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Hello Reader,

This week on the podcast I spoke with Patrick O'Malley, MD, an emergency physician with more than 20 years of clinical experience, an inventor, and a clinical educator. He developed a wound irrigation device, built laceration and abscess courses in partnership with EB Medicine, and founded ShiftChange, a private community for emergency, urgent care, and critical care clinicians who are building something alongside their clinical work.

The first idea came in residency. He was trying to irrigate wounds with what was on hand and started tinkering with plungers and valves, looking for a better way. He describes the emergency department as a place where you are handed a problem and rudimentary tools, which is where a great deal of innovation begins. Within a year of finishing training he was also working at a day spa doing Botox, fillers, and laser tattoo removal, mostly because he wanted something he owned.

Nobody mentored him through any of it. Twenty years ago, he says, no one in his program or anywhere else in the hospital was talking about starting a business during residency. That has changed. He now has these conversations with medical students and residents across the country.

He launched the laceration course in 2021, while working full time and moonlighting in a COVID-dense hospital. That combination contributed to his own burnout. In 2022 he partnered with EB Medicine because he knew what he did not know, which was the business and marketing side, and the course began to grow. He also started working with a coach. Rob Orman asked him two questions: does emergency medicine have anything left to offer you, and do you have anything left to offer emergency medicine? Answering them out loud took a weight off his shoulders.

The course taught him that people will pay for his clinical expertise, even after a residency director he admired told him nobody would buy a course on suturing. He pivoted his audience to urgent care, where roughly 85 percent of clinicians are nurse practitioners and physician assistants. Then he gave up one or two shifts a month, year over year, until the revenue supported the transition. That was a phased exit rather than a two weeks notice.

Teaching point: building alongside clinical work is additive, not an escape hatch, and it stays additive only if you are intentional about it. Without protected time and support, the thing you love becomes more fuel for the burnout you were trying to solve.

His first steps are unglamorous. Write the idea down somewhere outside your own head, whether that is a spiral notebook from Walmart or a folder in Google Drive. Name the minimum viable version of it. Put one or two protected blocks on your calendar every week. Then find people doing the same thing, because doing it alone is isolating.

Here's my question for you this week: what is the idea you keep carrying around between your ears, and where would you write it down today?

You can find Patrick at myshiftchange.com, which includes a free weekly webinar series, and on LinkedIn.​

🎧 Listen to the podcast sneak peek episode below and listen to the full episode on YouTube, Apple, Spotify, Podbean, or Amazon Music.

Stay mindful and keep leading,
Lillian
Founder & CEO

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