helps when you want a straight answer on whether Empire or Elite fits right now. The group works best when everyone at the table runs a business of similar size.
Five ways. The assessment in your first month. The Q&A window on every Call 1. The monthly Empire-only Q&A. The in-person events. And the Empire space, where you can tag me.
I expect you to do the work on the list. Submit your Q&A questions ahead of time. Post in the Empire space and answer other members when you can. Come to the in-person events. Be honest with Vaughn on the coaching calls.
