What Healthcare Leaders Will Take Away
If you work emergency or urgent care, your professional life is measured in shifts. You survive one, then the next, and it is easy to believe that is all there is.
Dr. Patrick O’Malley is an emergency physician, clinical educator, and founder of ShiftChange, a private community for emergency medicine, urgent care, and critical care clinicians who build ventures alongside their clinical work. Lillian is one of the certified coaches inside it.
Physicians, APPs, and clinical leaders with an idea they keep coming back to tend to ask the same three things: does building mean leaving medicine, how do I keep it from wearing me down, and who do I ask?
- Building is additive. A second venture can sit alongside a clinical career, not replace it.
- The grass is not greener. It is a different texture, and it still needs tending.
- Write the idea down. Then protect one or two blocks of time a week for it.
- Lead as a go-giver. Offer value before you pitch.
What does it mean to build something alongside clinical medicine?
Patrick’s own first project came out of residency, where he started tinkering with plungers and valves to build a better wound irrigation device. Right after residency, a new partner connected him to a day spa doing Botox, fillers, and laser tattoo removal.
“I want to do something outside of the walls of the emergency department, and to be able to express my own creativity, have a sense of ownership, something that I had a little bit more control over.” Patrick O’Malley, MD
Lillian names the opposite of the “and” as binary boundaries: saying no and choosing one thing. Adding something that fills your cup, she says, “actually translates over into other parts” of your life. The same word names our AND Framework™ at Transforming Healthcare Coaching®: Awareness, New Action, Deliberate Practice.
Why do so many emergency physicians start side ventures?
- Improvising is the job. In the emergency department, he says, “you’re forced to work with rudimentary tools,” and that is where so much innovation starts.
- The schedule leaves room. Depending on where you work, he says, “you’ve got 10, 15 days a month that you’re not working.”
- Many arrive with earlier careers. Inside ShiftChange he has met former software engineers, engineers, CPAs, and financial planners. Being a physician, he says, “doesn’t mean that you have to shut all of that stuff down.”
None of this was discussed when he trained. Twenty-plus years ago, he cannot recall anyone in his program or in the other specialties at his hospital saying they were starting a business as a resident. Today he talks with medical students and residents across the country who are doing it, and he thinks more hospital employment and less private practice ownership may be part of why.
Is building a side business a way out of medicine?
His laceration course launched in 2021, in the middle of the pandemic, while he worked full time and moonlighted in a very busy COVID hospital. He calls that “a recipe for my own burnout.” He worked with certified coaches Rob Orman and later Lon Stroschein. On one coaching call, Rob 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, he says, took a huge weight off his shoulders and let him be honest with himself. Rob also helped him find more joy in his career. Two years on, he could say it had been a wonderful career and let it go. “I absolutely loved emergency medicine until I didn’t, and that’s okay.”
He warns that building alongside full-time clinical work “does require intention and it requires self-awareness,” and that a passion project can add “extra gasoline on the fire” if you are not careful. Twice early in her career, Lillian says, what wore her down was not the EMR or insurance battles. “It was doing too much because I loved too much.”
Lillian points out that founders and entrepreneurs get worn down too. Patrick agrees: “the grass is not greener, it’s just a different texture.” You still have to water it, cut it, and tend it.
Why build a professional community off social media?
He also thinks paying for a community changes how people show up. When you put in your credit card information, he says, you are investing in yourself. “You’ve got skin in the game,” and you are more likely to engage, contribute, and get something out of it. Lillian compares it to a gym membership. Our own medTHRIVE® community runs on Circle too.
Episode 110, on creating community for physicians, covers the same question from another founder’s side.
What did turning clinical expertise into a course teach him?
He first imagined selling it to emergency medicine residents and residency programs. When he got involved with the Urgent Care Association and its College of Urgent Care Medicine, he saw an entire industry that could benefit, where, in his words, “it’s 85% nurse practitioners and physician assistants who are working in the urgent care setting.” He pivoted to that audience.
Business and marketing were not his strengths, so in 2022 he partnered with EB Medicine, and that is when the business started to grow. The course also paced his exit. Each month he gave up one or two shifts to work on it, and when it was time to step away, it was generating enough revenue to make the move.
Lillian points to the book Two Weeks Notice: almost everyone, she thinks, makes a phased exit rather than a sudden one.
Patrick expects the specialty itself to change. Maybe more emergency physicians work a 0.75 FTE to free up mental bandwidth. Maybe we normalize sabbaticals, four weeks every year or a month or two every other year. Maybe we normalize saying, “Hey, yes, I’m an emergency physician, and I do this on the side.” Lillian wants employers, professional societies, and organized medicine to ask, “How are we going to be the value add for your career?” If you are weighing a move out of clinical practice, Episode 122 covers nonclinical physician careers.
How do you take the first step if you have never built anything?
- Get it on paper. He keeps a 35-cent spiral-bound notebook. Ask what the minimum viable product is, the simplest version you could put in front of people, and what you are trying to create.
- Use AI as a thinking partner. He sees it as a collaborative partner for ideating, without hiring anyone first.
- Put it on the calendar. Shift work, circadian disruption, and family make time scarce. He recommends carving out one or two blocks every week.
- Find people who understand the process. “Doing this alone sucks, and it’s hard. It’s isolating.”
Lillian adds that every entrepreneur starts as a solopreneur. No one, she says, is a company right away.
How do physicians network without feeling like they are pitching?
“Leading with a go-giver mentality instead of just, ‘I need to pitch, I need to sell,’ it really does transform your life.” Patrick O’Malley, MD
The other half is knowing who to call. He jokes that as an emergency physician, “we don’t know how to do absolutely everything in medicine, but I know somebody who does.” ShiftChange brings clinician entrepreneurs together with select subject matter experts in areas like real estate, tech, AI, angel investing, and venture capital, so you are not left cold emailing strangers on LinkedIn and wondering who to trust.
Coaching sits inside the community too, through internal office hours that are often coaching-focused and led by certified coaches. One of his missions is to help normalize coaching. For more on what coaching really is in healthcare, start with Episode 119, or browse the Leadership Collection.
Build with someone in your corner
Building something alongside your clinical work goes better with someone in your corner. We are one conversation away.
Key Takeaways for Healthcare Leaders
Frequently Asked Questions
How do physicians start a side business while still working clinically?
Does building a side business mean leaving medicine?
How can physicians network without cold-pitching strangers?
Is a paid physician community better than a free Facebook group?
What is ShiftChange?
Can a coach help with a physician’s career transition?
Episode Transcript
Download transcript (.txt) ↓︎Segment 01 · 00:00
Cold Open: Working With What You’ve Got
Dr. Patrick O’Malley on how the emergency department forces you to work with rudimentary tools, and why that is where innovation starts, followed by Lillian on a professional life measured in shifts.
Segment 02 · 01:13
Meet Dr. Patrick O’Malley
Lillian welcomes Patrick, an emergency physician with more than 20 years of clinical experience, a wound irrigation device, and laceration and abscess courses with EB Medicine, and asks where his spark to build began.
Segment 03 · 03:24
Early Innovation Spark
Tinkering with plungers and valves in residency to build a better wound irrigation device, because the emergency department oftentimes makes you work with what you’ve got.
Segment 04 · 04:18
Side Gigs Early On
A first job partner’s day spa connection, the wish for creativity and ownership outside the department, and what to do with 10 to 15 days a month off.
Segment 05 · 05:51
Communities Go Mainstream
Social media helps clinicians find their tribe, earlier careers in software, engineering and finance, residency programs that never discussed business, and the move of online learning into communities on Circle and Skool.
Segment 06 · 11:39
Why Build Off Social
Distraction, algorithms and doxxing in Facebook groups, why Patrick built ShiftChange on Circle, and why paying for a community means skin in the game.
Segment 07 · 14:43
Escapism Versus Additive
Lillian asks whether building a side venture is about escaping clinical work, and Patrick begins his story of launching a course in the middle of the pandemic.
Segment 08 · 16:16
Coaching Pivot
Working with coaches Rob Orman and Lon Stroschein, the two questions that changed his view of his career, doing too much because you love too much, the grass as a different texture, and why physicians’ skills transfer to building.
Segment 09 · 22:20
Course Creation Lessons
The residency director who said no one would buy a suturing course, pivoting to urgent care, giving up a shift or two a month, the phased exit, having a plus one outside the emergency department, and what employers and organized medicine will need to offer as expectations change.
Segment 10 · 28:05
First Steps To Start
Patrick’s first steps for anyone with an idea: write it down, find the minimum viable product, use AI as a partner, protect time on the calendar, and find people who understand the process.
Segment 11 · 31:48
ShiftChange Ecosystem
Subject matter experts and peer support in one place, why every founder starts as a solopreneur, moving from go-getter to go-giver, and coaching office hours inside the community.
Segment 12 · 34:56
Closing And Connect
Where to find Patrick at myshiftchange.com and on LinkedIn, the free weekly webinar series, and how to send the show a topic.
Read the full transcript
Transforming Healthcare Coaching Podcast, Episode 127: How to Network Like a Pro: ShiftChange's Dr. Patrick O'Malley Explains. Host Lillian Liang Emlet, MD MS CHSE CPC ELI-MP, in conversation with Patrick O'Malley, MD, emergency physician, clinical educator, and founder of ShiftChange. Published September 21, 2026.
Patrick O’Malley, MD: What we're oftentimes forced to do in the emergency department is work with what you've got, and that's where so much innovation really starts to come out is you're faced with a problem, you're forced to work with rudimentary tools, and you're like, "Oh, gosh, there's got to be a better way."
Lillian Liang Emlet: So if you work in emergency or urgent care, your whole professional life is measured in shifts. The next one, then the one after that. You trade one, you pick one up, you survive the shift, and you do it all over again. And somewhere in between you might have this belief that this is all there is. This is all you are doing is you go to your random shifts. And so then your worth just resets again every time you clock out, and the only way to earn it back is to clock back in again. So for all of us who have done emergency medicine or shift work we are in that treadmill for decades often. And I'm always very conscious of how impressed I am whenever I meet senior clinicians who have been in the game for more than 20 years. So our guest today, Dr. Patrick O'Malley, has spent years in emergency medicine, and then built digital courses while still working clinically. And it wasn't because he wanted to escape medicine, it's because he wanted to do more and prove that physicians can be more than just a clinical schedule. And so on today's Transforming Healthcare Coaching Podcast, we're going to talk about what it means to add more things to your life that bring you joy and bring you pleasure, bring you fun, and excite you, and that actually rejuvenates your career. So Patrick, thank you so much for being on the show today.
Patrick O’Malley, MD: Lillian, it's an honor to be here, and thank you for having me.
Lillian Liang Emlet: So I just wanna introduce you to the listeners. You are an emergency medicine physician. You have more than 20 years of clinical experience. You trained at Carolinas Medical Center down in Charlotte, and you're also an inventor and a clinical educator. You have a wound irrigation device, and you have the laceration course. And I guess I think I'm also understanding too you may have the abscess course, and all in partnership with EB Medicine. Is that true?
Patrick O’Malley, MD: That's correct.
Lillian Liang Emlet: And so you and I didn't cross paths, believe it or not, in all of those 20 years that you and I have been practicing until now with ShiftChange. And so I really love this private community you've built specifically for emergency medicine, urgent care, critical care clinicians who want to grow and start a side gig, a side hustle, and another full venture alongside their clinical work to begin to show other people that there is a community of all of us out there who are maybe we're unicorns, maybe not where we just want to do more. We want to have a two jobs, actually. And so I know people will probably think both of us are a little bit crazy, but very typical for emergency medicine people. So I guess I'm curious tell us a little bit about how you thought about way back when you were doing emergency and urgent care shifts and you were just walking through a day-to-day. When you were living that life, did you see your worth, and how did you begin to have the spark to begin to invent something and also design a course?
Patrick O’Malley, MD: So going all the way back to the earliest stages of my emergency medicine career during residency we're exposed to so many different things and there's so many different clinical problems that you want to solve. And I think that's the the first time that an idea came to my mind that I wanted to do a better job with, and that was with wound irrigation. So even in residency, I started tinkering around with some different plungers and valves and trying to come up with a better... Building a better mousetrap. That's what we're oftentimes forced to do in the emergency department is work with what you've got, and that's where so much innovation really starts to come out is you're faced with a problem, you're forced to work with rudimentary tools, and you're like, "Oh, gosh, there's got to be a better way." So I think that's when the, the, the wound irrigation device that I worked on and developed several years later, that's where that seed was planted. And right after I got out of residency it was almost immediate. One of my new partners in my first job coming out of residency was doing we had a connection working at a day spa doing Botox and fillers and laser tattoo removal. So I think it was at a very early age in my career that I was just like, "You know what? I want to do something outside of the walls of the emergency department, and to be able to express my own creativity, have a sense of ownership, something that I had a little bit more control over, rather than just being in the emergency department and working those shifts." In emergency medicine depending on where you work and what your schedule looks like, you've got 10, 15 days a month that you're not working, so there is a lot of opportunity to explore other things. And so early in my career that I guess I just had that mindset or that mindset came in of what am I gonna do on all these other days off? I don't wanna just sit on my couch or I probably should have developed other hobbies. But I think emergency medicine just lends itself to that, is that there are so many other other things that we can do.
Lillian Liang Emlet: Yeah, this is true. I do think we are the breed where we work hard and we play hard.
Patrick O’Malley, MD: Yes. Yeah.
Lillian Liang Emlet: Playing hard, we accidentally sometimes start whole businesses. We go all in on extreme sports, right? That's the stereotype.
Patrick O’Malley, MD: Biking and, yeah, skydiving and so, so many other things. Yeah. Yeah, so 20 years ago, that's actually an early...
Lillian Liang Emlet: You're an early adopter, way early adopter, because now this is more normalized.
Patrick O’Malley, MD: It is. Become more mainstream, and I think with the advent of social media we've got Facebook groups, and you're able to find your tribe and see what other people are doing. And that, I think when we start sharing what we're working on together when we start sharing those ideas and experiences, I think it just stimulates that discussion. It's like, "Oh, so-and-so's doing that. Well, maybe I can do that, too." And now with AI, with social media, with these communities and groups that are available to us to join, we're just seeing that there is a lot more opportunity available to us. And I think that people have just realized that, "You know what? I don't want to just have this identity as a physician." Emergency, urgent care, critical care, whatever it may be they want to be able to reach out and explore other things that bring them excitement and so that they can express their creativity and the other gifts that they may have. 'Cause there's so many people who have careers and lives before they get into medicine, and just because you're a physician doesn't mean that you have to shut all of that stuff down. I mean just in inside of ShiftChange and the people that we've connected with there are people who were software engineers before they went to medical school. They were engineers. They were business CPAs, financial planners. There's so much diversity in medicine, and I think it's just more accepted and encouraged now for us to be able to explore alternative interests and really be able to have a sense of ownership of something outside of your identity as a physician.
Lillian Liang Emlet: So it's interesting you talk a little bit about how this seed was started in residency, but residency training programs and healthcare systems usually are not the places where you would find a mentor of activities or even communities. And so I guess I may be jumping all the way ahead out of order in terms of my thought process, but the reality is you're creating ShiftChange is a newer thing to have a community and a place where people can actually find information, guidance, peer mentorship tracks almost even in terms of whether you're doing product versus software versus service. Like in terms of different types of business models and also things to get involved in. Did you have any kind of mentorship within training programs or early on?
Patrick O’Malley, MD: No. 'Cause 20, 22, 23 years ago when I was in residency, it was just something that was not, you know, really thought of. It wasn't discussed. It wasn't encouraged. I think it would've been allowed and it would've been tolerated, but I think when you're in residency you're focused on learning and patient care and learning your skill and learning your craft because of the stakes. I mean you've got a lot at stake. You really need to be focusing on learning emergency medicine or whatever specialty you're in. So 20 years ago, I don't remember anyone that I was around not only in my program, but in the other specialties in the hospital, I can't recall anyone saying, "Oh, I'm starting my own business when I'm here as a resident." And I think the tables have turned quite a bit and I encounter and interact and have conversations with people who are very early in their career and as medical students or as residents who are in fact doing this now. So I think it's just become more accepted. And again, with social media, you've just got such a, a, a wide reach, and people can share what they're working on. So I'm in contact with and having discussions with medical students and residents who are all the way across the country, and that just didn't exist 20 years ago. There wasn't any way to be able to connect with o- other people who were doing that back then. So now I think it is, it's been more normalized. People are more interested in self-fulfillment, and they want to do something that brings them joy and something that they can have ownership of now. And that w- I don't think that was the case 25 years ago. I think that everybody was just focused on getting through residency to be the absolute best physician that they could possibly be. And now it's just, I don't know if it's a paradigm shift or just a cultural change in medicine. Possibly also with kind of trends in healthcare. There's more hospital employment, there's less private practice ownership, so maybe those are some of the contributing factors to some of these changes. But it's really exciting to see what these young innovator, these young physicians in training and recently out of residency, what they are coming up with and what they're doing. It's really exciting to see the advent of innovation at an earlier stage in people's medical careers.
Lillian Liang Emlet: Yeah, no, totally. It's interesting too, just looking at different software platforms that are all about communities. So ShiftChange and our medTHRIVE, our communities are on Circle. Obviously many other competing, platforms like Skool or where people are finding micro areas where they can learn. And I think it came out of the pandemic. Where we, in some ways we globalized everything, the opportunity to be able to to get into a private space where you're like, "Hey, I just wanna learn about knitting," or, "learn about butterflies." And you can spend your hours, like, fulfilling in other ways, and an offshoot, and then became for many people sometimes a creator business that actually killed two birds with one stone, where they actually just love making this content. People literally quit corporate jobs these micro communities or, we became authors and create these communities. And so I do think that it's a trend that's going to continue, because learning is much more fun together. I mean, I have to admit, we do book clubs. Book clubs are only so-so. It's really when you take a deeper dive into the books or into the content real learning happens.
Patrick O’Malley, MD: And I think that a lot of that started with Facebook Groups. I don't I can't r- recall exactly when Facebook started initiating the group-type concept. And I think that's... The- they're fantastic. And I'm sure you're in a bunch of Facebook groups. I am as well. I think the younger generation may not be as, as Facebook heavy, but there's, there are limitations with that type of community. One, there's the tendency for distraction. I'm guilty of it. And you're looking inside of a, a Facebook Group, and then you get a notification, you get distracted, you go down different rabbit holes. And then also the algorithm controls what it is that you are seeing or not seeing. And so there's a lot of things that get missed inside of a Facebook Group, or they're so tightly controlled by whoever it is that created that group, and they're very limiting with what you can post or what you can ask. And that's what really drew me to Circle and creating a community offline, and there were several reasons and that I'm sure you're familiar with this as well and probably have experienced it. One is I wanted to get people off of so traditional social media to limit those distractions and provide a place where they could come and truly be intentional and connect with like-minded people. And I think that was just really missing for me in a lot of the Facebook groups that I was in. So that's what really drew me to get offline, off of social media at least and to create a space where people could come together and to be able to make those connections and have more vulnerable conversations because I think there's a very valid concern if you're with a completely random group of strangers, and we've seen cases of this where people are taking screenshots, they're getting doxxed and some really bad things can happen there. So I think social media for obviously has some good attributes, but there's some negatives there, and I think that's where having a community space separate from traditional social media really allows people to be more vulnerable and to to make deeper connections and move things forward a lot better.
Lillian Liang Emlet: Yeah absolutely. And I think the reality is most of the communities are paid in some way. The reality is putting our money where our mouth is in want to actually learn and grow. We have memberships all the time. Gym memberships you subscribe to YouTube or TV, and, it's no different in that respect to be able to just have a small space where you're committed to whatever Again, butterflies, ShiftChange and medTHRIVE and our different ones, so.
Patrick O’Malley, MD: Yeah. And I think that's a very valid and important point is when I can't remember which movie it was about Facebook, but it's when the product is free, you are the product.
Lillian Liang Emlet: Yes.
Patrick O’Malley, MD: And when you've got a community that you actually have to take your credit card information and put it in, you're investing in yourself. You've got skin in the game, and you're much more likely to show up as opposed to a free Facebook group that, eh, it doesn't matter if I show up there or not. Doesn't matter. But if I'm investing in myself and I'm paying money to be part of this community, there's a higher likelihood of you actually engaging, being involved, contributing, and getting something out of it if you're personally invested in it.
Lillian Liang Emlet: Yep. And you've said before that ShiftChange and all of the things that you've done have never been about leaving medicine. And I know have this myth like, "Oh, why do you wanna have a side gig? Do you want to leave clinical work?" And what do you think is the difference in sort of the attitudes now about escaping clinical work you're unhappy with it something alongside it? 'Cause I think we also do not wanna attract people into the space where they're not really intentional about it. So the escapism versus... Could you elaborate a little bit about that?
Patrick O’Malley, MD: For 100%. Now, my story might be a little bit different. I was building something. So I started with this laceration course that I developed in 2021. And I can say that in the middle of a pandemic is not the best time to try to launch a new business. I was working full-time clinically. I was moonlighting in a very high acuity, very busy COVID dense hospital as well, while I was trying to build something. And that was a recipe for my own burnout, which it definitely contributed to. And then COVID faded a little bit. I went into a partnership with EB Medicine, and I did that because I knew what I didn't know. And the business side, the marketing, that's, those were some of my weaknesses, and I wanted to partner with somebody who would be able to fill in those gaps. So in 2022, we developed that partnership, and that's when things really started to turn around and to grow and thrive for my business. And during that time, I did navigate some burnout, and I worked with a certified coach Rob Orman, and then another one later named Lon Stroschein. And for me, my emergency medicine career had just simply run its course. And Rob had asked me two questions in one of the coaching calls that I had. And he said, "Patrick, does emergency medicine have anything left to offer you? And do you have anything left to offer emergency medicine?" And it did not take me long to answer those questions. And he just said, "Okay, well, maybe your work here is done." And that one, being able to utter the answers that I had for those questions I feel like I'm getting a little bit choked up right now. It took such a huge weight off of my shoulders, and it allowed me to be honest with myself, and probably for the first time in a long time. Now, Rob did help me navigate some burnout, and it allowed me to find some more joy in my career and navigate some of the issues that I was having. But fast-forward another two years, I was like, "You know what? This has been a wonderful career." I absolutely loved emergency medicine until I didn't, and that's okay. Just because we made a decision when we were in our early 20s or sometimes even in your teens to pursue a medical career, and then you choose a specialty, that doesn't mean that you have to do that for the entirety of your life. And just working with a coach, I think, was one of the most valuable experiences because it allowed me to navigate that process and to have those discussions and to realize that it's okay. We as individuals, we change. And at the age of 50, I'm not the same person that I was at 20. What I wanted back then is not what I want now. Family and young children and aging parents and just career aspirations can change. So my story may be a little bit different with that, but the last thing that I want to do is to encourage anyone to leave medicine because you can build alongside your clinical career. There are thousands of people who are doing it. I think that there are some things that you have to take into consideration if you are wanting to build something as you're working full-time clinically, but it's completely doable. But it does require intention and it requires self-awareness, and I believe working with someone to help you navigate this because it can be a recipe for burnout, and the last thing that you wanna do is to have this other thing that you're passionate about and that, that does bring you joy. You don't want that to add extra gasoline on the fire and burn you out even faster.
Lillian Liang Emlet: Yeah. It's really funny 'cause a lot of times the current popular narrative in clinical medicine and burnout is all about either the EMR or the insurance battles or the clinical things. And I can tell you also from my same burnout twice early in my career, it wasn't about those things. It was doing too much because I loved too much. And so yes, being a founder of the things that I'm a founder of I am highly at risk for doing the same as later without wisdom, except you're right.
Patrick O’Malley, MD: Right.
Lillian Liang Emlet: A coach really set you on the right path. And you would be surprised. I think a lot of people in healthcare would be surprised that there's a lot of burnout in the caregiving specialties chaplains, social worker advocacy, and also founders, entrepreneurs, tech. There is a lot of burnout there. And so we're not necessarily saying that it's, the grass is going to be greener. The grass is different.
Patrick O’Malley, MD: You took the words right out of my mouth, and I've been using that analogy a lot recently because I'll run into somebody, "Oh, hey, how's retirement?" And I just chuckle. I'm like, "Dude, there is nothing about retirement right now." That I'm working more now than I was when I was just working clinically. And the grass is not greener, it's just a different texture. It's a different shade of green, but you still have to water it, you still have to cut it, you still have to tend to that grass. Otherwise it's gonna get out of control or it's gonna die. So the grass is definitely not greener. It is simply a different texture, a different color. You still have to tend to that grass.
Lillian Liang Emlet: Yeah. And I think it's also really, what's also funny and interesting too is you complain about scut tasks when you're doing mundane work on the business side too, mundane things that happen also in the creative world. You and things like that. And there's things that may bring you more joy or less joy in any field or anything that you do. And so it really is about just well, I do think what's amazing is for most people don't really realize the fact we are physicians, and at any stage of the game, whether you're a medical student to where we are 20 years later you actually have a lot of transferable skills. You have many resiliency skills and ability to learn. And so anytime I start to get frustrated and I think about all the things I've learned in three years is like, well I can resuscitate someone, I can on ECMO. I'll be danged if, like, I'm gonna let this cons- get to... So whenever, I always take whenever some kind of tech issue.
Patrick O’Malley, MD: Yes. And passwords. I mean, there are so many things that are just like these little micro frustrations. And for me there were things about, you know, clinical emergency medicine that just irritated me, and it's like these the, the problems that you have to deal with all the time. But Just because you're escaping that doesn't mean you're not gonna be facing irritations, challenges, and problems that you're gonna have to solve. But like you said, the skill set that we have as physicians transfers very, very well over to the entrepreneurial space. Now, you still have to learn new technology, apps, programs how to connect with people, how to have business-oriented type conversations. So there's a new skill set that you're gonna have to learn, but after what you've been through in your medical career, this is very doable.
Lillian Liang Emlet: And it's fun. It's always fun to learn.
Patrick O’Malley, MD: It is.
Lillian Liang Emlet: And maybe that's what it is, just that we are just endlessly this is emerging as like we just are just, we keep wanting to find something else to so off we go. So speaking of learning, the laceration course was your first proof your expertise was worth something outside of the hospital or outside of your organization. And so what did building the course teach you that surprised you?
Patrick O’Malley, MD: That people are willing to pay me for my clinical expertise, and that me putting together an online course that teaches people very well how to manage lacerations and how to suture that's actually a monetizable product. And you had asked the question about mentors. I've never really had that many mentors. There have been further along, but I reached out to somebody who was a residency director, and I said, "Hey, this is... I've got this idea. This is something that I'm interested in doing." And he's like, "Dude, nobody's ever gonna buy a course on, on how to suture." I'm like, "Well, I think you're wrong." But it was somebody who I'd really admired, and I still do. And I don't have any ill will towards that. But it was almost like, I'm gonna prove them wrong. And it in fact is a very great way to be able to teach people. But I started pursuing other audiences. At first when I created it, my mind was solely in emergency medicine. And then when I started getting involved in the Urgent Care Association and the College of Urgent Care Medicine, that's when I really realized that, wow, this is the area that I need to be focusing on. Not emergency medicine residents and selling it to residency programs, but there's an entire industry here that really could benefit because it's 85% nurse practitioners and physician assistants who are working in the urgent care setting. So I really just kinda had to take my idea and just pivot and really find the audience that it would serve best. And at the end of the day, I'm able to and having that business was really the groundwork for me to be able to continue working clinically, generating revenue so that I could start giving up a few shifts. Every year I would like every month, I would just give up maybe one or two shifts so that I could have those days to be able to focus on the laceration course. And then eventually, when it was time for me to step away, I had something that was generating enough revenue that it was okay for me to make that step and make that transition away.
Lillian Liang Emlet: Yeah. And that's basically, I mean, I think what most people do. I think the reality, there's a book I can't remember who wrote it, but it's called Two Weeks Notice, it really is about you don't actually do that. It's just a play on words. You do a phased exit, and almost every person does a phased exit or do a combination, right? And so I think that's also why, at least with our company, Transforming Healthcare Coaching, we talk a lot about the and, that it's actually about being additive in your life. It's the opposite of everyone with the binary boundaries and saying no and dichotomy. It's actually not that. It's actually trying to add to your life in a intentional way so that you can find joy again, and everything then seems better. Because I'm sure just like you found also by having this other little nugget you were working on, you actually were more happy and tolerable doing your W2 regular clinical life. Because I it's so fascinating that by adding something else that fills your cup, it actually translates over into other parts.
Patrick O’Malley, MD: And I think especially for emergency medicine, and Rob Orman had done a webinar for ShiftChange, and I think Mel Herbert has talked about this as well. Just the unique stressors that we have in emergency medicine and critical care, the high acuity. I mean, it just, it, they're entities unto themselves. They're so unique within the healthcare ecosystem that it's important to have that plus one where you do have something that can divert your attention away from the I guess, abysmal healthcare system that we have to work in, and it gives you something to focus on. It allows you to express that creative side and give you a sense of ownership of something. So I think that over time we're going to evolve and see that maybe more people are still choosing emergency medicine, but maybe they're doing it as a 0.75 FTE, which frees up a little bit of their mental bandwidth to be able to work on something else. Or maybe we start normalizing the use of sabbaticals where maybe once a year you take four weeks off, or every other year you take a month or two months off, just so that you do have that time to be able to kinda decompress and focus on something else. But maybe we start just kinda normalizing, "Hey, yes, I'm an emergency physician, and I do this on the side." And it doesn't have to be some million-dollar tech company or a medical device, but maybe you do have some other entity that generates some revenue that you can build in parallel to your medical career.
Lillian Liang Emlet: I think given the fact there are so many burgeoning communities we had we've had other community m- members founders on this podcast. Given the fact there are so many burgeoning and growing, I do think the reality is not sure that the workforce really understands the degree that is looming in the next 10 years. It is gonna be a very different landscape for what people expect and want out of their and is they're to build it very intentionally much sooner, I because of all the things that are happening. So it's very exciting times, but the employers need to be thinking about this as well so that they can realize they're gonna be part of the job share. And as organizations and organized medicine, everybody really needs to think about, "How are we going to be the value add for your career?" And that, I mean that's any professional society, state medical societies local hospitals, and also all of our communities. We all work better together to figure out how are we gonna augment each other so that we learn and grow.
Patrick O’Malley, MD: Absolutely.
Lillian Liang Emlet: So if someone's listening right now who has no idea, and then they're like, "But this sounds really great, but I have never built anything. I want to join ShiftChange, but I'm really scared to join," what words of advice or what first steps should they take?
Patrick O’Malley, MD: So if you've got an idea and it's one of those things that kinda keeps you up at night you encounter and it doesn't even have to be a clinical problem, but whatever it is I think an, a very important first step is to write it down and have a, either a physical, like I I've got a note- a little s- 35-cent spiral-bound notebook from from Walmart, or a digital space, whether it's on Dropbox or Google Drive or whatever digital platform you, you prefer. But have some area where you can start putting these thoughts down and not just letting them live in between your ears. I think it's important to get it on paper and start working through it. What does this look like? What is the minimum viable product? What is it that I'm actually trying to create? And start working through it. Now fortunately with the advent of AI, you can use that as kind of your collaborative partner. It doesn't mean that you have to hire somebody to do that. You can start ideating and kinda running through what this might look like. Another thing is just having and protecting the time to be able to do this. And as busy shift workers, the circadian rhythm disruptions if you have a family and significant others and children it's difficult to to find the time. So I'm an advocate for and recommending that you just look at your calendar and you carve out, maybe it's one or two blocks of time every week so that you can actually run through this. You can start the brainstorming process and you can start to build this idea out. And then in regards to having a community and with ShiftChange the reason that I built this is because doing this alone sucks, and it's hard. It's isolating, and having others around you who understand this process is immensely helpful and beneficial. And that's really why I created ShiftChange was to bring the clinician entrepreneurs and select subject matter experts bringing them together almost in like a hyper-focused consolidated LinkedIn type of scenario where you do have the entrepreneurs and you've got the subject matter experts so that you can start making those connections and start collaborating. So if you do have that idea that you're working on I would love to just personally connect with you, and you can find me on LinkedIn, you can send me an email. I guess we can have my contact information on the on the show notes. But that's really what ShiftChange is for. And I will sometimes jokingly say as an emergency physician, we don't know how to do absolutely everything in medicine, but I know somebody who does, and that's exactly what the kind of the community that I'm trying to build there. I may not have all the answers on real estate or tech or AI or investing, angel investing, venture capital, but we've got people in there who are experts in those areas, and I just wanna connect you with them and really try to reduce the friction that is really inherent in this type of thing. Who do you contact? Who do you reach out to? Are they trusted? Have they been vetted? Has anybody ever worked with them? So instead of you just having to go out and cold email or connect with random people on LinkedIn, that's really what I'm trying to do, is find those people and bring them to you to help facilitate this process and get you in the mindset of making those connections and having those discussions.
Lillian Liang Emlet: Yeah, so I just, I'll just also put a plug in for ShiftChange, the fact that you really have created an advisory where there's people who have the subject matter expertise, but then you have the peer community for support, which every single entrepreneur really talks about the fact it's so lonely, especially where everyone starts a solopreneur. Everyone No one is a company, like, right away.
Patrick O’Malley, MD: Right.
Lillian Liang Emlet: I mean, even people who look like companies are still actually sometimes usually sole a person of one. Also have a bunch of coaches. So even within your help think through the c- the career transition all of the identity and all of our back skills and strengths kinda can augment into the entrepreneurial clinician life. And so you really have built like the, the ecosystem to be able to grow, especially for very like-minded specialties of hyper-acute, hyper-focused endlessly curious humans that we are in emergency medicine and critical care.
Patrick O’Malley, MD: I guess if you were to put a label on this audience, it would be go-getters, right? I mean, these are the people who were straight As in college, aced the MCAT high do well in medical school competitive residency programs. And so it- it's almost ingrained in us to be a go-getter and to put your head down, work harder. And what I'm really trying to to cultivate inside this community is the mindset of being a go-giver, and to reach out and connect with others, to have discussions on how you can add value to others. Because when you do end up creating your company, your product, and you start you're out in the world trying to sell it, leading with a go-giver mentality instead of just, "I need to pitch, I need to sell," it really does transform your life and the your approach to almost everything. So really just trying to grow that community where people are coming together and willing to collaborate and share ideas and share insights. And Lillian, I think we've all seen examples inside of the community of that very thing happening. And like you said with coaching, I wanted to have coaching as a very integral part of this community because coaching has made such a big impact on me, and that's why I invited you and several of the other certified coaches who are inside of the community. And so we've got, like, our weekly webinar series, which is free for anybody to join. But then we also have internal office hours, and those are oftentimes coaching based and coaching oriented that are being led by certified coaches. So it's really a great way for you to be able to get exposure, have conversations with some of these coaches, and then you can make the decision as to whether or not you want to work directly one-on-one with them. But I think that coaching and kudos to you, and thank you for what you do with coaching and being able to help colleagues navigate whatever issues it is that they're navigating. It's... Coaching is just such a, a powerful tool and one of my missions is to really help normalize coaching and really encourage more and more people to take advantage of it because of the massive benefits that it brings.
Lillian Liang Emlet: And coaches need coaches.
Patrick O’Malley, MD: Yes. Yes. Yeah, absolutely.
Lillian Liang Emlet: Yes. And so thank you so much for being on the show, Patrick, and,
Patrick O’Malley, MD: My pleasure.
Lillian Liang Emlet: About the opportunities and how to connect with you. And we'll leave all of these in the show notes below. And check out ShiftChange. And what is the website again?
Patrick O’Malley, MD: So the website is myshiftchange.com. So it's myshiftchange.com. We'll put in the show notes with the the free weekly webinar series. I spend probably most of my non-ShiftChange time on LinkedIn. That's my preferred social media platform, just because it really allows you to tell your story. So if anybody's interested, I would love to connect with you on LinkedIn. We're gonna have my email address in there as well. So if there's ever anything that I can do to help or support any of your audience who are listening please don't hesitate to reach out. That's really what my second half story is is based on.
Lillian Liang Emlet: Wonderful. And so for this, if this episode reached any of you that have been listening all the way to the nitty-gritty end, and you're wondering if there's more, please share with a colleague that, share with your friends, and come find us at Transforming Healthcare Coaching and find Patrick at myshiftchange.com. Thanks everyone for listening. Please email us at podcast@transforminghealthcarecoaching.com and tell us what you would like to listen to. What are your problems? What can we unpack? See you next time.
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Dr. Lillian Liang Emlet
Physician · Executive Coach · Founder, Transforming Healthcare Coaching®
Lillian is a practicing physician, certified executive coach, and the voice behind the Transforming Healthcare Coaching® podcast. She works with clinicians, clinical leaders, and healthcare executives leading through role transitions, seasons at capacity, and culture change — helping them lead with clarity, intention, and sustainability.
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