Latest Insights

In my experience, I've seen what heroics looks like in enough companies to recognize the pattern early.

Recently, we've talked about the "human middleware" problem, which brings attention to when people become the logic layer between broken systems. Something else that gets overlooked, believe it or not, is that leadership creates this. Not intentionally, but you may have seen this before. We do it every time we celebrate someone for staying late, for answering messages at 9 PM, for being the person who "always saves the day." We say, "We couldn't do this without you." And we mean it as a compliment. But what if that's the problem?

If you've been following my posts on operational scaling, you know I've been digging into the 'human middleware' trap. Here's the other side of that story. The person who makes impossible integrations look easy is your biggest operational risk.

When headcount grows at the same rate as patient volume, you don't have a scaling problem. You have a Human Middleware problem. Here's what that means and why it matters.

Why scaling with AI before stabilizing human mastery is the ultimate operational debt

Why founder-led healthcare services companies feel growing operational drag as revenue scales, and how stabilizing systems restores clarity, execution, and leadership confidence.