Leadership in M&A with Nicole Chiaramonte

November 22, 2023

In this episode, we are joined by guest Nicole Chiaramonte, a seasoned serial entrepreneur who has not only founded and exited multiple businesses but also led multiple teams to success. Tune in as Nicole shares her firsthand experiences with leadership, and sheds light on the challenges and triumphs of leadership. With a focus on medical aesthetics, Nicole emphasizes the crucial role of compliance and provides takeaways for those aspiring to become leaders in this industry.

Listen to the full episode using the player below, or by visiting one of the links below. Below is the episode’s transcript which has been edited for readability. If you have any questions or would like to learn more, email us at info@byrdadatto.com.


Intro: [00:00:00M] Welcome to Legal 123s with ByrdAdatto, legal issues simplified through real client stories and real world experiences, creating simplicity in 3, 2, 1.

Michael: Welcome back to Legal 123s with ByrdAdatto. I’m your host, Brad Adatto, with my co-host, Michael Byrd.

Brad: Thanks, Brad. As a business and health care law firm, we represent clients in multiple business sectors, especially health care. This season, we are finding common ground for our audience, regardless of your background. Our theme is Leadership, where each episode we will talk about leadership from multiple perspectives.

Michael: Awesome. All right, Michael, what’s on your mind today?

Brad: There’s something, Brad, that’s appealing when we hear stories about resilience.

Michael: Oh, absolutely. I mean, who doesn’t love a great underdog story? Well…

Brad: I read an article recently about a mother of three in Utah who had lost her husband about a year ago. She wrote [00:01:00m] a children’s book titled, “Are You With Me?” And it’s about grief. She authored this book to help children cope after the death of a loved one.

Michael: Yeah. And I think, you know, what a great way to share her grief and help others with it.

Brad: Yeah. I mean, the mother appeared on a local television show in Utah a few months ago to promote the book. The wife called her husband’s death unexpected and described how it sent her and her three boys reeling.

Michael: Yeah. I mean, I guess it’s somewhat of a heartwarming story that her, you know, with her grit and her incredible toughness getting through something like this.

Brad: Yeah. It was a great story. At least it was until a few months later when the wife was arrested for murder of her husband.

Michael: Okay, that just escalated real quick there, Mike.

Brad: Yeah. The husband had five times the legal dosage of Fentanyl in his system. And apparently he’s a realtor and apparently someone who sold the fentanyl to the wife came forward. [00:02:00m] And I believe the charge was that she had made him a mixed vodka drink that night with Fentanyl to celebrate him selling a house.

Michael: Okay. Two things. Number one, never put Fentanyl in vodka drinks, so that’s important. It does ruin the vodka.

Brad: And your life.

Michael: And your life, and then what the world does today’s story have to do with resilience?

Brad: Well, nothing at all. No, I just wanted to mislead you in the same way that the public was misled when this wife appeared on the local news and everyone felt that heartwarming gift of resiliency. Because you know, Brad, everyone’s a sucker for the feel good story.

Michael: Hey Riley, does Michael know that this podcast is not a True Crimes podcast? I don’t know if he knows that. Well, it’s the Legal 123s with ByrdAdatto, not True Crime Podcasts.

Brad: If our staff had anything to do with it, our podcast would be a True Crime podcast.

Michael: [00:03:00M] Yeah. That’s for sure. You can’t walk down the halls without someone telling us about the most recent book they read or podcast they listened to on some newest true crime thing.

Brad: Our office has a book club audience that is really heavy on true crime here. To kind of help you get the picture, here’s some of the titles that we’ve seen on the book club at ByrdAdatto: My Sister, the Serial Killer; Victim F; I’m Glad My Mom Died; The Hunting Party; Sharp Objects; and The Vanishing Half. And this is only to name a few of the dark titles.

Michael: You know what, Michael, I know that you did not read any of these books. And I don’t know if any of these are dark or disturbing serial killer books that you keep saying. They are.

Brad: You’re right, Brad. You’re right. I’m sure My Sister, the Serial Killer is a sweet coming of age romance novel.

Michael: So you’re saying there’s a chance. Well, Michael let’s kind of get off these, whatever, this podcast that we just [00:04:00m] got into, but today in studio, we have a friend and a longtime client joining us today, and people who are watching us, I guess, who’s watching us, they might be wondering, is this beautiful person from Utah or something like, what are you trying to bring it together?

Brad: Are you asking if I’m trying to connect her to this story? No, Brad, I’m not, of course not. She actually is an example of grit and resilience and has an amazing story, has been on with this before. She was on the show in Season Four. Our guest is Nicole Chiaramonte.

Michael: Yes. And I’m thinking Nicole’s relieved to know that you’re not trying to send a message about her, this story, but audience members who are watching us, you can see we do have this Nicole who’s making us look a lot prettier today, because it’s just Michael and I normally we have faces for radio. Nicole has a face for the TV cameras, well, why don’t you bring her on.

Brad: So Nicole is the founder and CEO [00:05:00m] of AMP, and it’s built as a superior alternative to the traditional private equity model. And we will let Nicole explain more about AMP here in a few minutes. She’s the CEO of TWG consulting, founder of Synergy MedAesthetics. She’s a private investor historically in over a dozen of medical spas. She’s been 25 plus years in startup management, 19 years in MSO ownership in the legal and medical industries. And that’s just scratching the surface. Nicole, welcome.

Nicole: Morning, gentlemen. How are you?

Michael: We’re great. Well, we’re excited to have you here in the studio, but I think we got to start off correct, Nicole, are you a true crimes kind of person? Like you do the books or the podcasts or the documentaries?

Nicole: I hate to disappoint you, but I’m not. I try and keep things as optimistic and positive as possible. I know that’s all out there, but I need to really focus.

Michael: Yeah. Well, that makes sense. Not my thing either. So apparently, [00:06:00m] you can’t be on staff here though. Sorry to tell you that.

Brad: But you can join Brad and I, because we aren’t in any of those. I’m right there with you. I don’t even like scary movies. Well, we’ll get in and I’m sure everyone’s a little curious. They heard me mention AMP just a minute ago. I’d love just for you to introduce AMP and talk a little bit about what you’ve been up to.

Nicole: I would be happy to. AMP stands for Advanced MedAesthetic Partners, and it is a platform that is partner and employee owned. And as you mentioned earlier, Michael, it was created to be an alternative to what I was seeing private equity doing in the industry. You know, three years ago I had 15 practices. For years I’d been buying, growing, and then selling practices, not in a strategic way, just going where I felt I could add value to practices and to teams. And private equity started knocking on my door. It was very appealing, the idea of selling my practices [00:07:00m] and benefiting financially from it. But ultimately, when I started talking to the people who had run the practice post-transaction, I wasn’t really thrilled the way they would be making decisions. Not that they were bad guys, not that they were bad people; I just was highly protective of my teams and the patients.

So had the idea to create something that would give all the benefits of consolidation, like economies of scale, better pricing with your vendors, and then providing things like a professionalization of services in HR, IT, and finance, because as, as entrepreneurs, we don’t love doing those things. We don’t love running payroll, dealing with our accountants and taxes, all of that. So that really was the vision and the motivation behind AMP. My hope was maybe 20 or 30 practices over a couple years would join us. And in the first six months we had 30 practices. Right now we have just a little over a hundred locations that are either under LOI or asking for LOIs right now. [00:08:00m] So, it’s just very rewarding and thrilling to see that people have caught the vision and they understand what we’re trying to do and create, which is a platform, that is not only great for our practices and patients. But ultimately, we’re really hoping to really have a great effect on the industry as a whole.

Michael: That’s amazing. I mean, I’ll just say this as an owner of a business, I can agree with it. The vast majority of people own businesses do not want to worry about the payrolls and benefits and that, and so it’s a great add-on that you’re being able to bring to them, besides the professionalism that you’re bringing to them.

Brad: I’m guessing that you don’t have much to do with all this.

Nicole: Well, we are a year old as of last Saturday.

Brad: Wow. Congrats.

Nicole: And yeah, thank you. It has been a hell of a year and amazing. I’ve met incredible people. It feels like I’ve been on the road for about 350 of those days – but well worth it and we’ve enjoyed every minute of it.

Michael: That’s awesome. Well, this season, as our audience knows, we’re really [00:09:00m] focusing on leadership, and as a leader in, in the industry we’d love for you to share some thoughts from your perspective. So let’s just kind of take a big giant step back and think back to when young little Nicole, what was your real first leadership position?

Nicole: Oh, wow. That’s a great question. I would say, you know, what first comes to mind is I’m the eldest of four, so I have all sorts of stories related to siblings. But I think for organizational purposes, I’m going to hit jump to my sophomore year in high school, I was elected president of Students Against Drunk Driving. The summer before, between my freshman and sophomore year, I had been in a car accident. I was a passenger, and our vehicle was hit by a drunk driver, so that hospitalized me for a period of time. By the time I got back to school, I was walking around on crutches and it was a write-in vote. I didn’t necessarily run for this position, but I was a definite choice. [00:10:00m] And I had some questions about whether or not I wanted to take on that responsibility. It was the first time running a club, an organization. It was a very popular club in our school, but I decided to do it. It was a good opportunity. My father encouraged me to take the opportunity and run with it.

And it didn’t seem controversial at the time who’s four drunk driving, but that particular year, we had a group of individuals in our small community who had decided to create something that was separate and it was more against drinking in general. So there’s Mothers Against Drunk Driving that in this community, they created something that was just against drinking, and then their children created a high school version of that. And what turned into, well, if you are just against drunk driving, that means you’re for teenage drinking. And I won’t go into everything, but when you’re only 15 years old, that’s a lot to deal with.

Michael: Yeah, no doubt.

Nicole: And the injustice [00:11:00m] of feeling so deeply misunderstood. There was a split in the club, and I realized how silly this is as adults looking back, but it was the first time, you know, stepping into a leadership position, stepping into a place of responsibility, and then having things fall apart when what you’re trying to do is something very, very good. And I could have highlighted all sorts of really great examples of leadership and experiences that I had, but people put out all of their leadership successes on social media, and they celebrate things publicly when things go well. I think it’s important to remind people that leadership has a lot of bumps along the way. There’s a reason you need grit to get from zero to one and one to two, but that was a big foundational moment for me when I started in leadership, realizing it’s not all sunshine and rainbows. Yeah.

Brad: I’d be willing to bet that you draw on those types of moments in your current leadership more than the success stories.

Nicole: [00:12:00M] Absolutely.

Brad: Cool. Well, I would love to kind of take, you know, the next step there, which may connect to this, you know, do you have any mentors or people that inspired you or led you or taught you how to become a leader?

Nicole: Absolutely. I think nothing that was organized. I didn’t have a professional or a standard mentor that was assigned to me. I just kind of a latched onto people that I really respected and admired. My father was foundational for me, watching him lead, people watching how people would just gravitate towards him when he walked in a room, whether it was professionally or personally. He was a great mentor for me. After that, in high school, again, my business career started early and I got to partner into and become part of a startup while I was in high school. So while other kids were going to prom and homecoming and football games on Friday nights, [00:13:00m] I was flying out to trade shows and talking with importers with the couple who founded the company.

And the woman who was the co-founder, I remember her one day saying to me, I made a comment one day when there was a meeting that didn’t go well. And I said, it’s because we’re women, the two of us had taken the meeting. And she turned and she looked at me and she said, “Being a woman in business is either a weakness or a superpower, and which is completely up to you.” And that was the most empowering moment of realizing I was not a victim of the people around me. Now, because of their lens or how they saw the world might throw challenges in front of me, but me overcoming those challenges would only make me better, so I needed to be grateful for those rather than feel like a victim of them. And that was probably, if I look back at a moment that really defined how I looked at the world moving forward, that was it.

Michael: Yeah. I can tell you, you’re a superpower. I think I know it’s when you elected, but I’ve seen you work the [00:14:00m] rooms and so yes, you’re using your superpowers.

Brad: That’s amazing too. Yeah, and if I remember right, was it a fish store? I think we talked about this before.

Nicole: We did. Like I always say, I wish it was something glamorous. It was in media or tech or something, but no, it was aquarium products.

Brad: Yeah. And so, that leads me to the question, because I know from our prior episode that your whole life have been a serial entrepreneur and that can be really lonely. You don’t have a “boss” a lot of the times, and so I’m curious how did you develop your own leadership traits kind of living in that kind of business world?

Nicole: Oh gosh. That’s been a process over nearly 30 years. And I think one of the things that was so helpful for me early on was Tony Robbins did a series, I don’t know if you guys remember this in, I think probably early to mid-nineties. [00:15:00m] And it was a 30 day series. And I remember one of the teachings that was part of that was the fact that you were able to control how you feel and if you feel something that doesn’t serve you, you can set it aside that you actually have the choice to do that. And that has been very empowering because we feel as leaders, you feel betrayed, you feel lonely, to your point, Michael, being alone is a big part of being a leader. You carry a burden and you carry stress and concerns that your teams don’t fully understand.

But knowing that you have the power and the ability to control how you’re feeling at the moment, and if it doesn’t serve where you want to go and what you’re trying to do, you can put it aside. That was incredibly empowering for me. So that teaching, like being able to find little teachings here and there, lot of personal development, lot of reading books, and then just knowing that the only difference between a loser and a winner is the winner tried one [00:16:00m] more time. I know that’s a cliche and you see it on social media, but it’s so true. I was no better than anyone else other than I got back up one more time and I kept doing it until it worked. I mean, that’s essentially how you become successful.

Michael: Yeah, going back to the grit. Well, it sounds like in some ways you’ve had these great mentors, you built your own style, but you do run in situations where either you yourself had at the moment or you worked with others where you had a really bad leadership experience. And I know we kind of talked a little bit about being in your first leadership role and how hard that was. Are there other examples that you had where you had a bad leadership experience?

Nicole: Oh, gosh. As a leader, there’s quite a few of them. I mean, you get a lot more bad ones than you do good for a period of time until you fine tune what actually works. Usually with leadership, at least for me, each person, it’s different. But because my driving motivation is contribution, [00:17:00m] if I’m misunderstood or someone feels like I’m trying to do something to them or take advantage of them, that’s what devastates me the most deeply.

So, I would say mine was, I actually arranged for employees to have stock and shares in a company before I sold it. And through a series of events, we ended up cashing them out because the sale didn’t happen. But I wanted them to benefit at the level that they would have benefited had I not pulled out of the sale. And to this day, they think I tried to take advantage of them in some way, even though I gave it to them, it was not due, I wanted them to benefit from it. And even when I pulled out of a sale, I wanted them to benefit regardless of my decision, so I paid them what they would’ve been owed in that sale. And that was hard. But you also realize that you cannot change how other people see the world. Nothing in the facts [00:18:00m] of that situation would indicate that I was doing anything to take advantage or hurt or short them on any sort of gain, but it’s how they saw the world..

And so, just being misunderstood is a huge part of being a leader. You are going to try and communicate every single possible way, but you’ll never be able to change somebody else’s life experience, and you have to be okay with that.

Brad: Yeah. And it is crazy too just as occurring to me listening to this and what you said earlier about kind of the emotions is that emotions play such a big role in leadership, not just your emotions. You may have your own strategy to deal with it, but the people you’re leading emotions. And so, that’s really challenging and I’m sure was a lot to try to sort through.

Nicole: It is. And to your point, I mean, everybody has a different philosophy on life and they pay attention to their own personal and emotional and [00:19:00m] mindset development at different levels, and some people they don’t prioritize that. So, learning to meet them where they are is going to be the way you’re successful, and not demanding that they be something they’re not.

Michael: Yeah. No doubt on that. Well, all right, Nicole, so we’re moving along. We’ve learned your history, took a step back and really get a good baseline understanding of kind of what molded you. But now you are a leader in the aesthetic medical industry, and as leaders, there are things that pop up that they give you concerns. So for our audience, what are some of the things that you think other leaders in this industry should think about and or be concerned with?

Nicole: First and foremost, don’t believe what you see on the internet and social media. I can speak firsthand. I have reviewed hundreds of practices in this industry looking to invest in them. This is pre and post AMP. What you see on social media is not a true reflection of the health of the culture or the profitability of a practice. The best practices we have [00:20:00m] seen are ones that they put their head down, they take care of their people, and they just focus on creating an exceptional patient experience. And they might not be famous, and they might not be Insta-famous, but they are solid. So if that’s what you’re trying to build, a solid business that is profitable for you and your family, and that can support your staff, focus on that rather than whatever you think you need to be doing on social media. It’s amazing the split that people have on where their focus should be.

Brad: That’s amazing. Have you noticed with those types of practices any kind of leadership traits or things that stand out about how those practices lead their teams?

Nicole: The Instagram famous ones?

Brad: Yeah. Or the ones that you like that have the head down.

Nicole: So the ones that I really like, they are people who come in, they take care of their people, they make sure that their people are trained. You know, something else that [00:21:00m] I want to highlight is, you want to be legally compliant. You want to be clinically compliant. Those are the first two things every practice owner needs to focus on before anything else, because that’s the foundational part of your practice, and that’s what’s going to make you successful. After that, then you have the training, and then you have the marketing and the development of your clientele. But overall, what I see are the people who just make sure that they get the foundational parts of their business right in the beginning. And again, legal and then clinical training that is so, so important. Then from there, they can build for the others. But if they get that right and their culture, they’re going to have an exceptional practice.

Michael: And what type of leaders then are you looking for since you have all these different groups when you’re looking at – that’s the two important core elements, but what does the leaders look like that you want to join your team?

Nicole: The people who are joining AMP right now are people who are very growth-focused, performance-focused, [00:22:00m] and they’re doing this because they want more for their teams. So an owner of one location, what we call the four wall, that is the extent of their team’s ability to grow within their company. When you join AMP, what you’re able to do is, a front desk person who’s an exceptional patient care coordinator, they can become a trainer for a national platform. They can still be based out of their home, they can still be part of their team, but they have great career opportunities. Same with the clinicians and the managers. So we’re looking for owners and partners who want to grow and who want to help their teams grow and give them additional professional development opportunities.

Brad: Awesome. I have one last question. We’re going to put a bow on maybe touching on things you’ve already said, but if you had to name a biggest lesson learned, positive or negative, could be drawn from those hard experiences that you can share with our audience on leadership, what would that be?

Nicole: [00:23:00M] Communicating clear expectations first and foremost, and then measuring. So, the biggest mistake leaders make, including myself, is expecting people to read our minds. So if we can let, whether you’re leading a team of executives, whether you’re leading a team at a location level, let them know exactly what you need as an outcome and help them with the steps to get there and then measure it. Do not wait till the day you want it done. Measure it along the way. Make sure the one that the work is getting done. And two, the way that it’s getting done the way you want. The biggest difficulty for leaders is that gap between expectation and reality, and that’s where disappointment comes in, and frustration and anger. If you can bridge that with clear communication, you’re going to save yourself a lot of heartache.

Michael: That’s a great answer.

Brad: Yeah. That’s amazing. Well, and that’s a great spot for us to wrap up for today. We’re so grateful, Nicole, that you [00:24:00m] came to join us and it was really fun doing it in person. What we’ll do next is we’ll go into a commercial and then on the other side, Brad and I will jump back on and have a little legal wrap up. Thank you.

Nicole: Thanks guys. It was fun.

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Michael: Welcome back to Legal 123s with ByrdAdatto. I’m your host Brad Adatto, and I’m still here with my co-host, Michael Byrd. Now Michael, in case you don’t know this season, our [00:25:00m] theme is Leadership. And boy, we had amazing leader in studio today with us. She brightened up the room with her smile and energy and obviously amazing leadership skills. Having Nicole Chiaramonte in here was awesome.

Brad: It was really cool, and so now we’ve gotta hold it together, Brad, for the last couple minutes. I thought it was really interesting at the end when she was talking about what she looks for in leadership for businesses that AMP is acquiring. And what I found really interesting was that she focused on kind of the substance head down, not Insta-famous. And she mentioned just foundationally how important for a business in health care and kind of the med spa world that compliance is. She’s talked about operations as well. Of course, [00:26:00m] compliance is singing our professions and we love that. But what occurred to me is really connecting the importance of leadership and compliance, because compliance is hard. We’ve talked about that on multiple episodes. And it’s not a, you show up one day and check a bunch of boxes and now you have a compliant business. It’s a living and breathing atmosphere, culture to a business to stay compliant because it’s not stagnant. And the way she connected to leadership, I was like, well, yeah, of course it starts at the top. I mean, if you as a leader don’t prioritize compliance, you can’t expect your team who are the ones having to be compliant to follow that same path.

Michael: Yeah, absolutely. And I thought, and the other thing I found interesting when she was talking about just because someone’s social media famous basically, doesn’t mean that [00:27:00m] they’re going to be compliant. In fact, in some cases, if you are posting, using social media, you’re describing certain things; understand that there are rules out there that still apply to you. The Federal Trade Commission, the FTC, even though you may be taking cash only, still controls what you put out there in social media, still controls what you put on your website. And if it’s false, deceptive or misleading, you actually in which they have, they can go after your practice. So that goes back to the being compliant from the beginning, but that outward face on your social media needs to be just as compliant. Well, Michael, what are your final takeaways today?

Brad: Well, I mean, you kind of can tie it all together just because you have a pretty social media handle with influencers, doesn’t mean you have a compliant substantive business. Just like if you publish a book on grief doesn’t mean you didn’t kill your husband.

Michael: Okay. I didn’t see that one coming; I don’t know why I didn’t. All right, audience members, guess what? Next Wednesday, [00:28:00m] we will be back again. We will have Paula Allgood, who is the managing partner of Beaird Harris, joining us so we can continue to learn about leadership. Thanks again for joining us today. And remember, if you like this episode, please subscribe, make sure to give us a five star rating and share with your friends.

Brad: You can also sign up for the ByrdAdatto newsletter by going to our website at byrdadatto.com.

Outro: ByrdAdatto is providing this podcast as a public service. This podcast is for educational purposes only. This podcast does not constitute legal advice, nor does it establish an attorney-client relationship. Reference to any specific product or entity does not constitute an endorsement or recommendation by ByrdAdatto. The views expressed by guests are their own, and their appearance on the program does not imply an endorsement of them or any entity they represent. Please consult with an attorney on your legal issues. [00:29:00m]

ByrdAdatto founding partner Michael Byrd

Michael S. Byrd

ByrdAdatto Founding Partner Bradford E. Adatto

Bradford E. Adatto