What does it actually take for a high-performing clinical practice to step into research for the first time? In this episode, Zach Gobst sits down with Dr. John Mandeville, a leading oculoplastic surgeon at Ophthalmic Consultants of Boston, to trace his unexpected path from bench science and surgical practice back to clinical research and what he's learned in his first year running studies.Dr. Mandeville shares how a career spent treating Thyroid Eye Disease (TED) led him to seek out new treatment options when surgical approaches alone weren't enough, and how that curiosity brought him from enrolling a single patient to running eight or nine clinical trials in just twelve months. He reflects honestly on the steep regulatory learning curve, the importance of building the right team, the challenge of managing patient expectations and motivations, and what it really costs, financially and personally, to build a research program inside a busy private practice.His perspective on patient recruitment is especially candid: from understanding why some patients are eager to enroll, to knowing when to talk someone out of a trial entirely, Dr. Mandeville brings a grounded, empathetic lens to what is often treated as a purely logistical problem.