Every year, I celebrate and mourn when I officially left my primary care pediatric practice full of patients and parents that I loved to launch my non-profit, Teach a Kid to Fish.

May 31, 2008, was the last day of my practice. Had I known what I was in for, my future self may have stopped me. But I’m so delighted that possibility didn’t exist.

I’m a vision-oriented person and wanted to name the organization Teach a Kid to Fish, and You Can Change the World. Our mission was to reduce and prevent childhood obesity by empowering children and families to eat healthily and be active. I set it up to focus on four key areas: Health care. Early Childhood. School Systems. Community.

As the founder, it was just me, Google and the $15,000 my husband and I invested as seed money.

What I didn’t give myself credit for was my in-kind investment into the organization, which was priceless.

I still have the notebook I started with. I would meet with a person at the health department who would then tell me to meet with ten other people whom I would then meet.

Over the course of the first year, Teach a Kid to Fish had community and state and national grants (I became an excellent grant writer), an amazing and active board of directors, partnerships and launched a community strategic plan to prevent childhood obesity with community stakeholders. I still have the plan — and it’s epic.

Some people got the name Teach a Kid to Fish as the metaphor that it is. Others would ask, “Why fishing? It’s not that active of a sport?” Other people would go on and on about how much they love fishing, and I would listen and nod my head in agreement.

Others would tell me that I was going to cause harm and eating disorders. That was noted as a legitimate concern. My focus has always been on positive messaging such as 54321 Go!, created by CLOCC.

Just smile, move on and don’t over-explain when people don’t get what you’re doing. People who find relevance through cynicism are not your people.

So, what have I learned after all these years, and would I do it again?

Visionary physician tip #1: Never explain or convince people.

You will find your fellow visionaries, and when you do, you know right away. It’s magic.

Visionary physician tip #2: Community partnerships are key to the successful manifestation of your vision and are 100 percent based on trust.

If you are not a trustworthy human being — especially when it comes to partnering — you have nothing.

Teach a Kid to Fish partnerships, in the beginning, included our local health department, Lancaster County medical society, Lincoln Public Schools, Nebraska DHHS, Nebraska Medical Association, Malone Community Center, University of Nebraska-Lincoln Department of Psychology and pediatric practices, and Community Health Endowment of Lincoln.

Visionary physician tip #3: Love the problem, not your solution.

Physicians tend to be pretty ego-driven and think we know best. Sometimes we do. Sometimes we do not. I’ll use BMI or body mass index as a good example.

In 2007, the Expert Committee Recommendations for how a community pediatrician can assess, prevent and treat childhood obesity were published. I operationalized each of the bullet points throughout the Expert Committee Recommendations and found them to be helpful but incredibly solution- and BMI-focused.

In other words, be agile and flexible and learn with a continuous QI lens. In health care systems, there is almost zero ingenuity, especially in corporate profit-driven health care.

This can be very frustrating for the visionary physician who sees the needs of the patients and families but feels stuck slapping the same old profit-driven maintain C-suite executive salaries solution band-aids on gaping wounds. None of it is easy, but at least on a community level, the visionary physician can flex and change things up more easily.

Visionary physician tip #4: Determine your own measures of success.

Celebrate your wins and take breaks to restore your energy. It is very exhausting at times to take on all the roles you need to take on to carry out a non-profit mission. You will feel the total weight of the burden of sustainability on your shoulders. Community funders are good at this power play. Be willing to walk away.

Visionary physician tip #5: Get ready for other physicians to duplicate your work and peripheralize you.

Never worry. Stay with your vision and speak up when you need to.

Visionary physician tip #6: Community funders will keep moving the goal line on you.

Stay with your vision and do not jump through their hoops or chase their carrots. You will have to do some of this but try to strike a healthy balance by letting some opportunities for funding go.

Visionary physician tip #7: Stay out of founder’s syndrome.

Back to the ego part of being a physician and being so focused on our external achievements, I fell into the trap of carrying the weight of funding my staff positions at the cost of my own.

However you decide to operationalize your vision, whether through a non-profit or another means, you need an out. Most non-profits have a half-life of 8 to 10 years because of the way the funding paradigms are set up and limited community resources and all the needs in a community. Health care non-profits are especially difficult to fund.

Though I successfully created a strategic partnership with Children’s Hospital Omaha to launch the Center for the Child & Community, which I founded, led and funded with the assets of Teach a Kid to Fish, I failed at creating a sustainable community model that could be replicated.

Or did I?

I dissolved Teach a Kid to Fish as a non-profit in 2016 when I launched the Center for the Child & Community at Children’s and served as Medical Director for the Center until Sunday, September 29, 2019. That’s when I resigned, effective immediately, per my attorneys’ directive at 10:30 p.m, leaving nearly $500,000 of grant assets, community donations and my husband and I’s donations. I created all of it from scratch, from my vision, Creating Community Solutions for Children’s Health.

Karla Lester is a pediatrician, certified life and weight coach, and diplomate, American Board of Obesity Medicine. She is founder, IME Community, and can be reached on Twitter @DrKarlaA, TikTok, Instagram @ime_community, Facebook, and YouTube.

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