Driving Compassionate, Forward-Thinking Mental Health Care, with Sam Mandel

[00:00:03] [SPEAKER_01] Welcome to the Human Capital Leadership. We're your source for personal, professional, and organizational growth and development. We share our own original research, explore industry trends, and interview executives and thought leaders from across the globe. Join us for practitioner-oriented content around all things leadership, HR, talent management, organizational development, and change management. Maximize your personal and organizational potential with the HCI Family of Podcasts.

[00:00:35] [SPEAKER_01] Samantha Baltadonis, welcome to the conversation today.

[00:00:37] [SPEAKER_00] Thanks for having me, John.

[00:00:38] [SPEAKER_01] It's a pleasure to be with you. You're joining us from the LA area in South Salmon City in Utah. Today we're going to be talking about your practices there in Southern California. I'll share more about this in a minute when I share your bio, but your co-founder and chief executive officer of Pedamine Clinics Los Angeles focused on driving compassionate, forward-thinking mental health care, which is a really interesting space, a really interesting topic.

[00:01:05] [SPEAKER_01] So we're going to be focused in the conversation today around ketamine therapy, patient experience, how it works, risks, benefits, things like that. But also, you know, just how you run your practice and how you manage those sorts of things to make sure that, you know, things run effectively and efficiently and, you know, how you've done things as a co-founder and as a CEO. So as we get started, I wanted to share your bio with everybody. As I mentioned, Sam Mandel is co-founder and chief executive officer of Pedamine Clinics Los Angeles.

[00:01:35] [SPEAKER_01] His commitment to supporting others began early when at 12 years old, he volunteered as a teen suicide prevention hotline. That formative experience sparked a lifelong dedication to mental health advocacy and ultimately led him to co-found the Pedamine Clinics Los Angeles in 2014, alongside his father, Dr. Stephen L. Mandel. Sam is a recognized voice in innovative psychiatric and ketamine infusion therapy. He has been featured in Entrepreneur's Top 10 Inspiring Health and Contours to Watch

[00:02:02] [SPEAKER_01] and honored by MSN as an entrepreneur leading the business frontier. He is also a two-time Stevie Award recipient, Best Entrepreneur and Thought Leader of the Year at the American Business Awards. I could go on. So many really cool things about what you do and your accomplishments, but I'm going to pause there. Anything you would like to highlight? We have your own background before we dive on in further.

[00:02:21] [SPEAKER_00] No, I think you covered pretty well, John. I'm just here to help people and, you know, fulfilling a mission of relieving suffering and providing really high quality care and support and with a lot of compassion. And that's really what I'm about and what we're up to at Ketamine Clinics Los Angeles.

[00:02:35] [SPEAKER_01] Very good. Very good. All right. Well, so let's dive in and perhaps for anyone who is just unfamiliar other than maybe, you know, what they just heard and kind of scary media stories or whatever, like shape up for us, like why ketamine therapy? You know, because there's lots of scary news stories around ketamine, right? It gets lots of negative press all the time. But that's not what we're talking about here, right?

[00:03:03] [SPEAKER_00] Yeah, yeah. And it's very unfortunate. I mean, it's heavily stigmatized. There's a lot of misinformation and disinformation about it. And, you know, ultimately ketamine is a tool. And just like any tool, it can be used for good or to cause harm. And it's a powerful medicine. And I like to use the analogy of a hammer. You know, a hammer is an inanimate object. It has no kind of will or wishes, right? And you can use a hammer to build a home or a church or a temple, or you can use a hammer to assault someone and hit them over the head with it, right?

[00:03:33] [SPEAKER_00] It's just a hammer. So ketamine is really not any different in that regard. It's a FDA-approved anesthetic. A lot of people don't realize that because they only know of it through its illicit uses as a party drug or that people have used in predatory contexts, as we've recently seen in some media. So it's actually FDA-approved medicine. In 1970, it's been used for tens of millions, if not hundreds of millions of times all over the world. It's a very safe and effective medicine.

[00:04:03] [SPEAKER_00] And utilizing it in the way that we do is off-label, which simply means that it's being used in a way that is other than what it was originally approved for. When the FDA approves a medicine, they approve it for specific use in a specific population. A lot of other details included in that. It's not a blanket, just a stamp of approval. Yes, this drug good. Use it. It's more granular than that. So, you know, one in three psychiatric medications are prescribed off-label in the United States.

[00:04:31] [SPEAKER_00] About one in four of all prescriptions are. So it's very common practice. And a lot of people are taking medications off-label. They just haven't heard of the term. It's also used in veterinary medicine. So a lot of people know of it as a horse tranquilizer or cat tranquilizer. And they go, oh my God, how come you give that to people? Well, this is actually a people drug we're giving to animals, not the other way around. And, you know, it is used illicitly or on the street. It's also used for pain as an analgesic or as a pain reliever. So this is a pretty ubiquitous drug with a lot of different indications.

[00:05:01] [SPEAKER_00] And it's very versatile. And so we provide IV infusions in the clinic under medical supervision to treat various mental health conditions. Primarily depression, PTSD, anxiety, suicidality. There are others that benefit, but those are the core four that we focus on. And it can be absolutely life-changing, life-saving for people struggling with these conditions,

[00:05:25] [SPEAKER_00] especially when they're treatment resistant and they haven't responded to other conventional options like therapy or prescription oral medications.

[00:05:34] [SPEAKER_01] Yeah, I've heard just some incredible stories, transformative stories of individuals just like you described, who are resistant to other forms of medication or therapy or things where ketamine therapy was just a game changer for them. Now, obviously, we're not talking about illicit uses. We're not talking about using it in other ways, right? We're talking about controlled, approved ways of using it. And it can be extremely...

[00:06:01] [SPEAKER_01] And, you know, I joke, like my 13-year-old son, I think he was 11 at the time. He had to go to the dentist. Like he had a dental procedure where they had to give him ketamine, you know, to like do the procedure, right? And like whatever the low dose of ketamine was, I think for pain or whatever. And, you know, he always jokes about, you know, how he had to, you know, use ketamine or whatever. And, but that's the point, right? Like it's completely safe, completely normal, completely like in certain settings and certain circumstances. It's completely like normal.

[00:06:31] [SPEAKER_01] And that's how it's used, right? That's how it's supposed to be used, right?

[00:06:34] [SPEAKER_00] It's actually the medicine of choice in pediatric cases like that for conscious sedation. Right. Because it's so safe.

[00:06:43] [SPEAKER_01] Right. Exactly. Exactly. So, yeah, exactly. And so, like you said, there's a huge stigma around it. And in some ways, rightfully so, because it is an illicit use. You know, it is very problematic. And obviously we don't want that. But that's not to take away from all the positive uses. And we don't want to undermine our ability to use it in positive ways.

[00:07:04] [SPEAKER_00] Yeah. Well, it's a little out of proportion because, you know, there's over 100,000 deaths by alcohol every year. There's over 100,000 deaths by opioids every year. There's a lot of other substances that cause way, way more problems for people individually and for society than ketamine does. The last meta-analysis I looked at, there were zero deaths in a clinical setting. And there were maybe a couple hundred ketamine-related deaths. And most of them were mixing other substances with it.

[00:07:31] [SPEAKER_00] So, you know, to put things into perspective, you know, not to say that there aren't people out there that are using it in unsavory ways. But it's a pretty tiny little drop in the ocean compared to a lot of other things. But, you know, the media likes to focus on what they like to focus on. I think also, in all honesty, ketamine has started to really take up some market share away from the pharmaceutical companies that make competing drugs that, frankly, don't work as well.

[00:07:54] [SPEAKER_00] So, you know, there's always money in politics and the perception of medicine and what's good and bad that I think people need to understand often is outside of just what's actually safe and effective versus what's not.

[00:08:07] [SPEAKER_01] Right. And, you know, politics, you said it, politics, polarizing topics, often the polarizing things that get focused on are like these little minute little issues. When the big issues, the big problems, the big challenges kind of get set to the side, they get ignored. Major frustration I have, but that's another topic for another day.

[00:08:28] [SPEAKER_00] Yeah, I'll have to come back to talk about that one. But, you know, John, what I want your listeners to really get is that this is a safe and effective medicine. And when it's used responsibly with medical professionals. So, you know, to your point, we're not talking about these other uses. We're talking about in the clinic, IV infusions. That's what we specialize in. And it is amazingly effective. I mean, we have an 83% success rate across all mental health conditions. And it works within hours to days.

[00:08:56] [SPEAKER_00] Whereas, you know, conventional antidepressant medications often take four to six weeks to start working. There's trial and error, adjusting doses, trying different combinations, and kind of waiting and watching with often very negative side effects. Ketamine doesn't have any of the negative side effects of SSRIs and other conventional medications. It works within hours to days in most cases. And in our clinic, about 83% of the time.

[00:09:25] [SPEAKER_00] So this is a faster acting, safer, more effective medicine for various mental health indications than really anything else that's available today. I mean, we've been doing this for over 13 years. So I co-founded one of the first ketamine clinics in the country to offer IV ketamine for mood. And in that time, we provided over 35,000 infusions. So we have a lot of experience and a lot of data.

[00:09:48] [SPEAKER_00] But it's not only our experience that I speak from, because there's also hundreds and hundreds of clinical studies at leading and reputable institutions that prove the safety and efficacy of IV ketamine. And all of those that you've heard of, the big universities like Harvard, Stanford, Yale, National Institute of Mental Health, UCLA, USC, the list, the Cleveland Clinic, Johns Hopkins.

[00:10:12] [SPEAKER_00] I mean, the list really does go on and on of all of the institutions who have done at least one paper on ketamine. And dozens of them peer-reviewed, high-quality gold standard studies. So this is way beyond just my opinion or my personal experience that I speak from.

[00:10:28] [SPEAKER_01] Well, great. Thank you for that background and just kind of setting the record straight around what it is, how it's used, the benefits. Certainly, there are some risks, especially with licit use and some of those sorts of things. It has a tremendous upside and for patient experience and just tremendous benefits. Now, let's transition a little bit and talk a little bit more about your clinic.

[00:10:54] [SPEAKER_01] So pivoting towards your experience as co-founder and CEO, you found the clinic to your father. Talk to us about just that experience of a co-founding experience with family, with your father. The first or one of the first clinics in the country around the specialty area. Yeah. Tell us what that has been like.

[00:11:16] [SPEAKER_00] Yeah. It's definitely been quite a journey. You know, we started out in a literal closet in Santa Monica and no investors or funding, really bootstrapped it, put everything on credit cards and just built it from the ground up. And that was quite an experience. We had my father is an anesthesiologist and he also has a master's degree in psychology. He was doing anesthesia for a plastic surgeon and asked if we could sublet some space in his office.

[00:11:46] [SPEAKER_00] And the only room that he wasn't using regularly was a storage closet. So we said, all right, we'll take that. So we took a literal utility closet. We put a plastic folding table, two folding chairs, two laptops. And that was it. That was our first setup. Oh, and I had a Motorola flip phone from Radio Shack that I got as our first business phone. And that was it. And then on the other side of that room adjacent to it was an operating room recovery suite with two beds divided by a curtain.

[00:12:15] [SPEAKER_00] That was kind of like a hospital room. And the surgeon said, yeah, you can use the OR recovery suite when I'm not using it. So that's where we saw patients and really how we got our first start in the beginning. And then we just grew organically from there. The results were so amazing and so helpful for people that we thought, man, this is like the coolest thing ever. We got to find a way to scale this and make this more available to people. No one else was doing it at the time or virtually no one else. Definitely no one really in L.A. and hardly anyone in the country.

[00:12:45] [SPEAKER_00] So we just made it happen. And now fast forward, you know, almost 13 years later, we have a full time team of 12, a 5,000 square foot clinic in the Playa District on the west side of L.A. It's purpose built. It's a very serene, you know, beautiful setting. And it's been just an incredible, you know, journey to grow. I'll say as far as the working with family, you know, working with family is a blessing and a curse. It's been, you know, really incredible and also very difficult.

[00:13:13] [SPEAKER_00] And my father and I were not a likely duo to start a business together. And we really came together out of a shared curiosity in medicine, a shared passion and an interest in specifically supporting people dealing with mental health afflictions and an excitement about making a meaningful impact. And so those things that really brought us together enabled us to work through many, many challenges.

[00:13:39] [SPEAKER_00] And I would say to anyone who's working with family that, you know, I have a lot to say about that topic. But, you know, it's definitely can be beautiful when it's done with the right care and support, trust, respect and boundaries.

[00:13:53] [SPEAKER_01] There's a whole lot to unpack there around the boundary comment, right? Yeah. Anyone who's worked in business with family, you know, knows that that can be challenging. But like you said, it's a blessing to like there are a lot of really positives that go with it also. And it closeness, you know, and shared meaning and purpose around it. So, you know, really a lot of really great positives that go with it. Talk to us a little bit of just about the growth that you've seen over the past decade plus.

[00:14:23] [SPEAKER_01] You know, as you go from the closet, right, to having this huge clinic, just the workforce needs, the staffing, like just that kind of growth, you know, comes with brings with it. Obviously, it's a good problem, right? Everyone loves growth, but it does bring with it staffing challenges. It brings with it just growing pains, variety of types. And from an organizational perspective, right? That's probably not originally what you got into this for.

[00:14:49] [SPEAKER_01] Like, you know, when you're sitting down thinking, I want to provide, you know, patient care and like help people. You're not thinking, oh, I want to deal with organizational problems, right?

[00:14:58] [SPEAKER_00] Of course. Yeah. Yeah, it's tough. I mean, it's always a balance between feeling like it's just easier to do something yourself, you know, versus bringing someone else on to do it with you or for you. And figuring out systems and structures for delegation, oversight, accountability. You know, these are all really challenging things to navigate while, you know, working in a business, while working on the business. You know, and there's so many different levels to it.

[00:15:25] [SPEAKER_00] I always think of myself kind of as a pilot flying a plane and I'm literally building the plane, which is unfinished, while I'm flying it. And I'm also doing repairs at the same time. So that's what it is to be, you know, the CEO of a small business is you're the mechanic and the carpenter and the, you know, and the pilot all at the same time. I think, you know, the old adage, good help is hard to find, is very real. It feels like that more and more than ever in today's world.

[00:15:53] [SPEAKER_00] And building the right team around you and the business is essential, especially in a very people and patient centric kind of business that we are, where it's all about the care and the support and the relationships that people have with me and my team and with the company or brand as a whole. It's very sensitive stuff. People are really trusting us with their deepest, darkest times. And I take that honor very seriously.

[00:16:22] [SPEAKER_00] And with that, there's got to be an incredible group of people to support that through and through from the first phone call that we get from someone curious to learn more to long after they've completed their treatment with us. And we're checking in on them just to see how they're doing and to hear both their, their, you know, continued challenges and when they might be in need of follow up care and support, as well as their, their breakthroughs and their successes and the ways that they're thriving, which we, of course, love to hear those stories as well.

[00:16:51] [SPEAKER_00] So, yeah, I could talk a lot about this. I don't know, kind of where do you want, might want to drill down more, but it's definitely been also like a very, very big challenge and also a beautiful process.

[00:17:04] [SPEAKER_01] A few minutes. Any, any thoughts, any tips to, to those audience who might be thinking, you know, and this is kind of zooming out from specifically, you know, like mental health, patient care, that type of an organization or that kind of business. Thinking just about, you know, starting business and then growing and scaling it. Any lessons learned from the process?

[00:17:27] [SPEAKER_01] I mean, I'm sure there's a gazillion lessons learned, but like any, any like one, two or three, like core lessons learned that you would like to share with folks about like how to go about scaling in an effective, healthy way.

[00:17:39] [SPEAKER_00] Yeah. I mean, in the beginning, we put everything on credit cards. I would say, don't do that. Get a line of credit if you need to get a loan or a line of credit or something. That wasn't the best way to do it. We were able to shift the pain. And those balances often fall every month pretty quickly, but definitely don't recommend that as a starting point. I would say, look at doing a business that you're passionate about first and foremost. It's got to be something you really care about. And just because you care about it doesn't mean you're going to be a good business person either.

[00:18:07] [SPEAKER_00] I think there's a lot of individuals that start companies doing something they like, but they don't really get how different, you know, running a business is from the thing that they're doing. Right. So, you know, if you're an artist or, you know, you're a tradesman of some kind, you know, being being a good carpenter doesn't mean you're going to have a good carpenter business, for example. Right. But I think if you're really passionate about it, it's going to help you to weather the storms, the ups and downs and really more, I guess, the downs.

[00:18:35] [SPEAKER_00] Because any business is going to have its challenges and there's going to be days where you really don't want to do what you're doing. And as it grows, more of your job may entail things that you don't like or want to do that you have to be responsible for. And I think the only real way to persevere through that is to really love the work and love what it is that you do. And so I tell people, I mean, about 80 percent of my job is dealing with stuff I don't want to deal with.

[00:19:04] [SPEAKER_00] I get the problems that no one else can solve. I get the fires to put out. I have to deal with the challenges and, you know, the things that are broken and not working and figure it out. And it's not always fun. I mean, certain things, sure, it's intellectually stimulating and that's, you know, it's fun to solve a challenge. But a lot of it is really unpleasant. And the other 20 percent of what I do is fun and interesting and I really enjoy it. And so the vast majority of my time is not enjoyed in the company.

[00:19:33] [SPEAKER_00] But why am I doing it? Because I really believe in the mission and in the work that we're doing, the impact that I and we as a collective team and as a company are having on people's lives and on the community. And I see the transformation in people. You know, the person who's come to us after 10, 20, 30 years of suffering from treatment resistant depression, who gets their life back, who's excited to live again. The gentleman who's gone back to school and now has a new relationship and he's moving to the other side of the world.

[00:20:01] [SPEAKER_00] And he's, you know, following his dream and is asking if I can make time to, you know, say goodbye. But, you know, his next visit before he leaves the country, because he wants to give me a hug and just thank me for creating the clinic. I mean, these are the moments that, you know, stand out when someone stops me in the hallway with tears in their eyes and they want to, you know, give me a hug just because, you know, of the impact on their life and how it's transformed. These are the reasons why I do what I do and just to make a positive impact.

[00:20:29] [SPEAKER_00] And it's that's so gratifying for me. And it's so meaningful that I'm able to eat a lot of dirt.

[00:20:39] [SPEAKER_01] I love that. I love it. And you're absolutely right. And, you know, we all have to do the old adage, you know, do what you love and you don't have to live in your life. Uh, I mean, I am so happy for that person if that actually if that actually exists. But I think the vast majority of us, even when we do something that we love, I love what I do. But there are still everyone has to do stuff that they don't love, like even as part of what you love.

[00:21:08] [SPEAKER_01] Right. Because that's just the real world. Like that's just life. There's always a mix of stuff. And in fact, that's actually what brings richness to life. Right. Because you don't fully appreciate the good without kind of the stuff that you don't like as much. Right. Anyways, I think I think, you know, it's just a mixed bag.

[00:21:26] [SPEAKER_01] And so, as you said, having that defining meaning and purpose behind the kind of the overarching kind of purpose behind what you're doing can see you through the dips, see you through the hard things, see you through the things that frankly are the less sexy aspects of like doing the business. Right. But have to be done. And someone has to do it. Someone has to put out fire. Someone has to, you know, do the unsavory, you know, aspects of dealing with, you know, the people problems or whatever happens. And it's just it's just the reality.

[00:21:55] [SPEAKER_01] And so I think that's good advice. Well, Sam, I know at the time I need to let you go. But before we wrap things up for today, I just want to give you a chance to share with the audience how they think that you find out more about your work, your team, and then give us a final word for today.

[00:22:07] [SPEAKER_00] Yeah. Thank you so much, John. I do want to just clarify or add that we do offer other innovative mental health treatments. And that's really our focus. So we started out as, you know, a ketamine clinic, but really have expanded. And now we do offer transcranial magnetic stimulation or TMS, Spravato or S-ketamine nasal spray and general psychiatric care, both in person and telehealth throughout California. So psychiatric evaluations, medication management.

[00:22:33] [SPEAKER_00] And I would love to be a resource to anyone who's in need of any kind of care or support in California. They can go to our website, ketamineclinics.com. And that's K-E-T-A-M-I-N-E-C-L-I-N-I-C-S dot com. They can call us at 310-270-0625 or text us. And we do offer free consultations.

[00:22:56] [SPEAKER_00] We accept most health insurance and insurance does cover all of our services except the IV ketamine, which is out of pocket. Everything else is covered. And we take most health insurance, including Medicare. So we'd love to be a resource if people want to reach out. They're curious to learn more or get any kind of care or support with, you know, anything that they're dealing with or for their loved ones. Awesome. Awesome.

[00:23:17] [SPEAKER_01] I really appreciate that. It's been a fascinating conversation. I appreciate your time. I encourage the audience to reach out, get connected, find out more about what Sam and C-View for you. And as always, I hope everyone can stay healthy and safe. If I'm meeting him, I will meet you every day. I hope you all have. Thanks for joining us for this episode of the podcast. We hope you stay healthy and safe. And please join us again soon.