Nathan Preheim realizes most people are probably thinking, “What the hell?” right now.

That’s because Preheim, co-founder and COO of MindMixer, arguably one of the region’s most successful startups, has stepped down.

His new gig? COO of Kugler Vision, an Omaha ophthalmology practice. He’ll be in charge of on-boarding patients, training new hires, optimizing work flow, marketing and sales.

“It’s an unconventional move for sure,” Preheim told SPN. “But there’s a ton of reasons why.”

He wasn’t willing to make the move to Kansas City when the startup picked up and left Omaha for the metro to the south. 

“I’ve had a long career path and my wife has been accommodating in the three moves we’ve made in California and Nebraska,” he said. “Our roots are deep here and I didn’t feel like it was right to ask her and our kids to move again.

“I thought I’d be able to go to KC every couple weeks, but that didn’t work. It wasn’t constructive, it wasn’t meaningful and I couldn’t do much from afar.”

The toughest part about leaving, he says, was knowing he’d put everything he could into MindMixer the past four years and then watched it take off as he left.

“When you have people buy into the idea, you assume you will be there for the rest of your life—and I had intentions of making it a lifelong thing, but I didn’t foresee the move and adapted the best I could.”

He sits on MindMixer’s board and remains a soundboard for co-founder Nick Bowden, whom he still sings praises about. He was driving back from a board meeting when Preheim called SPN on Monday.

“I’m still very invested in making sure that company is hugely successful,” he said.

So he’s stepping out of technology, but isn’t losing the entrepreneurial mindset. Lance Kugler’s practice is a progressive, forward-thinking group with big aspirations, he says. Kugler is a regular at Big Omaha, too, and penned a piece on the seemingly odd fit.

“We’re going to reinvent ophthalmology,” he said. “I like the challenge and I’m looking forward to applying my startup mentality and experience to disrupt health care with a serious bent on patient engagement.”

But he won’t miss the lifestyle, at least for a while. He said it’s been taxing on his family, his mind and body. Being in a startup, he said, is running a marathon over and over again—he wasn’t sure he wanted to jump back into it again. Innovating an already established practice seemed like a good fit.

Preheim isn’t ready to share his landscape-changing disruption, but said he’s excited for something different and the possibility of disrupting a traditionally, well, traditional field.

“I’m going to bring this startup mindset—iterating, testing, learning—into a stodgy, slow-moving and non-innovative industry like the medical field, and you just look at the possibilities of disrupting it,” he said. “There are people in the industry who think like that, but they are comfortable and stay put.”

Preheim described Kugler’s operation as a “blue ocean” venture, the kind of place that create an entirely new market, instead of trying to compete against others.

“Cirque du Soleil didn’t try to compete with Barnum & Bailey, they created a new circus experience,” Preheim said. “Lance’s practice is reinventing ophthalmology and eye care.”

Preheim also said he’s looking forward to giving back to the entrepreneurial community. He said it was a sad reality that he’s played a very small part of it in the past because he was so heads down.

“I really regret that,” he said. “I feel like I have a moral obligation to help others who want to do (the startup thing). There is nothing more powerful or impactful than starting your own business and I want everyone to try that because it is so rewarding, fulfilling.”

He hopes to be out in the community more, “growing the size of the choir” and making the community more approachable. 

“I don’t have a solution, but I want to be a part of finding those solutions.”