Header Logo
Meet the coach Testimonials Blog
← Back to all posts

Story and Reflection: Foundations First

by Dr. Tonya Caylor
Jun 12, 2025

You know my husband and I have taken on quite a few renovation projects over the years. Back in medical school and residency, we bought an old historic home in a neighborhood filled with beautifully restored houses. Of course, we could only afford the fixer-upper.

It was built on piers and had plaster walls. The very first thing my husband tackled? Shoring up and leveling the foundation. No matter how beautiful a home looks, a failing foundation will eventually bring everything down. And if you wait to fix the foundation until after you've repaired the plaster, installed new flooring, or put on a new roof—well, you're just asking for unnecessary damage to the things you just finished.

It took 7 years for us to complete but it turned out really nice.

That principle holds true in so many areas of life and work.

In 2003, I joined about nine others in laying the foundation for a faith-based indigent care clinic in our community. At the time, 1 in 5 people were falling through the cracks—unable to afford insurance because of the nature of their work - part-time school lunch ladies, solo home-care workers, independent handymen. But who didn't qualify for Medicare or Medicaid. We networked, planned, and built a place where volunteers—social workers, pharmacists, providers, and program assistance teams—could come together to serve.

When we moved to Alaska in 2007, the clinic had grown to about six providers, a handful of nurses, encouragers, community assistance workers, a pharmacist, a med tech, and a front office team.

I just received a newsletter from them this past week, and the numbers in 2024 are staggering:

  • New patients this year: 1,677
  • Total patient visits: 14,819
  • Total volunteers: 390
  • Licensed healthcare providers: 180
  • Service in $ value given to the community: $1.5 million
  • Value of prescription meds provided: $4.36 million

Incredible. (There's also a lesson in there about how others may take things to the next level when you pass it off!)

And now? I'm once again working with nine other individuals—this time on expanding GME in Alaska. We’re laying the groundwork for a statewide GME Council, a coordinated effort to sustainably increase residency slots, enhance specialty options, and strengthen the physician pipeline. The ten of us are focused on building the foundation, and we hope to launch the Council this fall. I'm optimistic about its great impact for all Alaskans long into the future.

Foundation work takes time. It’s roll-up-your-sleeves effort-heavy. It requires patience. It can be messy. But with a fantastic team and a clear mission, it’s exhilarating.

Reflection Question for You:

What area of your life or work needs foundational attention before you build something new, better, or bigger?

Responses

Join the conversation
t("newsletters.loading")
Loading...
Mise en Place for the Mind
One of my coachees recently identified the missing link in his project workflow. (Thanks for the metaphor, Michael Caçoilo! - shared with permission.) He had developed the right structure for him: breaking big tasks into smaller chunks and blocking time to get them done. But something still felt off. When he sat down to start, he’d often find himself gathering resources, opening documents, or w...
Lessons in the Messy Middle Reflection
“Celebrate the abundance within troubles.” – Will Miller, MD, Annals of Family Medicine, 2010 📸 Thanks to Jay Fetter for the reminder and this powerful slide in Atlanta last week where the year long STFM CBME pilot project wrapped up. The CBME pilot participants showed us what it looks like to lead through the mess. They navigated growing pains, limited time and faculty, skeptical colleagues an...
Keep Digging (And Savor the Moments Along the Way)
Dinner was beautiful. A nice evening, bold flavors, shared stories of challenge & success, and laughter with friends who are in simlar trenches. The meal came with this quote came tucked in tableware: “Work. Keep digging your well. Water is there somewhere.” It stayed with me—not just because it was wise, but because it met me in a season that’s been full of effort. Of showing up. Of planting ...

Joy in Family Medicine – Stories & Reflections

Lessons, lightbulb moments, and honest reflections from life inside and outside medicine - served with a side of perspective.
Footer Logo
Terms Privacy Disclaimer Contact us Login
Powered by Kajabi

Stay Connected


Join my mailing list to receive free weekly tips and insights!