Latest / Healthy Happy Wise Wealthy / Buy, Build, Exit: A Masterclass in Human-Centered Healthcare Business with Ross Tomkins

Transcript

Buy, Build, Exit: A Masterclass in Human-Centered Healthcare Business with Ross Tomkins · Healthy Happy Wise Wealthy

• [Mary Meyer] Welcome back to Healthy, Happy, Wise, Wealthy. We have with us today Ross Tomkins. He is a founder of Balmoral Partners. And his business history to me is fascinating. He is really everything that this podcast talks about in health and wellness. Balmoral Partners is an international company that is really focused on healthcare throughout the world. And you have, you tell me if I'm not saying any of this correct, but the UK, Dubai and Sydney. Okay, so there's a lot. But you, you started out as a physiotherapist. And you said physical therapist in the US might be how we talk about that. And you use, you've done so much of your own health and wellness for yourself, which really kind of has, I think supported your business growth in being just being grounded and working through that. So, so many acquisitions, knowing how to scale, knowing how to exit, you probably could give a 2010 talks. So we're going to dive in and get as much out of view as we can in this next hour. So Ross, can you just tell us a little bit about kind of how it started? And I know there's some physical health journeys with you too. So, but starting out as a physiotherapist. [Ross Tomkins] Yeah. Thank you so much, Mary, for having me on today. I'm really looking forward to sharing with your audience. So starting out as a physiotherapist and really my desire for getting into that business was I had a love of sport. I had a real intrigue in the human body, how it worked. And I was always empathetic as a child. I always enjoy deep conversations, finding out what was really going on with someone deep down the root cause. I think deep down, I'm probably an introvert, although over the years, I've probably learned to be an ambivert and when necessary, I can speak on stages and hold an audience. But I really like that connection that you get, you know, when you're speaking to someone. So set off into the world of physiotherapy didn't get on very well with our version of the NHS. They wanted me to speak to someone and talk to them and have 15 minutes to do the treatment. And I wanted to spend a full hour. So clearly there was a misalignment there. So I set off into the world as a private practitioner, learned where I thought I should focus. And that ended up being in occupational health and economics. I had this kind of epiphany moment where I realized I could be the best sports physiotherapist in the world. But most of my patients only played sport for about an hour a week. And then they went to the pub and I thought, unless I'm going to be in professional sport here, I could probably serve my clients much better by understanding about workplace health. You know, how do people get injured when they're at the workplace? How do I help them have a healthier life where they can prepare, try not to prepare, where they can provide for the families? So I went into the world of occupational health, started our first business in 2006. And I was your typical accidental entrepreneur. I was good at what I did. People came back. And that grew. It actually grew that business to 35 members of staff, almost by accident, which was amazing. But it kind of forced me. Yeah, we were at the time, we were probably the, we were certainly in the top 10 physiotherapy companies in the country. Now, the industry has had quite a lot of consolidation. There's a lot of private equity in there now. So we have much bigger players. But at the time, we were up there and, and that was not my intention. You know, I set out to try and help people and to be the best version of myself. And we accidentally grew this business. That all came crashing down one day. So it was actually about a week after I published my first book, which was the business of health. And everything was going great. We had 35 members of staff. We were in US dollars, about two and a half million in US dollars. And we were called into a meeting by our largest client, who are Amazon. And they said, Ross, we're making you far too much money. And we're going to do this ourselves. Oh, it wasn't what I was expecting as well. So this calm facade disappeared momentarily. I was like, wow, this changes everything because they were about 70% of our revenue mixed up and amongst a number of contracts. So everything changed, as I say, it's almost overnight. We had to think differently. I say we, my wife was in the business sense, our operations manager, and we still work within our portfolio now together. And I stumbled across this world of mergers and acquisitions. And it just seemed really interesting to me that you could grow so quickly. We could double, treble, quadruple the clinic overnight almost by buying a competitor. So that's what I set out to do. I absorbed all the information I could. I joined various groups, took on mentors. And it took a while. It took two years until we did our first deal. But we did. We doubled the business straight away with one deal. And that was closely followed by a second clinic. We then had a small group in northeastern England of four clinics that we were approached to sell. And when we sold the business, that was like another light bulb moment where I thought, wow, you can exit businesses as well. And that creates this capital event, which can then be redeployed into various asset classes, or indeed into more businesses. And that's what we've done. So since that first deal, which was seven years ago, we've been involved with 29 acquisitions, mergers, or exits by Christmas, which we're racing up towards. We're about three months away. We should be on around 34 deals, including our first in the US. So that's kind of a quick five minutes of where I came from and where we are today. [Mary Meyer] That is amazing. Thank you for putting that in the shell. I was saying to Ross before we started this, I'm like, there is so much that you've done. This is hard for me to know even like where we even start and go, because you have so much information or so much good wisdom. It's really interesting to me. I just heard I was at an event called Reno Startup Week, which is very tech forward. Basically, it's such a good startup week. It's so great. And I've not been in Reno that long, but it has been such a good thing to see the entrepreneur stuff that does happen here. One of the things they said was someone who is maybe the accidental entrepreneur, like you said, who's grown really big, is that innovation happens when you take two different business things and put them together. So if you're just in your business, burgers and acquisitions doesn't go with physiotherapy. Those are two different worlds. So I think the fact that you put those together to create something is going to be fabulous for people. Can you tell us, I know you just mentioned so briefly that I don't know what the initials meant because that's in England where you are, yes. But is it insurance that says only 10 minutes per patient and you wanted to spend an hour with patients? [Ross Tomkins] So the NHS is the National Health Service. And it's the free government funded medical service that anyone in the UK can tap into. But they are overstretched, underserved. And unfortunately, they are amazing at reactive health. So if you break your arm, if you need an operation acutely, you're in, out, it's a wonderful service. But if you're looking for preventative medicine, unfortunately, they aren't equipped for that. So as I say, I wanted to get really deep and find out what was going on with someone. In my even early experience back then, I kind of realized that nobody ever went to the doctor because they had a bad back. They went because of what the bad back was stopping them doing, picking up their grandchildren, driving to work, riding the bike with their friends. And since their partner passed away, that was really the only exercise they got, or the only chance socialized. And it's really when you find those deeper motivations that you can make a really good difference for someone's life. Because if you sit there as a doctor, a physiotherapist, or any other clinician, and just say, go away and do this, this, and this. It's not personal enough. You haven't got the deeper reason why. And inevitably, they come back, and it's no different. And I didn't follow your advice. I didn't change my diet, do any exercises, or change any of the things that we discussed. But when you marry it up with a deep reason why, the results spoke for themselves. So I got a fantastic response rate to my clients, even though I would say, and I have said this many times over the years, on paper, I was probably an average therapist. And what I mean is I hadn't completed a master's degree. I wasn't probably as well read as some of my peers. However, the response rate I got from my patients was incredibly high. And that's what we talked to all of our colleagues as well, that it's about listening. It's about listening to what's really happening in someone's life. And often when someone was head down on the bed with me working on their back, it was the fact I asked about the problem they were having with their children, or the issues they were having at work, or with their marriage. And actually, it was almost like a counseling session. So they would get all that off their chest. And when they stood up, they go, wow, I feel better, Ross. That's fantastic. So that's how it started. I went a little bit off Tundian perhaps there, because it would be more of an insight into how it started and a little bit about me, I guess. [Mary Meyer] That's really good information. But I think there is something so fabulous about when we actually are tuned into people, progress happens faster, which it sounds like what you were doing, you were tuned into them. And I think when you feel heard things, isn't that interesting, but the mind and the body are connected enough that you got results through that and grew quickly. That in itself is a huge lesson, probably. [Ross Tomkins] It definitely is. I think you've got to be a little careful sometimes as a clinician, because if you don't describe that in the right way, it sounds like it's all in their head. The mind and the body connected and how one interacts with the other makes a difference. But yeah, the last thing somebody wants to be told is there's nothing wrong with you. It's all in your head. Think of that out. [Mary Meyer] Yeah. So from there, so you started acquiring different businesses and it's all healthcare related. So most of them are healthcare. Okay. So what other healthcare did you take on and what was your thoughts about how you wanted to do what you wanted to take on? What types of healthcare businesses? [Ross Tomkins] So in the world of mergers and acquisitions for anyone who isn't familiar, you can do horizontal acquisitions or vertical acquisitions. Horizontal are buying more of the same thing. So we, as I mentioned before, we acquired two other clinics. Vertical integration up and down your supply chain. So the first business that we acquired outside of a clinic was a medical supplies and pharmaceuticals business. We literally went down our supply chain. What do we buy on a regular basis? We buy medical supplies. Let's find a medical supplies business for sale. And actually I typed it to Google. There was no AI back then showing me the medical supplies businesses near me in the Northeast of England. I think five came up. I sent all of them a letter. One of them came back and said, let's talk. This sounds ideal. There are three directors. One's in the seventies. The other two are in their sixties. This could be perfect. So and that was the first outside of a physiotherapy business that we acquired. And since then, because sorry, just missed the part out. The other thing we looked to do was go up and down the age range, because our key business was occupational medicine. So we were helping individuals of working age. And my idea was if we went down to pediatrics and if we went up to what I like to call the more experienced end of our population, we could incorporate everything. You can literally help a child, work in age adult or someone in later life as well. So the next few acquisitions we did were all in that elderly care space or experienced individuals. And we acquired four home care businesses. Since then we've gone on and we now own eight care homes as well. But along the way, we acquired three mobility companies. I think on this side of the world, you call it DME, Durable Medical Equipment. So wheelchairs, scooters, commodes, walking sticks, and everything else in between. We then acquired a medical device company. So we sell microscopy into universities, research establishments, and private clinics. And then throughout all of that, we started, we founded a men's health business as well, which is wonderful because one of the things I enjoyed in my physiotherapy days was I got to help people every day. Someone would come in with a bad back and they left and they didn't have a bad back. Someone would come in with a bad knee and when they left, it was feeling better, which meant they could get down to the floor and play with their children or they could go and kick a ball with their friends. That really made a big difference. And when I stepped back from the hands-on clinical just into a business role, I sort of missed that a little bit, but with our men's health, I'm still very much available to all of our clients. A patient can call me at any time and any day and I'll answer. And the reason for that is when I wasn't very well myself, I would sometimes wait weeks to get an answer from a clinician. One of the main symptoms of the male menopause or andropause, very similar to the menopause as well, is brain fog, low mood. It can show itself almost as depression. And if you've got something on your mind, you want an answer yesterday, not in two weeks. So we built a service where a man can be heard. And if there are problems, relationships, erectile problems, and any other gambit of issues that can happen with the hormone problem, I wanted to make sure they could get those answers quickly as possible. So if the team isn't around, I still pick up calls now. And I do enjoy that. I enjoy still having that interaction with my clients. [Mary Meyer] Oh, that's great. Everything you're talking about, I've had a guest on local in Reno who's working with people at some capacity of what you're speaking about. And so this is very interesting to me. I'm like, there is definitely, where do I even start? Because you've done so much. Let's talk a little bit about the men's health aspect of it. The word andropause is not a word I've heard. So I have someone on, I think he called it, manopause. Something I'm not sure if he made that word up or not. But the whole testosterone thing with men can certainly affect health. So let's just dive in a little bit with that. And you said you got into this because I was reading some of your stuff on one of your various websites. And because you were struggling with this with brain fog and different things. And can you tell us just a little bit about that? [Ross Tomkins] Yeah, so we did start the business because of my own health journey and experiences. And it actually took me ages to get a diagnosis in the beginning. I saw two general practitioners, three endocrinologists, and all of them said pretty much the same thing, which was there's nothing wrong with me. Now, I didn't accept that. Probably because I was a therapist or a diagnostic clinician. I knew my own body. I've lived with it at this point 35 years and knew it pretty well. And I didn't believe that there was nothing wrong. But I guess without that determination and the tenacity and perhaps some degree of medical knowledge, it allowed me to continue exploring and finding the answer. And I did eventually find a fantastic man who changed my life forever. He was already in advancing years. He was about to retire, but he took me on as a patient. And I remember my first meeting with him vividly. He said, what's wrong? I said, it's a really long story, Dr. Willis. How long have you got? And this was the first experience I'd ever had of paying privately for something before that it had all been on the NHS. He said, Ross, you've paid for an hour. You can talk for an hour if you like. I was like, okay. So I spoke for about 58 minutes about how my thought approaches were really foggy and how my joints ate. I was kind of apathetic just going through the motions. And how I described it, I said, I feel like one of those antique toy robots. I feel like someone needs to put the key back in me and wind me back up. I feel like I'm sort of running out of wind. And it was the best description I had to describe how I felt. And nobody had understood it until that point. And I've seen three endocrinologists, two general practitioners, and they all said, there's nothing wrong with me. He actually got low testosterone. I said, can you prove it? Because a part of me was a little skeptical. First time going private and kind of thinking he just wants to sell me something. And he said, yeah, we can absolutely prove it. We're going to do a blood test. If the number comes back below here, you 100% need treatment. If it comes back here to here, we can probably fix this naturally. So we're going to talk about diet, going to exercise, going to talk about lifestyle. And if it comes back above this number, I was totally wrong. And it's nothing to do with the hormones. We ran the test. It was spot on. And we started on treatment very, very soon afterwards. And I guess it was also alien for me at that time. I was very aware of the menopause. That's been discussed for years ahead of men's health, I would say. But I was surprised. But starting on treatment, it completely changed my life. Within weeks, I was feeling more like my old self again. Within months, I was running up the stairs again, where that had been quite a while. And I worked for that doctor for a couple of years until he did retire. I then bounced onto another couple of doctors, one that he introduced me to and one that I found myself. And I realized nobody was really using the same knowledge base as Dr. Willis did, which is a very American cutting edge way to look at hormones. But also, none of these doctors I'd spoke to were very good at customer service. It just wasn't there. And I think we sold our other business at this point, our clinical therapist business. And I knew we were world class at the back end. We were managing thousands and thousands of clients from the top to the bottom of England. So I thought, well, if I can apply what I know from a customer service perspective, incorporate that into cutting edge male health medicine, we can create something that's pretty amazing. So I actually tried to buy the clinic that I was with at the time. And they said, no. And I said, I'm going to start myself. And that's what we did. We tested it with 10 individuals to prove that it worked. And our approach was different and valued and could make difference in somebody's life. And just over five years ago, we started. So that's the journey I suppose I've been on from a men's health perspective. [Mary Meyer] I really appreciate you sharing all that. It seems remarkable that someone who has a health journey where things didn't work, you found out what did work, also with the physical therapy aspect, and taking an hour with patients, all these things I am so personally so for. And this is very interesting with the hormonal changes, too. It's an interesting conversation, I know, because it seems like as soon as I hit perimenopause, every time I would go into a doctor's office, and I've said this before, it's like they're just excited to give me a drug. And that's not exciting to me. And it's almost like I feel like I'm being sold. I don't feel like that anyone was, and this is good people, it seemed like in different states even, different practices. So we are definitely handed a here's your prescription that we want you to fulfill and then we make money. So I'm not super excited about that personally. [Ross Tomkins] It's become quite a sort of cookie cutter approach in medicine. I do feel at scale, a lot of that person personal approach is just isn't carried forward. So you are seen as a number, you know, you're just there to return on the bottom line. And I think we deserve better than that. [Mary Meyer] Yeah. Well, that's awesome. And then you're buying a, you know, and doing the mergers and acquisitions to get more of that. So when you when you take on a new business like this, or when you're running one, do you take these principles and implement it throughout the businesses? [Ross Tomkins] We absolutely do. Yeah. So we encourage everyone to see the businesses their own. And I'm all senior leaders have equity in the companies as well. So they all feel driven. But I very much lead from the front. So we talk a lot about health, the importance of what's a good analogy, putting your own mask on in an airplane before you help somebody else. They say that every time you get on a plane. We very much believe that as well, you know, you have to be the best version of yourself, if you are ever going to help somebody else. And I wholeheartedly believe that not only from a medical perspective, but also just as a being a good human, you know, and looking after everybody around us in our community. [Mary Meyer] Yeah, absolutely. So how is how is it just going to the business side of it? How is that taken when people when you come in and you're like, hey, we're the new owners. So we want to make these changes. And is there things that help with that rollout? Or are people are like, Yeah, this is sounds great to have more time with patients or are you or do you just buy them that are already aligned? I'm out of totally out of curiosity. [Ross Tomkins] How do you I know you pick them kind of based on supply chain and different things like that, you explained that it's definitely it's definitely not the majority of the time it's received very well, that somebody has a voice, somebody can share their ideas about the business, but also that we generally care about them as well. So for instance, today, we booked a long weekend for one of our managing directors in Poland in a beautiful hotel. And that's a gift for the hard work that she was saying, but but also because you know, respect to her time at health, and not being on all the time at work is one of the things that we believe in and talk about. And that's often very odd with how that business was ran before, where they might have been working way too many hours, never really received any sort of praise, or thanks for what they were doing. So generally, I'd say what we talk about is well received, we do have the odd one, of course, that stuck in the ways and perhaps doesn't want to change and they have no interest in their own health and doesn't don't see the correlation. But on the whole, it does go down well. [Mary Meyer] Yeah. Well, it's very exciting to me to see this. When you come into the US, what's your what's your first area? Are you going to different certain location? Tell me whatever you're able to tell so far. [Ross Tomkins] Yeah. Some of it we are NDA about with the first deal we're doing over here. But what I can share is the three largest verticals within Balmoral are elderly care, because of our interest from the UK, but also because my CFO and my business partner now has an excellent pedigree in that industry as well. So he was the mergers and mergers and acquisitions director of a company called HC one, who were the largest privately held healthcare company in the UK. They've just been sold for slightly under $10 billion. And he did around 500 million, 700 million dollars with them. But he kind of got bored of doing that to somebody else. And he wanted to do it for himself. He wanted to be a bit closer to it. And so he joined his experience has opened up a lot of doors. So he's very, you know, he's very intimately connected to a lot of these at an event later this month. So that would be the first one. So we're looking for home care businesses or care homes. The second industry that we're looking to do in the US and get involved with is clinics. Because of my background, we're looking to acquire physiotherapy clinics, chiropractors, osteopaths, functional medicine clinics, hormone replacement clinics and all of those similar service-based businesses. And then the final one, which I shared a little bit about earlier off camera, is in the psychedelic space. And this is something I find truly extraordinary. We're living in this age now of a psychedelic renaissance, and there are molecules that are coming back into fashion, if you like. It's probably not the right word, but these things were being used in the 60s and 70s, LSD, psilocybin, to name just two, to treat people with treatment-resistant depression, with PTSD, with anxiety. MDMA was used back in the 70s with veterans, with soldiers who were struggling. And then there was war on drugs back in the late 60s, and all of these molecules were just thought to be bad. And they all went underground, but that also meant all the money stopped rolling in for research. But I'm really pleased to say over the last decade, that's been starting to change. And now with an FDA ruling over here in the US, I think we're gonna see things change at a rate of not. And it's very exciting, because one session of psychedelic-assisted therapy with a variety of different molecules, ranging from ketamine through psilocybin, LSD or MDMA, can resolve someone's depression for up to a year of a single dose. And that's very different, of course, and you mentioned this before, being hyper-reliant on a drug of a pharmaceutical, which you take day in, day out, and arguably it doesn't even solve the symptoms. So yeah, the third industry that we're looking to go into in a big way and really support is the psychedelic world. We've chosen America because you are so far ahead of the rest of the world in that category, which a lot of people are sometimes surprised about. Here in the US, there's almost 3,000 ketamine-assisted psychotherapy clinics. To put it in perspective, there are five in England. [Mary Meyer] Okay, well, I know I had a lot of clients in a previous job that I had that were in that space, and one of them did ketamine treatment. Of course, it's right at the time when you hear of someone, you know, the famous actor ODing on it. So all these, it is an interesting thing about in the world of, we're gonna say, drugs, right? So what you're talking about, psychedelics and then prescription drugs. And here in the US, there is, you can advertise any kind of pharmaceutical drug on television, as long as you say all the side effects, and there's a billion. And most people are pretty pro-drug, you know, prescription drug, and pretty anti any, you know, all the stuff that you're talking about, in a general sense, a wide general sense, not, then there's all the people that are also like you, like, we're gonna try it, but, you know, around here, you probably, you know, the burning man happens really near Reno. So I think about, I don't know if that's an international thing that people know about, I think it's international, people know internationally about this. But what you're saying is, forget all the good, bad, good, bad. What you're saying is there's a lot of research that has not been done on this, and it is more effective than pharmaceuticals is what I'm hearing you say. I'm not an expert on any of this, so. [Ross Tomkins] Yeah, you're absolutely right. The cynical side of me, of course, says the big pharma don't want that to happen. Right, of course not. Yeah, so very interestingly, there's a few different pharmaceutical companies not getting involved. And the latest research I saw was six sessions of their synthetic psilocybin reduced depression by around 54%. Now, compare that to one session of a naturally produced psilocybin from the mushroom, and then 90% after one dose. So it creates a really interesting question, which is why did one work differently from the other? Is the synthesized molecule not working as well because it wasn't grown, it's not natural? Or is it because you've isolated one particular compound and in many naturally occurring psychedelics, there are more than one, so you can't control everything? Or again, with a slightly cynical hat on, is it because a pharmaceutical company would much rather give you six of them, which would be very expensive, as opposed to you just having one with a facilitator? [Mary Meyer] Yeah, I have a cynical hat on about that all the time. Pharmaceutical companies make a whole lot of money out of creating customers, and I think creating customers is what they do, and our food supply seems to be getting more terrifying almost by the day this year. So with lab-grown food and nothing's labeled and that's rolling out. [Ross Tomkins] Yeah, I saw that, that's scary. [Mary Meyer] It's terrifying, you know, it's terrifying here, but if we're sick, then we're customers. Definitely, and people- I don't like it. [Ross Tomkins] Yeah, I'm the same. But with these particular medicines which are now being supported from researchers coming out, I think what's interesting is if you, there'll be a huge cohort of people around the world that if you said you could go to this place, take a hallucinogen and it will get rid of your mental health problems, they would definitely not do that. They'd be like, this is illegal, you know, this is a woo-woo and not clinical or scientific. They will gravitate to the clinics that are providing these medical grade psychedelics. So if it's a way that we can help these people see the value, then I don't see that as a bad thing. [Mary Meyer] No, I don't see what you're doing as a bad thing at all. I think it can be very helpful. Especially, oh my goodness, mental health issues are massive, depression is massive. And I think there's a lot of issues around that, like we're very denatured, we're on our computers, we're not in sunshine, we don't get morning sunshine, we don't know what the stars look like anymore, we just have no idea whatsoever. Spending 48 hours in nature would even be like, most people just don't even know at all. Or they've forgotten like me, like, because I don't do it enough, you know? And I think about that a lot. Go ahead. [Ross Tomkins] Everyone feels better in nature. People instinctively relax and unwind when they're close to the sea, for instance, or they're in the presence of beautiful mountain ranges. There's something that hasn't been measured and most people can feel it, where they just settle, they feel better in that situation. [Mary Meyer] Yes, absolutely. And I do, just looking a little bit into what's prescription medicine for mental health, a lot of them have the side effect of suicidal ideation. So that is, sorry about that, I thought that was off. My little ringer on my phone. So like if a side effect of something is suicidal ideation and you're going to do it because of depression that automatically to me goes, that shouldn't be on the market. Like, that's not an acceptable thing. But the side effects of prescription drugs are death, the cancer. So it is, you know, and I think we all know that because we know that, but we follow the path that's been in front of us for a long time. So I love what you're doing. And I've had a bunch of clinics on the podcast here at Reno. One was a men's testosterone clinic. One was the hour long physiotherapist clinic. One was a home health agency. So like a lot of the things you're talking about, I'm like, yes, I've gone deep with them. I was helping them with marketing for a while, these different ones. So you go deep into what they're doing for their clinic in order to, or their practice to do that. So it is, and these are businesses that are like for their private pay, you're going to get a lot of time and attention. And there is that question of why pay private if you can go insurance. Here insurance, of course you pay for it, but it's similar in that insurance only covers so many things. So it's a limited thing and it's not going to be an hour long sitting with a physical therapist, physiotherapist, right? It's not going to be that. So that's where the private pays are really coming to be a thing here. And people are becoming more open to it, I think. I certainly am. I'm certainly more open to it. Yeah, so Balmoral Partners. So with that, if someone's like, I want to know more about that. I'm a clinic owner, I'm an investor. Who should be contacting you or if they're interested in knowing more about that from the business side? [Ross Tomkins] Great question. So on the one hand, we would love to speak to clinic owners or healthcare business owners that are looking for an exit. They have run the business for most of their life, for instance, and now they're a little bit tired, but they don't know what to do next. They haven't got a succession plan. Maybe their children don't want to go into that business and they're looking to offload it. So that would be one person that we would typically love to speak of to see if we can help them to exit. [Mary Meyer] I might know one of those people. [Ross Tomkins] Okay, well, let's talk about that. So that's the first one. The second person would be a founder or an operator that doesn't want to retire yet, but they need help growing. And that's where we can come in. So we can bring capital, we can bring knowledge, expertise, relationships, networks. So in that instance, so we could partner on a particular healthcare business, they remain the majority stakeholder and we become a minority stakeholder and we grow together. So that's pretty exciting. Someone had offered that to me in the beginning and I could collapse time and accelerate the growth far faster. I would have snapped that handoff. So that's the second person. And the third one are investors. So people who are looking to get into the world of healthcare as an investment. Many of our investors over the years have been doctors, nurse practitioners, dentists, care homeowners because they can see the synergy. They can see that we generally care about what we're doing and they want to invest in something that sits right with them. And rather than just a cold, hard investment, they don't know the names of anybody, they don't care as long as they're getting a return. We're offering both. [Mary Meyer] What a beautiful, and that's such a beautiful pairing of like you're focused on health forward options that are in the alternative medicine space, let's say. And then paired with investment opportunities, grueling, scaling, mergers and acquisitions. Mergers and acquisitions, you usually don't think of as having a heart. [Ross Tomkins] A hundred percent. [Mary Meyer] Or a compass besides money. I don't know. [Ross Tomkins] Without a doubt. No, I think you're definitely right. And a good story for you there is we took a stake in a company around 18 months ago. I've met this gentleman in 2019. We made an offer in his business back then. He didn't accept it. He was hoping for a little more at the time. And then COVID happened. And that obviously changed a lot of people's businesses all over the world, including this guy's. But we stayed in touch. And I'll say about 18 months ago, this gentleman called me up because I stayed in contact with him, as I generally do. And he said, I think I'm ready, Ross. Do you want to buy my business? I said, let's go out for dinner and we'll talk about it. And we don't live anywhere near apart. We live on the opposite sides of the UK. But we met for dinner and sort of in the middle. And he said, you know why I'm here, Ross? I said, well, I hope you're looking to sell the business because that's why I came. And he said, yeah, but there's another reason. He said, back in 2019, when I was first looking to sell this business, I was approached by any number of private equity, or trade buyers and individuals. So you were the only one out of everybody who actually traveled to see me. Everybody else was trying to do this on email or virtually, so that you actually came, met me, shook my hand. And I remember that. I said, yeah, I remember as well. He said, yeah, what you don't know is that morning, I was really nervous. My wife said, don't forget to wear a suit. We're going to meet this investor. You've got to make a good impression. And he said, you've chosen a pretty swanky place to meet in the center of London. So I got dressed up, I put my suit on and I walked in to meet you. And he said, I've never felt so stupid in my entire life because you were sitting there in this quite posh establishment, in shorts, t-shirt and a hat. He said, I realized you would just be new and I was not being myself. That's the reason I'm here today because you've never been anything else other than honest. You are just who you say you are. What you see online is who you are every single day. You're living and breathing what you extol as the virtues to the businesses that you're involved with. So that's why I'm here today, which I found really interesting. And ultimately we did help him grow a business. We doubled the business actually from US dollars kind of four to eight in less than nine months. [Mary Meyer] That's great. What a great story that is. And it's such a good business story of establishing relationship with people. And there's so many people in business that don't do that or kind of do it, but there's a lot of shady people in the realm of business, unfortunately. And sales, I've done a lot of sales and I'm like, man, this is insane. This is like insane. How it's not, yeah, it can be like that. [Ross Tomkins] I trust everyone. I like everybody. I think everyone's doing their best. And it turns out not everyone is those things. And there are some charlatans out there and some people that are just looking out for themselves. I personally don't want to change and I wouldn't want to live in a world where I was cynical and didn't believe people. So I'm not going to change, but how I have mitigated some of the risks over the years as I've found my perfect partner is not quite the antithesis of me, but they're certainly the different end of the spectrum. So I jump out of bed in the morning and I am positive. I go to bed in the nighttime, I'm positive. And as I said, I trust everyone. I believe everyone's doing their best. And what I've found is my perfect business partner or associate is someone that's on a scale of zero to 10, probably about four. So I'm 10 all the time. I'm positive, I'm optimistic. You know, we're looking for large scale growth and they're on the more risk averse side. So it tempers my enthusiasm and means that we generally make a lot better decisions I think long-term. [Mary Meyer] That's also such really good little wisdom nugget there. Because to me, that sounds like what I heard is in order to drive, if you're driving from point A to point B in a car, you need an accelerator, the gas go, but you better have brakes or you're not going to make it, you'll die. So, which is kind of, you know, an analogy of what you're saying in a way, but. [Ross Tomkins] Yeah, I'm going to borrow that, Mary. I think there's an absolutely phenomenal way of summing it up, but it's true. You know, my business partners are all that kind of complimentary opposite in a way. My wife, who we've worked together for many, many years, literally is my complimentary opposite. You know, if you look at that yin and yang sign, we are that. She's encouraged. I would never have started my first business if it wasn't fair. And the support she's showing me over the years is on wavering, which is incredible. But likewise, I've made her do you think she would probably never have done because she is naturally risk averse. So, she would probably still be in the job she had when we met. She wouldn't have traveled to the countries that we've traveled to, which are now like 64. And I've really probably helped her to spread her wings, but she's also kept me grounded and made me focus on the things that really matter. [Mary Meyer] Yeah, oh, that's great. What a great, great testimony to a good marriage. So, how it can work. I imagine at this point, people are like, man, I need to get more wisdom from this guy. You have three books out and the fourth one coming. Can you tell them to just run through the books a little bit and what's in each one of them? Because they all are great sounding. I've looked a little bit through them. [Ross Tomkins] So, the first one, which I mentioned at the beginning, was the Business of Health. That one was designed to give sort of an insider's perspective on how to grow a clinic. That then came, that was back in 2017. 2017, 2017, yeah, 2017. 2022, we released Aging and Andropause. So, this was my experience of going through the manna pause as you heard it earlier, as you said earlier, and that midlife crisis, I guess, where everything wasn't going the way I thought it was from a physical perspective. And then we've now got the How to Sell Your Business Quickly book Without Losing Legacy, which is, I think, really important for a great many business owners out there. They've built this, it's their baby. They care about it. They don't want a big private equity firm coming in, assets stripping it, sacking everybody. So, that's what that book is really about. And the next one, which is coming out later this year or early next year, is called The Three T's, which is timing, tenacity, and transformation. And there are three elements of business and particularly which work well in mergers and acquisitions and how people can focus on those things to grow. [Mary Meyer] Okay, so the second one, Aging and the Andropause, is that really for any man who's, you know, or maybe it's a wife. Is that one for anyone kind of to go through and then the other three or more for business? [Ross Tomkins] 100%. The first one is very much geared around clinicians. So, if you have a clinic and you want to see what we did to grow ours back in the day, that's there. The Andropause one is very much geared towards men who think they might have hormonal issue. And all of these books are very much written with my journey embedded. So, you know, they're almost like a novel in some ways. And they sort of take someone on that journey of what happened to me, how did I solve that issue? And then the final two of that are very much geared towards mergers and acquisitions. [Mary Meyer] Okay, so how did, I had a hard time finding all of those. [Ross Tomkins] Is there a good place to find all of those books outside of the- Yeah, so in the very near future, they will all be available on our new website. My personal website is rostombkins.co.uk. And they will all be on there within the next couple of months, I think. [Mary Meyer] Okay, so soon enough, check in by the end of 2026, rosstomkins.co.uk. Co.uk, okay, all right. So, and if someone is, okay, so they have a clinic, they're in the US, or they're maybe listening around the world, we do. We're on JioSaavn and Anghami. I think I'm saying those right. And those are international podcasts also. But if there is someone who wants to, first of all, let me ask with the US, is there certain parts of the US you're looking at to start? Are you going anywhere in the US? [Ross Tomkins] We're very open, actually. Yeah, it could be anywhere. I think, you know, the states, because a lot of the businesses we're looking at are cash pay businesses, then as a business perspective, we are focusing probably more on the more affluent areas, I would say. So, New York, Texas, Arizona, Florida, California, you know, all places where there's a high population, but where people generally have more disposable income that they can invest in their own health is something we've got our eye on. [Mary Meyer] Yeah, okay, so cash businesses. So around the world, is there certain countries you're focused on around the world? [Ross Tomkins] So US is a big one for us. It's all so far ahead in so many areas of medicine and leading the way. So we definitely want to be here. And the UK is still where the majority of our portfolio businesses are held because that's where I started out, and I'm an English man at the end of the day. So that's easier. That's where a lot of our team is based. Australia is really interesting. I think that's an interesting location for us to grow. There aren't many acquirers in Australia, despite its size. So there are less people bidding for every business if you like. So from a strategic point of view, that's interesting. And the UAE, over the last 20 years, I've seen the UAE grow. And over the last five years, we've had sort of a business interest over there, which is only gonna grow. It's taken a little bit of a pause at the moment with the regional conflict that's happening. So Dubai itself, which is where I spend a lot of time, I'm just out there a couple of weeks ago, I'll be back at the end of this month, is dead. Despite what people say on the news, which is it's bounced back, it's fine. It really isn't. There's hardly anybody on the streets. You can stay in a hotel that a year ago was $1,000 a night, and now it's about $150. There's disturbances to their supply chains. And I think it's gonna take another couple of years for that region of the world to really rebound. But it is something, I say, which we've got an eye on, it's a growth area of the world. Abu Dhabi has been a liken to Silicon Valley for the amount of capital that is available, particularly for health tech. So that's, they're the locations we're predominantly focused on. I did speak to someone a couple of hours ago who wants to do something together in BC, up in Canada. So that's something that perhaps is on our radar as well. [Mary Meyer] Okay. So man, there's a lot of different areas which the world is getting definitely more global. So I can imagine there's a few people I can think of that I'd probably send your way, but to that point, how does someone contact you? [Ross Tomkins] So probably the easiest way is through LinkedIn. So it's just my name, Ross Tomkins. You'll see a guy wearing a hat because it's pretty much what I wear all the time. And just contacts is on there. And that's my biggest channel from a social media perspective. I post them there every day, my thoughts about business and also on why people go into business. We start a business ultimately deep down so that we can take control of our own life and that we can invest it in ourselves. And what I mean by that is I do see many people, particularly in the corporate world or just starting out and running their own business and then leaving the house at six in the morning, not getting home until then at 10 at night and maybe making some good money, but at the detriment to their own health, to their own family life. Sometimes they're not seeing their children, they're not getting to spend time with any of the loved ones. And so online I talk a lot about freedom as well. So that is freedom to choose. You should be able to go on holiday without taking a laptop with you. If you can't do that, I would say you're not a business owner. You've got a job. You might also be your employer, but you've still got a job. So it's about building the foundations of the business that allow you to step out and that business still grow. So LinkedIn, definitely you'll find me on there and I can stay quite active. If somebody prefers email, they can email at ross@balmoralpartners.global and that will come straight through to my phone. I'm happy to talk to anyone and everyone about these subjects. [Mary Meyer] That's awesome. And Ross, I'd love to have you on a second time. I know we're right about in an hour, but to go a little deeper for people who are running a business, want to run a business, want to scale it, want to exit. And you have, I know you have training around all those things for them. And then of course you can be the exit too. So if it's a healthcare thing. So we'd love to have you on to talk just more in depth about that another time when we're both maybe feeling fresh. So that sounds good. But anything else as we close out today? [Ross Tomkins] I think one just final thing that I would love your listeners to take away. And this, we have this by the way, in huge letters in one of our warehouses written on the wall, which is imperfect action beats perfect inaction every time. So if you've got someone listening to this and they perhaps they've thought about starting a business for a while, or they know that they're approaching retirement age but they don't know what to do, just take action because you will not get there without it. So message me, speak to another mentor, speak to yourself, speak to friends, speak to people who've been there and done it, but take action because it's the only way you're gonna move forward. [Mary Meyer] Oh, that's so good. You know, I initially started this podcast with that thought and we're about here, I think maybe your 73rd episode. I celebrated so hard at 10 episodes. I'm like, this was exhausting. 10 episodes in the first 10 weeks. And in some ways it's still a lot of work, but people come to me now and that makes life a lot easier than trying to go find those first 10 super interesting people out of my network who would come on quickly. And that was about the first 20 really, and then 20, even 30. And then, you know, so that makes me a little teary-eyed just because sometimes you do just have to start and you're not gonna have all the answers and the truth is you're never gonna have all the answers when you start, I don't think. [Ross Tomkins] Yeah, we 100% agree. And I think nowadays with social media and particularly with Instagram, TikTok, they're very fast at these little snippets. And if you listen to every single social media entrepreneur on there, you think success is easy. I can just go on this course and three weeks later, I'm gonna be a millionaire. You know, whether that's drop shipping or affiliates or those acquisitions or property, there's always someone saying, you know, you can be insanely wealthy in two weeks. And you know, as well as I, that's not true. Like the most successful people I know in the world and I'm fortunate enough to have a couple of billionaires I could call as friends. And they've just been doing the same thing day in, day out for decades. So that success or the overnight success that people see has typically taken a lot of hard work, a lot of sacrifices, a lot of tenacity and resilience, a lot of late nights until ultimately it pays off. So, yeah. [Mary Meyer] Yeah, for sure. And let me, you said drop shipping and how to drop shipping business. I started in 2020, didn't work out, but I gave it my all. Yeah, so that's all you can do for sure. Well, thank you Ross for so much wisdom and I just really appreciate, you know, your heart for taking something that was an issue for you personally, turning that into a business, having a business where you're spending a lot of time with people listening and that that becomes your business model and then you're scaling internationally. So that's, that's big hurrah to that. So thank you for coming on. Yeah, you're welcome. All right, have a great rest of your day. [Ross Tomkins] Yeah, I was about to say exactly the same thing. [Mary Meyer] I'll speak to you very soon. [Ross Tomkins] Take care. [Mary Meyer] Bye.