What I See in Clinic That Should Change How You Lead

I became a doctor because I wanted to care for children. I spent years in medical school, in residency at Children's Hospital of Michigan, and in practice building a patient panel of pediatric patients I love. I did not expect that the most consequential clinical observations of my career would come from the parents sitting in the chair next to the exam table.

But that is where they have come from.

Every week, I see parents who look exhausted in a way that goes beyond having young children. The children I can treat. The parents I am often watching unravel in slow motion. Chronic sleep deprivation that is not about the baby anymore. Weight gain that will not respond to anything they try. Hair that is thinning. Hands that shake slightly when they hold the patient intake form. Blood pressure numbers I would not expect in a thirty-five year old. Menstrual cycles that have gone irregular or stopped altogether. The adults I am seeing are not patients I can bill, but they are patients I am clinically assessing in real time, every single day.

What they tell me, when I ask, is almost always the same. Work has become unmanageable. Not any single thing. The accumulated weight of all of it. The volume of emails. The meetings that never stop. The sense that they cannot ever fully step away. The pressure to perform at a level that was once sustainable and is no longer. The fact that they are usually the one holding everything together at home as well, and the two systems are consuming the same finite physiological resource.

I started doing corporate work because I could not keep watching this and saying nothing to the people with the power to change the conditions producing it.

Here is what I want executives to understand. The patterns I see in clinic are not the exception. They are the baseline for a significant portion of your workforce, especially your highest performers. The people who are reporting to you, running your teams, carrying your most important accounts, are physiologically operating under conditions that would set off alarms in any clinical setting. The reason you are not hearing about it is not because it is not happening. It is because high-performing people have been trained to downplay it, override it, or hide it until they cannot anymore.

The specific clinical signs I would want you to understand are these. Elevated resting cortisol correlates with impaired executive function, which is the specific cognitive capacity you are paying your senior leaders to exercise. Disrupted sleep architecture degrades decision quality within days, not weeks. Chronic inflammation shortens the window of productive performance in any given day. Hormonal dysregulation in women at peak career stages produces mood volatility, cognitive fog, and physical symptoms that most workplace cultures penalize rather than accommodate. All of these are measurable. All of them are reversible under the right conditions. All of them are being produced, in many workplaces, by the way work is currently designed.

The implications for how you lead are specific. The way you structure meeting cadences matters clinically. The expectations you set about response times matter clinically. The visible behavior you model about rest, recovery, and boundaries matters clinically. The language you use when someone needs to step back matters clinically. These are not soft leadership choices. They are physiological inputs that are shaping the operating condition of your workforce every single day.

I did not plan to become the physician in the room for executives trying to solve this. But I am. And the reason I keep taking the stage, taking the corporate engagement, taking the strategy call, is that the people with the authority to change workplace conditions are often the ones most insulated from the clinical reality those conditions produce. If what I see in clinic every week could reach the people making those decisions, I believe many of those decisions would change.

That is the work I am trying to do.