Charles Runels MD started out as small town internist with a passion for science, a drive to excel and a knack for marketing. His career has been shaped by a series of challenges.
Transcript
There are 24 hours in a day, your day, my day, everybody’s day. Hey, it’s Marco Pelosi III, and this is the Top Cosmetic Gynecologist Podcast. If you take your 24 hours and commit yourself to a solid plan with a solid strategy and relentless action every day, amazing things can happen. You can become educated in a specific field, you can become an expert in a specific field. You can even create your own special niche.
Marco Pelosi III:
I didn’t know the backstory of the subject of today’s episode. All I knew was that he was a world expert in a special niche. Maybe you knew him the way that I knew him before our conversation, but now that I know his incredible backstory, I am uniquely impressed. And when you’re done listening, I think that you will be equally impressed and definitely inspired.
Marco Pelosi III:
Hey, it’s Marco Pelosi III, and my guest today is not a cosmetic dermatologist or a facial plastic surgeon, but his name is synonymous with one of the most popular facial treatments in the world. My guest today is not a gynecologist, but his name is synonymous with one of the most popular vulvovaginal treatments in the world. My guest today is not a urologist, but his name is synonymous with one of the most popular penile treatments in the world.
Marco Pelosi III:
He comes from a small town and practices in a city of only 15,000 people, yet he attracts physicians from all over the world to learn his techniques and his genius has taken him everywhere but the bottom of the sea. So here he is, live from the Gulf Coast, from Fairhope, Alabama, the father of the Vampire Facial, the O-Shot, the P-Shot, and a few more innovative techniques, the Iron Chef of platelet rich plasma, the one and only Charles Runels MD. Thanks for being here, Charles.
Charles Runels:
What an introduction. I’m honored to be on your show. I know you and your father have really revolutionized gynecology, so thank you for having me.
Marco Pelosi III:
Well, you’re no sloucher yourself, Charles. I was on the Google Maps just now, and I saw that you’re about three hours east of New Orleans, and about an hour west of Pensacola. I also saw that the Census Bureau came up with a word to describe where you live. They call it a micropolitan area because it’s so small that they don’t want to call it a city, but it’s big enough that they don’t want to call it the middle of nowhere. Have you always lived in Alabama?
Charles Runels:
Yeah, so I grew up in Birmingham, went to medical school there, and went to undergraduate there, and then I worked as a chemist there in Birmingham. And part of the reason I came here is, I was born in 1960, and so that was the days when Birmingham was a big steel city. Actually, the thing that put Birmingham on the map is everything you need to make steel is there in one city. You’ve got iron ore, you’ve got coal mines and so I would wake up in the morning, and sometimes you couldn’t see.
Charles Runels:
This is before pollution control, and you couldn’t see a quarter of a mile sometimes from the smog. I would help my dad wash the car in the morning, and by the afternoon, you could write your name in the soot, so I always said, “When I grow up, I’m going to go where the air is clean.” Even though they cleaned up the city when I finished medical school, I just drove south down I-65 until I hit the beach and that’s where I stopped.
Marco Pelosi III:
So what do you like most about living down there?
Charles Runels:
Well, I like the fact that, I’m sort of an introvert, I am an introvert, and so I can be outside, and as far as social distancing we’re supposed to be doing, I do that every day. There’s nothing different about that, but I enjoy people, and so I can go jump on a plane to Pensacola and be wherever I need to be but live my life in my hermit sort of way.
Marco Pelosi III:
It looks like you’re like a big outdoors man. When I first met you, I thought you were a retired pro wrestler or something. Have you been into… You’ve got that look. You’ve got a shaved dome, you’re a big guy.
Charles Runels:
Oh. Well, I never was a very good athlete, but Jack LaLanne was always my hero, even as a child, and so I’ve always tried to stay fit, and that’s the other reason I like this area. I can go running on the beach, or I can walk for a long time out in the fresh air, and so it’s a healthy place to live. But I enjoy the city too so I like coming to visit and speaking in New York and Miami and Los Angeles, wherever. But this is where I plug into my battery, down here in the south.
Marco Pelosi III:
Now, you’ve been traveling all over the place with your Society for Teaching, the platelet rich plasma techniques.
Charles Runels:
Yeah, so we’re in 50-something. countries. I’m really honored to have had some, a lot of really bright people like yourself who thought the ideas were worth talking about, so we have physicians who teach for us, and also in New Zealand we have Alex [Bader 00:06:09] teaching in Greece and London and others, [inaudible 00:06:12] in London. We have people in Spain and South Africa and Brazil, and many people in your group who speak for us, who teach around the world, so I’ve really been honored and blessed to sort of been born as kind of a mad scientist kind of guy, because you can’t…
Charles Runels:
I actually remember evacuating the house once when I think I was about… I discovered electrolysis reading in a book, or I didn’t discover it but I’d learned about it, and had managed to make a little container of chlorine gas when I was probably 12. And I remember having to evacuate the house when my chlorine gas escaped using electrolysis and table salt and some batteries, which I’m sure you remember from the chemistry how to do. So, I just, I have always kind of been… Then I worked for a few years as a physical chemist before medical school, and was blessed to be in that environment where if you don’t have new ideas, you don’t survive.
Charles Runels:
We were creating things that our Armed Forces use now to protect themselves, and I was blessed to live in that PhD world for a while as a physical chemist. So, it’s been an interesting journey, and I’ve been blessed to have been around smart people like yourself, and basically just try to soak it all up and digest it and come up with something new. It’s been a fun journey.
Marco Pelosi III:
Now, when you went into chemistry, was that a career change going from chemistry to medical school, or were you planning medical school all the way through and this was just another step in the process?
Charles Runels:
Honestly, I was one of those guys who had to apply a couple times to get in, and I had always sort of vacillated between engineering and medical school anyway, so when I didn’t get in the first time, I worked as a chemist and going to weekends and nights to study to become a biomedical engineer and working as a chemist in the daytime. And actually, I’d kind of given up on even going to medical school. I thought I was going to be the mad scientist and create the next instrument that doctors would use, so I was working on… We had a top secret lab and obviously can’t talk about what we did, but we were doing pretty amazing things.
Charles Runels:
I had pretty much discarded the idea of going to medical school, and as moms sometimes do, my mother said, “You know, you ought to just go put in an application one more time,” and I halfheartedly did and got into medical school down there in Birmingham. But in my heart, I was always sort of the want-to-be inventor, but that’s sort of like saying you want to be an astronaut, so I thought, “Well, I’ll just go do medical school and see what new ideas I can think up along the way,” so that’s kind of how it worked out.
Marco Pelosi III:
Yeah. In medical school, what specialty did you decide on?
Charles Runels:
I did internal medicine largely because I thought if my idea was to invent things and think about the science part of it, it would give me a strong face that was broad, and I could pick what to dive into, and so I dove into… For example, for a while I was doing VO2 max and was doing some clinical trials to see how Genotropin, a form of growth hormone, is affecting VO2 max and Pharmacia was paying me to do that. So, in spite of being in a little town, I managed to hook into some clinical trials, but during my training as an internist, I did ER.
Charles Runels:
I did (like a lot of people) a lot of moonlighting, so I worked in a busy ER here in Mobile, Alabama, 35-bed ER back when they staffed it with one person. I did that for 10 years, so that gave me I think an understanding of… And during that time, I ran the wound care center at the hyperbaric chamber there in the hospital base, so we treated a lot of diabetic ulcers but we also did things like necrotizing fasciitis and Fornier’s gangrene, so running a ventilator through a hyperbaric tube of wall in the hyperbaric chamber and that sort of thing. So, it gave me a good strong understanding I think of wound care and that’s part of what led to the PRP procedures with having that background and interest in how wounds heal from my ER background.
Marco Pelosi III:
Right. It seems like it is a smaller hospital, each physician is actually doing more of different specialties out of necessity and getting some really broad perspectives.
Charles Runels:
The thing that’s really been interesting to me is that something that may help some of the doctors in your group, I know a lot of the doctors in your group are connected to big universities, but many are not. Many are in, they’re in community hospitals. There is this unspoken rule, I think, that doctors pay attention to which goes something like this… “Unless you publish 20 papers and you’re connected to a big university, who are you to say anything? And if you do say something or you write a book, or you have a new idea, maybe it’s dangerous to talk about it,” and the close… Rightly so, we have to be careful to first do no harm, and so it’s not like we can just be out experimenting on people.
Charles Runels:
On the other hand, I think that we as physicians, even if you’re in a small town, have an obligation to pay attention to what’s going on, and have the courage to speak up about it, whether it’s in writing just in a local medical journal or speaking at a meeting and asking questions, or going to meetings, that’s why I like to go to meetings like the ones that you and your father put on with the ICG, because there’s this… As you know, the research lags probably what gets published, lags of maybe six months to three years, depending on the topic, to what the true leaders are doing.
Charles Runels:
So, I think this idea of paying attention and being willing to dive deep into the literature and go to the meetings and figure out not… When you say a specialty like internal medicine or gynecology or urology, that’s still very broad, but when you take a real specific problem like, say, “How can you inject around the urethra to help incontinence,” that’s a very small area that you can now go read about and read everything that’s been written about that in a week or two, and now you’re an expert. It doesn’t matter what’s your specialty.
Charles Runels:
Then, you go to meetings like what you guys put on, and you talk to the people who are the world experts, and before you know it, you’re able to take part of the conversation, no matter where you live, and no matter what letters are behind your name, if you’re thoughtful and you truly do your homework and dive into the research, and you keep an attitude of always thinking that there’s something really important you don’t know about, it can lead to a real fun adventure. So, that’s one reason I appreciate people who go do the work, who put on meetings and form societies like you guys have done with ICG because if you have that idea that you’re at home, very proud of the wagon wheel you’re building while someone across the street may be making a rocket ship, it keeps you paranoid and it keeps you out there on the street and your nose in the literature, and good things happen.
Marco Pelosi III:
Yeah, absolutely. What you were saying is, really I was doing an intro for next week’s podcast, and I was talking about how the change in technology and communications that have come about over the last 15 years have broken down to traditional academic filter system for information and have allowed people to communicate around this wall of academia at a much faster pace, and that the traditional curators of information have now been challenged by different curators with different ideas and different speeds of action, so now it’s not just one voice like it used to be, like always from the ivory tower, but it’s coming from different places. Like anything else, the more ideas that you have, the faster that you burn out the bad ideas and the faster that you funnel the good ideas.
Charles Runels:
Yes, and the other… If you think about, along the lines of what you just said, if you think about how it used to work when I was in medical school back in the 80s, someone had an idea, they did some research, they’d publish in a journal. That came out on pieces of paper, in a magazine, in your mailbox. And then, you read it and you wrote a letter to the editor to voice your opinion about it, and maybe you did another followup, research based upon that idea. That still goes on, but while that’s going on, as you just alluded to, you have… I just saw where the Newman Journal put out a link today to where an audible discussion of what we can learn from the hotspots with COVID-19, and so that’s out immediately.
Charles Runels:
And then, you have people like yourself who are doing podcasts about it, and then you have websites with blogs where doctors, instead of something getting published in a magazine and you sending a piece of paper, letter, that maybe gets published in the magazine two weeks later, you have a live blog where doctors are talking to each other, so with our organization, where we are focusing on, say, just an O-Shot procedure to help with incontinence or lichen sclerosus, we do conversations like this every week, but we have doctors sharing their ideas real time. So, like you said, it allows the ideas for us to rub minds against each other so that when you do get around to doing the research that gets published, it’s already been fine-tuned to a certain extent so that the results are more meaningful and maybe more pointed than they would’ve been otherwise.
Marco Pelosi III:
Absolutely. Absolutely. I think we’re living in an exciting time. All right, so you were working in ER medicine and internal medicine for about 10 years. Let’s explore the bridge from that to the first major hit that you had, which was the vampire facelift. How did that come to be? How did you get from point A to point B with that?
Charles Runels:
Yeah, so it’s like a lot of things, our best stuff comes out of getting beat up. I’m a firm believer when someone punches you in the nose, you should look at them and say, “Thank you very much,” because it usually motivates you to do something, and so I sort of got punched in the nose. The short version is that when I quit the ER, it was largely so I could see my children more. I would be home on a Tuesday and then working on a Saturday, and when my oldest started school, that meant that I quit seeing him so much, so I said, “Okay, I’m going to open my practice,” and I decided the best person to market to would be the 40-year-old women, because we know that women rule medicine. In every family, every doctor should know this, if they don’t they should make a poster to remind themselves, every family has a woman in charge of the health of that family.
Charles Runels:
If you take good care of her, she’ll bring the whole family. If you don’t, the whole family’s gone. And I don’t care if you’re a physician and you’re a man, there’s a woman that’s in charge of your health somewhere, maybe your mother, your wife, your sister, and we all, as ER doctors, you see it and you can talk to the rest of the family but until you find the woman in charge, they’re not all in, but if you find her, and it’s usually the daughter at the bedside or the mother, whatever, if you explain it to her, and she then, she’ll make sure all the rest of the family comes in line. Does that sound right to you, or am I off base here?
Marco Pelosi III:
No, no. That sounds like… You had, what marketing people say is you had your ideal patient, and you learned everything there is about how that patient is, how they feel and you direct the whole approach aimed specifically at that one target and you become the king of that domain.
Charles Runels:
Exactly, so I decided when I quite the ER, I enjoyed taking care of women. I pondered gynecology as a resident, and I enjoyed taking care of women, and they’re more complicated than men. They’re interesting because their hormonal milieu and the way, just their whole, the way they work to me is fascinating, and so I said, “Okay, I’m going to take the best care possible of the 40-year-old woman who’s 40 pounds overweight and feels tired and having trouble with sex and thinking, and if I take care of her, she’s going to bring the daddy and all the kids,” so before I ever quite the ER, I started going to meetings. How can I take care of this woman? How can I help her think better, lose weight, have better sex, help her think, help her with her blood pressure and her diabetes, whatever?
Charles Runels:
And so I was at a meeting, it was an A4M meeting before they were as big as they are now, in 1999, and I’m sitting there and a gynecologist presented a paper. This is one of those pivotal points in my life, I think. I’m sitting there listening and the gynecologist presented a paper in 1999, so it’s 22 years ago, and the paper was about using testosterone pellets to help women with migraines associated with their menstrual periods, and he had published the paper in neurology. So I thought, “That makes sense.” Back in 1999, to get good pellets, at least the best way I could find them, was to order them from Europe. I had a autoclavable [inaudible 00:20:43] and so when I opened my practice in 2000, so 20 years ago, when I quite the ER, I’ll be 60 this month, so when I quite the ER in 2000 and opened my practice, I introduced testosterone pellets.
Charles Runels:
And as you know, it does a lot more than help women with migraines, and before I knew it, I was doing, I had 3,000 women, 3,000 charts, most of them menopausal women, and that’s what led to the clinical trials with Genotropin and [inaudible 00:21:19], and I had the same mass spectrometer that Stanford had, was doing VO2 max and anaerobic threshold, and seeing how growth hormone was changing. And I was doing formal stem testing and looking for growth hormone deficiency by formal stem testing, not just [inaudible 00:21:36]. So, I became, I was going to the endocrinology meetings and the A4M meetings, so I became this sort of hybrid that was taking conservative endocrinology but looking for the people using the same open-mindedness as an A4M doctor.
Charles Runels:
Before I knew it, I had 3,000 menopausal women I was doing hormones on. Then came a punch in the nose, and this is what led to the O-Shot and the vampire facelift. The punch in the nose came when a bunch of things happened at the same time that felt like a punch in the nose at the time but was the perfect, exactly what I need. So simultaneously, remember I’m doing stem testing so I had a higher standard than insurance did, much higher standard, and part of the phase four study of Genotropin, but I had about 300 people, 310 people, that Blue Cross Blue Shield was paying for their growth hormone, and it was extensive, also because they had failed stem testing, and these were people that were… It wasn’t bodybuilder stuff.
Charles Runels:
It was things like, there was a woman who had been diagnosed with polycystic ovarian disease and was infertile and trying to get pregnant, 100 pounds overweight and on prediabetes medicines, but when I stem tested her, she had no growth hormone. And after she lost 100 pounds and got pregnant, and I sent her to the high risk OBGYN department down here at University of South Alabama, they diagnosed her with empty sella syndrome and kept her on the growth hormone, and she delivered a beautiful baby. So, it was those kind of people [inaudible 00:23:19] like nothing was a vet from Vietnam who dated his obesity to a head injury. Well now we know head injury can cause shearing forces in the pituitary gland and leave a growth hormone deficiency, and I had replaced him and he lost weight. Basically a lot of amazing stuff happened.
Charles Runels:
With people, these were not jocks. These were people that as an intern, I was doing hardcore medicine and putting these people in a phase four study, but it was costing Blue Cross Blue Shield too much money. And so simultaneously, three things happened. Blue Cross Blue Shield audited me, and some things happened with my marriage and all of a sudden I had three boys, ages four, six, and eight that were in my house six nights a week. So now I’m a single dad. So I looked at all that, and so when I go see Blue Cross Blue Shield, I have to explain how this feels. By the way, this has a happy ending, or it’s not over yet. I’m still out here doing stuff.
Charles Runels:
But there was a transition point because, and it was it turns out really great, because I was seeing these ladies and I really wasn’t making money because I would get maybe 80 bucks and spend an hour and a half with a woman trying to think about her hormonal milieu and these were complicated people. And Blue Cross would send me $80 for an hour and a half. So I was floating to practice on the clinical trials. I did other things with the antibiotics and some pain medicine, those sort of clinical trial for hire guys, so I could practice. So when Blue Cross audits me, I’m driving up to see them, and by the way, I buy Blue Cross Blue Shield insurance. They kind of rule Alabama, and I have it for all my stuff, and from a patient side, it’s wonderful.
Charles Runels:
But the doctors in the crowd will know all the insurance companies, in my opinion from the doctor side, they’re basically pimps. The way I look at it, the pimp tells you, “Listen. I’m the pimp daddy, you’re the prostitute. These [inaudible 00:25:26] patients are going to pay me money and I’m the pimp daddy. I’m going to decide if you get paid and when you get paid and how much you get paid, and if you don’t like it, you’re going to starve to death, because I got better looking prostitutes coming out of medical school every day.” That’s how it felt to me.
Charles Runels:
The other thing I was doing is Hyalgan had just came out and I was the number two doctor in the state injecting Hyalgan into knees because it helped my overweight patients walk. So I get up there and Blue Cross, I’m sitting at this long table, and they had an endocrinologist from the AV and a couple of people from Blue Cross Blue Shield, and I swear the table was 30 feet long for four people. So they’re doing the intimidation thing. And they tell me they’re going to fine me $3,000, something like that. And they’re going to change the policies for how a growth hormone is prescribed, because I was doing the standard higher than what they required, but when they realized it was costing them money, at that point they didn’t age adjust IGF-1s.
Charles Runels:
Think about it. We’ll age adjust TSHs, and there’s no… If we did, then we wouldn’t be treating the elderly people with hypothyroidism. And back then, they did not age adjust IGF-1. There’s no science to back up that idea in my opinion. But anyway, so they changed their policy the very next month. They told me how they were going to change it, and honestly I thought it was unethical, and it meant that they were cutting off my 300 patients, including that lady that had polycystic ovarian disease, including a lot of other people that I could tell you were just train wrecks. So they cut off my patients.
Charles Runels:
So I took a big, deep breath and I said, “You know what? I’m supporting this whole thing on my clinical trials anyway, and now I’m a single dad.” And by the way, the first week after that, getting my children six nights a week, I would take them to the hospital. I didn’t think you were a good intern if you only had 15, 20 people in the hospital, and I thought it was a good intent of this. So I would have people in the ICU. I took all three boys and I’d just stick them in the doctor’s lounge, and then after about a week of that, I said, “Okay. I get to decide. Am I going to just not come home and hire somebody to raise my boys? Or am I going to give up hospital privileges?”
Charles Runels:
And it was like falling off a ledge, because I felt like with 10 years in the ER and an interest in pulmonary medicine, I felt like I was just taking a piece of my brain and putting it on the shelf. But I gave it up. And then I started just doing clinical trials because when I told Blue Cross Blue Shield to piss off and gave up my PMD status, I found out that you can’t bill cash to Blue Cross Blue Shield patients for six months after that. So they try to starve you out with a non-compete. So for six months, I just did clinical trials, and then I started seeing patients on a cash basis, and I said, “Okay. What will they pay me for?” I said, “They’ll pay me for sex and they’ll pay me for their hormones.” So this was around 2003, 2004, and as an intern in Alabama with not many people in my county, I started doing a cash practice.
Charles Runels:
And I figured they would pay me for cosmetic work, because when people lose weight, they want their faces fixed. Like ladies who want to gain their weight back would make their face look old when they lost weight. So I found who’s the top cosmetic guy so that I can learn how to… We didn’t have Juvederm yet, we just had [inaudible 00:29:06], but I found the top [inaudible 00:29:06] in the world was a guy up in Toronto. So I went up there a couple times and stayed with him a few days, learned what he knew about injections, and I started doing cosmetic work on my weight loss patients to help motivate them to keep losing weight.
Charles Runels:
I thought cosmetic work was kind of a wimpy thing to do. But I saw it as a way to motivate people to lose weight, and then I learned how important it is to people’s psychology, and it became really important to me. So now that was the perfect storm. I’m taking care of people for cash and I have a background in wound care and I’m doing cosmetic work. Then a guy walks into my office one day, and says, “I see you’re one of the top cosmetic injectors in town. I’ve got this stuff PRP and use it like Juvederm, and you get new volume, new blood flow, and there’s never been a side effect.
Charles Runels:
And I’m thinking, “Man, I’ve done wound care for all these years and I’ve never really worked with PRP much. But if that’s true, I have a better place for new volume and new blood flows in my space, because I’m a man, right?” So I thought, “I’m going to play around with this for a while and see if, and read the research and become an expert on PRP, and if it really does what they say it will, this should be a good thing to put into the penis.” But here’s the problem I saw. Here’s the worry I had. I thought, “Okay. When you see a doctor advertising, say, Botox, if you think about what that means, it’s like advertising beef but you don’t know if you’re going to get a hamburger or a Ruth’s Chris steak, because you’re advertising the material, not the way it’s going to be used.”
Charles Runels:
So I thought, “The same thing with Juvederm and the rest of them. It’s a material, and we’re advertising the material, not the method.” So as you know, you can go into one doctor’s office and get something wonderful and then someone else can get something scary, and it’s still not managed by any medical board, even the plastic surgery boards, it’s not part of their boards. So it’s like the Wild West. So I thought, “If that happens with PRP for sexual problems, somebody’s going to get hurt.” So I had an idea to do… I was watching what physician’s weight loss had done, what synergetics had done, Priapus Shot in other arenas, not medicine, but other arenas where a trademark meant a way of doing something.
Charles Runels:
And honestly, I thought the vampire thing was just going to be a one or two month experiment. I thought, “I’m going to experiment with a trademark that means a way to do something to the face.” And if that works, I was still thinking penis, I’m going to roll out the thing with the, Priapus Shot is what it turned out to be, but I tried it out in my penis. It was working. I was doing it privately with my patients. They were loving it. But I hadn’t talked about it openly yet. So I wrote out the vampire facelift after studying things and thinking about how to design the business side of it for a few weeks, and when it went viral, it just went crazy after that.
Charles Runels:
Then before I rolled out the Priapus Shot for men, I did the O-Shot on my lover. I had followed Matlock’s work and that’s a whole different story. We can talk about it if you want. But it felt to me like women needed something more than men, so I actually rolled out the O-Shot before I did the Priapus Shot. So it all came about if I hadn’t gotten beat up by Blue Cross Blue Shield, I’d probably still be making rounds and keeping 20 people in the hospital, so it was good.
Marco Pelosi III:
Now tell me, that’s some really, really insightful marketing thinking. So you just came up with this in your head? Did you have any marketing background? Did you seek out any marketers? Or you just were a good observer?
Charles Runels:
Well, that’s stand that part of the story. If you look on the map and you look at the demographic, last time I looked, we have about 250,000 people in my whole county. That’s including the tourist area at the beach. That’s the equivalent about four square blocks in New York City. That’s what we got in the whole county. And yeah, there’s some people who retire here and have cash, but there’s a lot of farmers and people who are really good people, but don’t have money for cash stuff so much. And so I thought, when I went to all cash, 2003 was when that happened, when I went all cash, I thought, “I need to be able to attract people from other places.”
Charles Runels:
And by the way, when I went all cash, it was a very scary thing. It was not a smooth transition. The house was almost paid for and I gave it back to the bank. I declared bankruptcy. I went to the little house across the street from my kids’ school to see if I could walk them to school in the morning and they would find their way home in the afternoon, usually with friends. I became sort of after school care for four or five kids most days. And I just plowed into marketing, because I thought, remember, I had the little six month hiatus when I couldn’t bill anybody cash and was living in a couple of clinical trials, and I thought, “I need to be able to attract people from other places.”
Charles Runels:
And I started going to marketing class, and the deal, because my, again, thanks to getting punched in the nose and starting all over, my deal was whatever I spent on a marketing class, this is actually, I still do this. When I went to your guys’ meeting, by the way, that was a wonderful meeting, the ICG meeting down in Fort Lauderdale a month or two ago, I started having a rule that if I went to a class that was a marketing class or a medical CME class, I had to take at least one thing I learned and make some money back within a month. That was the game I started playing. That included travel expenses and time lost from being away from the house.
Charles Runels:
And back then for example, I was doing a clinical trial that involved investigators meeting in San Diego. And so I literally, after that meeting, I could afford the airplane ticket but not the hotel room, so I slept out by the pool at night and went to the meeting. But again, this is not a sad story. This is just a kick-ass story, right?
Marco Pelosi III:
Right.
Charles Runels:
Nothing was going to stop me, and because my back was against the wall, if I was to learn something, I had to implement it in such a way that people got well and I made money. And this was something that a lot of doctors I think skip over, but if you stop and just think about what that means, if you’re charging a patient cash, then unless you are a thief, which we are not, and by the way, if you’re a thief, you’re going to go out of business because people will figure out you’re a thief. So if you want to make money by people giving you cash, it meas you have to do something profoundly good for that person that a doctor taking insurance cannot do. I’m going to say that again.
Charles Runels:
If you’re going to take cash from a patient, you better be effing good at something, and so much better than the doctor taking insurance, so much better than that doctor that the patient is glad they gave you the cash, or else you’ll be discovered to be a fraud and you’ll go out of business. So I became even more passionate about learning and learning medicine and learning marketing, too. So it’s not an exaggeration to say that I’ve spent over $2 million on my market education. For example, I paid one guy $1,200 a month for three years for just one hour a month, but the guy still marks over 10 million a year just writing emails. And so he would read my emails and think about what I was doing and advise me, and then I would take what he taught me and I’d send out an email and I’d have patients come and see me.
Charles Runels:
I couldn’t afford to hire somebody to build my website, so I studied how to build websites, and I still do that. For the past six years, I’ve paid a couple of programmers $2,000 a month, so do the math on that. $2,000 a month, one hour a week, you look at my websites, I have 31 websites that make money for me. I have over 150 websites that are out there feeding the other 31. And so we just look under the hood, by the way they look under the hood and how the software works, you make them work harder. So that website that we just threw up, COVID-19 switchboard to help people find people who have COVID-19, help their doctors find people with convalescent plasma, that took about three days to build, and it came from that background of having to do my own websites.
Charles Runels:
So yeah, I’ve studied profit models, like one class I did last year cost me $35,000 for one class. But one of the guys in the class who spends $500,000 a week on his TV ads. So as I learned more, the classes became more advanced and the people I was hanging with became more hardcore, like the guy that made Taylor Swift famous was in one of my classes. He was actually hiring Taylor Swift’s father as a physician who paid this guy $250,000 a year to make her famous. And so it’s been a really… By getting beat up and going broke, it forced me to work my brain harder and it gave me an understanding. I know what it’s like to be the primary care doctor who has three babies sleeping in the room next to you, single dad, and wondering how you’re going to feed them, and waking up in the middle of the night wondering how you’re going to take care of them and take care of patients.
Charles Runels:
And there’s a climate for physicians has gotten worse. It’s given me a real heart for the doctors who are struggling, and it actually was a really blessing to me to get beat up and out of it came this interest in marketing. Marketing, good marketing makes you a better doctor because if you’re a really good marketer, you realize you have to tell the truth and if you’re going to have people give you money, you better get to be really good at what you’re doing. So we kind of feed off of each other.
Marco Pelosi III:
Sure. When did you start teaching doctors your procedures?
Charles Runels:
It was about a year after I’d been doing them. I started with a P-Shot idea, but I started doing the facelift as a way to combine a specific manner of fillers with PRP. And I had developed I think an expertise by doing what we talked about. Finding the wizards, who’s the best at this? When I talk to surgeons when I’m in London, they know the Pelosis. When I’m in Madrid, they knew who the Pelosis are. I’m talking to gynecologists around the world, they know the Pelosis. So there’s those wizards in other arenas as well. So I had the guy that taught me Juvederm and Botox was the top [allergen 00:40:11] account because he was a wizard.
Charles Runels:
So I had developed an expertise there that surprises people still, thanks to my teachers. So I started teaching after about a year, I started teaching the Vampire Facelift® first because I know this idea of being [inaudible 00:40:29] at risk of giving the… There’s so much hokiness around penis growth and such. It’s becoming less so now that we have legitimate surgeries and such. But 20 years ago, it was not so much out there and you were at more risk for being labeled a quack if you talked about penises. So the first class just taught the vampire facelift and Botox and Juvederm, and then I started teaching the O-Shot after I developed that.
Charles Runels:
And I probably had… I was still doing everything else, but after about two years and having some of the physicians whom I taught tell me that the O-Shot® was really working surprisingly well for incontinence and some of these problems. So two years after developing the procedures, I started offering a class once a month and then helping other doctors fill their classes. So we’re up to now we have 80-something doctors who teach our procedures, and [inaudible 00:41:29] teaches his laser classes. So I’ve really been blessed to have some of the wizards think about this stuff and help me think about how to make it better.
Marco Pelosi III:
The first time I heard about you, I said, “That’s the Vampire Facelift® guy, and he came out with the O-Shot®.” But people that I trust love this thing and they’re having a great experience. I was really impressed. I said, “This guy is an interesting guy.”
Charles Runels:
Well, thank you. There’s a little trick about the face that I don’t usually talk about except in my classes, but part of what gave me the idea of the O-Shot is really three things that happened. One is that by doing, as you know and doctors who take care of women know, but most people don’t know this, is that even now, most women who’ve had sexual problems, they don’t talk about it much. Unfortunately, sexual problems are like psychological problems. Consider this. If you have pneumonia, if you have COVID-19, if you had a broken arm, your family asks people to pray for you and everybody talks about it. If you’ve got schizophrenia or major depression, you don’t.
Charles Runels:
There’s this stigma for psychological problems for people who are embarrassed by them, even though there may be a neurological problem or a chemical problem that causes it, people are embarrassed by, and it’s the same with sexual problems. People are embarrassed. Like you’re never going to see a celebrity endorse the O-Shot®. Even though celebrities and movie stars, they’ve been in my office. Yeah, they come to Alabama. They still pee on their leg and they still have dyspareunia and trouble with orgasms, but you’re not going to see a movie star talk about dyspareunia because it kills the image. So sex problems are a secret, and they’re not talked about much, but if you’re taking care of women and you make it safe for them to talk to you, they will open up to you and they’ll start crying because they’re afraid to tell their husband, afraid he’s going to get his feelings hurt. They don’t tell their girlfriends because their girlfriends don’t give any sympathy most of the time.
Charles Runels:
And so they just kind of keep it to themselves. And their doctors, you and I know, most of the doctors will cut off the conversation after one question. So they’re suffering. I’m watching Dr. Matlock with his G-Shot, and I’m watching what he’s doing. I’ll never do this because as an internist, as you know, there’s a risk of granuloma, urinary obstruction, and so I don’t want to be making a problem I can’t fix. So I never did it, but I was watching his work. Now when I started doing the face, here’s what gave me the idea for the O-Shot®. First, I had a heart for women. I’ve been doing their hormones and many of the problems they were having with sex they weren’t telling people about.
Charles Runels:
Second, I’m looking at all this stuff with wound care, but when you shoot PRP under the eye, when I shot PRP for the first time into the tear trough under the eye, it causes aqueous. You can just see it hydrodisect. And I thought, “That would be the same thing around the periurethral space.” So again, I’m not a surgeon, but I know you guys hydrodissect that space when you’re getting ready to put in a mesh and a lot of other things. But I shot that in there and I thought, “Man, that might help incontinence, because you can do what Matlock does, only you wouldn’t have to worry about granulomas, there’s never been a granuloma from PRP, and it would take on the shape of that space without worrying about causing any problems, infections or neoplasia or anything like that.
Charles Runels:
So doing the face really, had I not done the face first, I would have not gotten the idea for the O-Shot® procedure. The other thing that’s kind of weird probably for most people is to think about that I don’t talk about much, but I might as well confess to your people, is that in the process of taking care of those 3,000 women and just from my personal experience, I had written a book on how to teach a woman to ejaculate. And I was fascinated by the physiology of it. I’ve read probably everything that’s been written about in the medical literature as well as every book on Amazon about it and too many lovers that a man shouldn’t even be talking about.
Charles Runels:
And so I had developed a way to teach a woman to ejaculate, clearly ejaculate, as in from the Skene’s glands and the periurethral glands and had written a book and it was one of the things I was selling on my website. So the first time I did the O-Shot, I’d like to say that I had thought about the incontinence thing. I really hadn’t. I was thinking more in terms of sexual function. So the place where I put it, I put it more distal from the bladder so that I could wake up the periurethral glands (the Skene’s glands), and then I put it in the body of the clitoris so it could hydrodissect in the corpus cavernosi and helped with that because we know from research that the development of that and the distance from, we know from the eye study, the distance of the corpus cavernosi, the clitoris correlates with a woman’s ability to orgasm.
Charles Runels:
So that was the thoughts behind it, and then when my lover at the time just went ape crazy, I thought, “Well, let me try it on somebody with a problem,” and my next patient was a woman who’d been physically abused in the genitalia by an ex-husband to the point she had dyspareunia, and really lots of trouble with anorgasmic and dyspareunia. And after treating her, three months later, dyspareunia’s gone, she was engaged to a high school sweetheart, that’s when I kind of had something. But she’s the one who told me, “Hey, this stopped my incontinence, too.” So it was really accidental, that part of it, that I was thinking more in terms of healing the scar tissue and dyspareunia and not so much incontinence. My patients taught me that.
Marco Pelosi III:
Now when we treat incontinence as gynecologists, we stratify up the diagnosis to see which specific type of incontinence we have. Now in your practice, do you just tell the patient, “Let’s just try this,” or do you have them analyze for the specific type of incontinence?
Charles Runels:
Yeah, so it does matter, but there’s a couple of things that make it interesting in that I know there’s urge and there’s stress incontinence and there’s all sorts of things that can happen. Mechanically, if you just think about the cause of disease, you’ve got hormonal and you’ve got mechanical problems that usually you need to treat surgically and you’ve got autoimmune and all these different classifications of disease processes. But again, I just discovered it by listening to my patients, and then I thought, “Well, how is this working?” So before someone comes for a cash procedure, they’ve already had a workup by at least two different doctors who take insurance, as you know, because as they should.
Charles Runels:
And so the common and most needed tests have usually been done. But surprisingly, people with mixed incontinence or even a large part of it being urge incontinence still get better and I’m guessing here, but my thinking is that there’s probably some help with the nerves of micturition, that if you go in the literature and just start reading PRP, you go deep into the science, there’s over 12,000 papers now in pub med about platelet rich plasma and appears that, and it’s quite a number about regenerating nerve, there’s some about Bell’s palsy, it’s antiinflammatory, it down regulates autoimmune response and is shown to help with rheumatoid, and we have three papers now about it helping lichen sclerosus.
Charles Runels:
So my thinking is that the PRP is way smarter than I am, and it’s maybe doing more than I ever expected it to do. And it’s going to, it’s like anything else. Once you figure out something works, there’s an infinite number of ways it could be done, and it’s really a small need for people like you and the others in your group to learn more deeply about what’s happening. And I can tell you a dozen studies off the top of my head that need to be done about figuring it out. If you just take the PRP itself, there’s a lot easier ways to make it. We know if you cool it, it works better. You can wash the platelets. There’s things you can add to the PRPs. You know, people are playing around with amnion and [inaudible 00:49:55] and all sorts of things to add to the PRP, stem cells and such.
Charles Runels:
But then there’s where do you put it and how much do you put it? And I’m hoping that over the next five to 10 years, I’ll see more research about variations on how the O-Shot can be done based on the problem you’re looking at. For example, someone like yourself who knows anatomy the way you do, much better than I, you might be more specific where you put the PRP. As I’m putting it in the anterior vaginal wall, very distal from the bladder, just literally millimeters on the other side of the hymenal ring, and sliding a needle and so that stays between the anterior vaginal wall and the urethra, anybody on the call could go, we have videos they can go watch, they can go to my website O-Shot.info and we’ll send them all sorts of stuff for free if they’re a doctor.
Charles Runels:
But I think what, for example, we found putting the material there workers better than putting it back closer to the [inaudible 00:50:56] junction and that happened accidentally because I was trying to get the Skene’s glands involved, but it turns out it works better that way for incontinence as well. The other thing, okay, so injecting the body of the clitoris trying to get PRP into the corpus cavernosi, as you know, it’s more of a valve in the sphincter that works to help with incontinence in women, and some of the… There’s actually erectile tissue near the urethra. So it could be by accident that I got lucky and injecting the clitoris itself is also helping with the continence mechanism.
Charles Runels:
But all that needs to be looked at with ultrasound and MRI studies and you guys as surgeons thinking about where else and what variations could be done to improve what it’s doing. It’s never going to take the place of surgery, but either used as an in between step for those who might not be ready for surgery or as an adjunct to surgery… There was one study looking at… I could go on and on. I start ranting because to me, it’s like we just started and I know that your listeners are skilled enough and bright enough to take it and think of 100 things that have never even occurred to me. So I hope they’ll dive into it deeper and figure out better… Like we know, Oscar Gary and other urologists in our group, [inaudible 00:52:24] have told me repeatedly they’re just shocked at how some of their chronic long-term [inaudible 00:52:31] patients are getting better, and we don’t know a good reason. We’re just doing it the normal way, just hydrodissecting that space.
Charles Runels:
And so if I was going to have one thing come out of our conversation, it would just be that the people in your group, I know they represent the kind of people that are… I call them sort of like King Arthur and his knights or Lancelot, I call them the Sir Lancelots of medicine. You remember why Sir Lancelot was waiting by the bridge when King Arthur came along? I know this from reading books to the three boys. The reason Sir Lancelot was waiting by the bridge is he could kick everybody’s ass, and he didn’t have a king that he thought was worth taking up for. So when King Arthur come along, kicked Sir Lancelot’s ass, partly by cheating, because he had the magic sword, then Sir Lancelot, he said, “Okay, I’m going to be your knight.”
Charles Runels:
To me, that’s the people in your group. People that have already mastered their specialty. They’ve become extremely good at the thing they do, so good at it they’re looking for the next king that’s worthy of their sword, their brain. The next idea that’s worth their thinking about. And my hope is that the people in your group will at least consider thinking more deeply about how to use injections, either before or to prevent or a long-lived surgery to enhance the magic they’re already doing with their skills of the surgeon. I think there’s going to be a lot of research around the idea of using cellular therapies to down regulate autoimmune processes, to increase…
Charles Runels:
Like there was a real good study of menopause using PRP to help them with dyspareunia, secondary to dryness. We’ve had breast cancer, and shockingly, most gynecologists still haven’t read that study. But it’s one of our easy wins. You do the O-Shot on a woman with pain from dryness, you can’t [inaudible 00:54:39] hormones, you’re afraid of them because of breast cancer, it’s a slam dunk for us and those gynecologists don’t know that yet. But even if they do know it, now there’s instant varieties about how that could be done. Wherever you put it, how you put the plasma, I guess I sound like I’m pleading now because I am because I know there’s so many smart people that listen to you, and I hope that they’ll take their brains and I know some of them in your group already have, it’d be great if they would jump on our website and look at what we know already and figure out what the next thing might be to try to do.
Marco Pelosi III:
Now as I was going through your about page, I realized that you are a human guinea pig. You’ve tried all kinds of crazy things on yourself.
Charles Runels:
Yeah. I’m afraid I have.
Marco Pelosi III:
So let’s see. You’ve run marathons, you’ve fasted, you’ve stayed awake for days trying to alternate your day and night, all kinds of body hacking kind of things. So do you have a routine that works for you right now as you’re going to hit 60 years old that’s keeping you fresh and energetic?
Charles Runels:
Yeah. I think I’d like to remember what Abraham Lincoln said, “If you had [4 hours] to chop down a tree, you’d spend three hours sharpening the ax.” And when I was chopping the tree, our bodies and our brains and conditions are, that’s our ax. And unfortunately, we have a personality that we want to sacrifice and take care of other people and we have to do it to a certain extent and ignore our own health. One of the people in our group just got off the ventilator. He’s a family practitioner, he does my O-Shot® and teaches for us, and I don’t want to break confidentiality, but he was in New York and he was on the ventilator, almost died from COVID-19. It’s what we do as doctors if we know there’s going to be some beating up of our bodies.
Charles Runels:
Actually as a kid, I was a lifeguard once for, it was a pool party for children with cystic fibrosis. And that was the roughest, toughest bunch of kids I’ve ever seen in my life, and I asked one of the mothers about it and she said, “Yeah, we know our children are going to get sick. So we make them tough so that when they do get pneumonia, they’re more likely to survive.” And I thought, “That’s really how we all should live in that we know as physicians we’re going to be exposed to all sorts of pathogens and stress,” and everybody on this call is tough or they wouldn’t have survived medical school. But maybe I take it to a different level.
Charles Runels:
Like I said, I’ve been a fan of Jack LaLanne since I was a kid, and my routine is I try to do… Jack LaLanne always says, “Fast one day a week on juice,” so I usually do that. Since I was a teenager, I’ll do once a month, I’ll do a day with nothing but water. Once every quarter or so, I might do a couple of days of no calories. But I think there’s also a need for walking. If you look at the research, just walking, most people don’t do enough of it, but just walking somewhere between 20 and 25 miles a week, it cuts your all cause mortality almost in half if you just look over large populations, these studies have been done more than once, and it cuts your risk of heart attack, it does all these different things for you.
Charles Runels:
And so I think if I were to pick the one habit that most people don’t do enough of, it’s just getting out on the street and walking 20, 25 miles a week. I’ll layer that, I’ll do my phone calls or I’ll listen to books while I’m doing it, so it’s not completely dead time. And that’s probably good. I can go on, but that’s maybe my… I don’t drink alcohol. I don’t think there’s anything particularly immoral about it. I like it when my date has a drink or two, but I don’t drink alcohol. I don’t smoke. I try to be like one of the artists said, “I don’t do drugs. I am a drug.” And so I live a pretty clean life as far as what goes in my life.
Charles Runels:
Jack LaLanne says, “If it tastes good, spit it out.” I don’t know if I’d take it that far, but that’s pretty good advice.
Marco Pelosi III:
Yeah, yeah. Do you come from a long-lived family? Jack LaLanne went to about 96.
Charles Runels:
Yeah. Actually my grandparents, I do have grandparents and great-grandparents that lived a long time. My dad’s 82 and still walks every day, and Mom’s healthy. I’ve been blessed with some good genes. I feel like if you’re blessed with good health, that’s why we went into medicine. If you’re blessed with a decent brain and good health, it’s not something really to be proud of. I didn’t somehow earn this body. I just was given it. And to not take care of it and not do something useful with it is almost unethical. And there’s a letter that George Washington’s mother wrote to him after he was president, kind of giving him hell. It went something to the effect of, “Don’t get too prideful with your good brain and your good genetics and your good upbringing. You should have done something good. If you hadn’t, you were goofing off.”
Charles Runels:
So I feel like I was blessed with good health and I do some things to try to maintain it, but part of it is just I could have been born with lots of genetic problems, and I think as doctors we get it, and I’m preaching it to the choir. But I feel like it’s our obligation we went into this, not to make money, if we wanted to make money we’d be selling real estate or in the stock market. We went into it to help people. But part of that is to treat yourself like you would someone else you were responsible for taking care of, it’s good advice. Like what would you do for the guy next door if you were responsible for his health? You do that for yourself.
Marco Pelosi III:
Right. I think we’re going to wrap it up, and I want to leave the listeners with a couple of ways to reach you. So for physicians that are interested in learning your techniques and for patients that are interested in having procedures done by your techniques, by people that have been trained in your techniques, what references can you give them?
Charles Runels:
[inaudible 01:01:20] is called the Cellular Medicine Association, and we have a website that goes by the same name. Cellularmedicineassociation.org. For the various procedures, there’s a place for patients to look to see if maybe the procedure may be of help to them. On the Cellular Medicine Association, there’s a directory of our teachers across the planet, and on the various procedure websites, there’s a place for doctors to get [inaudible 01:01:55] actually put a stamp on something in an envelope and send it to them and send them some videos and things they can look at to see what it is we’re dong.
Marco Pelosi III:
Now we talked about the Vampire Facelift®. We talked about the O-Shot®. We talked about the shot for men, the P-Shot®, the Priapus Shot®. There’s a couple of others, right? Which ones are they?
Charles Runels:
So I have ideas, but I try not to just dump them all out at once. You almost have to wait until the world’s ready for it. But we have a procedure for the breast. It doesn’t make the breast larger, but it can do things with PRP like restore sensation, because we know it helps grow nerves, you can put a little PRP behind the nipple and help with women who have lost sensation from breast feeding or from implants, not from reconstruction for breast cancer, that’s some milder damage from, help with some of the defects, symmetries that happen. We have one for the labia majora, it really surprised me, it wouldn’t surprise you as a surgeon, but as you know, a lot of women, their labia majora goes flat out and it gets darker, and they were often, say, you know, it just doesn’t look as pink and happy as it did when I was younger.
Charles Runels:
And if they need a lot of volume, they need the fat that you guys do as surgeons. But for a 30 to 50-year-old woman, I can do the same things we do with the cheek. We call it the Vampire Wing Lift®. I like all the names to be G-rated. There’s an old Rod Stewart song where he talks about the labia being wings. If you go back and listen to Tonight’s the Night by Rod Stewart, he talks about wings. But anyways, so we call it our Vampire Wing Lift®, we use PRP and Juvederm to restore the labia majora in a younger woman who doesn’t need a fat transfer. So there’s another thing coming down the pipe, but that’s the main things that are out there now.
Marco Pelosi III:
All right. Well, thank you for spending some time with us. I learned a lot of things, and you have some very, very innovative ideas. And I didn’t know about your marketing side. I’m even more impressed now.
Charles Runels:
Cool, thank you. I always come to your guys’ meetings with awe, and surgeons talk about the Pelosi dynasty, and there’s some things that… Part of the cool thing about my procedures is they’re easy. I can teach most people with a decent hand to do them. But some of the stuff that you guys do is just like, you know, you have to be a wizard to even think about doing it. So I’m in awe of you and your group, and I appreciate you-
Marco Pelosi III:
Well, thanks.
Charles Runels:
… being interested in some of my ideas. Thank you.
Marco Pelosi III:
Well, thanks, man. So stay safe and we’ll be in touch.
Charles Runels:
Thank you. [crosstalk 01:04:41]
Marco Pelosi III:
All right, bye now. Share this podcast and this website and this blog with the people in your life who you feel would benefit from this information.
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Dr. Charles Runels can be reached at CellularMedicineAssociation.org
Dr. Marco Pelosi III can be reached at DrMarcoPelosi.com
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