You Can’t Scale a People-Based Business by Burning Through People. Here’s a Better Strategy

Burnout is often framed as a workload problem. But in high-performing organizations — especially those that are people-based — that’s rarely the full story. I’m seeing this play out daily in veterinary medicine.

One vet I recently spoke to was seeing 20-plus patients a day, and the mission that drew her to the field had been buried under performance targets. She walked away for one simple reason: everyone she worked with was unhappy.

In vet medicine, it’s been a perfect storm: a shortage of skilled professionals, growing patient demands and emotionally intense work are pushing teams to their limits. The broader economic environment (rising costs and pressure to expand services and revenues) has only added to the strain.

Of course, vets aren’t unique in this. Across industries, growth targets have become disconnected from operational realities, and the people doing the work are paying the price.

The problem is growth without guardrails

U.S. workforce burnout has reached a seven-year high, with nearly three in four employees reporting moderate to very high stress at work. A do-more-with-less culture has taken hold across industries, often accelerated by the drive to prioritize short-term financial performance and show continuous growth.

Don’t get me wrong, businesses need healthy growth, but how you define ‘healthy’ can mean the difference between a genuinely productive environment and one that drives people away.

For me, it doesn’t mean extracting every ounce of possible profit, and groups that operate that way are playing a very short game. To grow people-based businesses, you need a team that is willing and able to do the work.

The key question for leaders is: how do you grow without completely frying staff in the process? In my experience, here’s what works:

Actively surfacing and reducing workplace agitators

One of the most effective shifts leaders can make is also one of the simplest: ask employees for input — and let that feedback genuinely inform your policies and procedures.

At my company, that means engagement surveys twice a year, and this year the feedback was clear: our benefits package wasn’t meeting people’s needs.

In response, we added mental health benefits, improved pet care discounts and negotiated down healthcare premiums for most of the team. We also launched a profit-sharing structure: if the team hits its goals, everyone shares in the gains.

Many of the issues surfaced in our surveys are what I call workplace agitators: small, persistent frustrations that compound over time, contribute to burnout and make it feel like leaders are out of touch. Paying attention to these agitators is important — when employees feel their leaders are truly listening, they’re 12 times more likely to recommend the organization as a great place to work.

Of course, most leaders aren’t deliberately ignoring frustrations; they’re simply focused on larger challenges. But when friction points go unaddressed, it starts to feel like indifference. And a broad belief that management is indifferent to employees’ challenges is a much harder problem to fix than a subpar benefits package.

Leveraging engagement to buffer burnout

I was at one of our hospitals recently when a veterinarian came in on her day off to see a long-time patient: a chihuahua with a recurring issue.

She held the little dog throughout the examination while taking the time to reassure its worried owner. It was clear she cared deeply about both of them, and that willingness to go above and beyond reflected a profound sense of responsibility and purpose.

That level of commitment isn’t something you can manufacture with a policy or a revamped benefits package. It grows out of meaningful work and a workplace where people feel seen, supported and valued.

When work feels purely transactional, especially in demanding sectors, strain can build fast. However, employees who understand how their role contributes to a larger purpose — in our case, providing next-level care — are far more willing to navigate demanding workloads and long days than those who simply move from task to task.

Creating that sense of purpose and belonging is one of leadership’s most important responsibilities. And it starts with managers who invest the time to know their people as individuals. Leaders ultimately create the climate their teams work in every day, and that climate has a profound impact on whether people feel energized (or depleted) by their work.

Engagement does not eliminate burnout, but it can create a powerful buffer. Only 13% of employees with a strong sense of work purpose report feeling burned out frequently, compared with 38% of those with a low sense of purpose.

In people-based businesses under real pressure, that buffer is often the difference between a team that stays and one that walks away.

Setting realistic goals for growth

There’s a tendency in many industries to treat unused capacity as inefficiency. Teams are pressured to produce more, deliver faster results, and optimize resources more effectively — especially now that many companies are implementing AI for efficiency and growth.

But at a certain point, running lean equates to running on fumes.

I’d rather grow intentionally with an effective team than fast with a broken one. For instance, I believe volume targets should be set so teams can actually achieve them — hitting realistic goals builds momentum and makes people feel empowered. Missing inflated and unrealistic ones, meanwhile, breeds cynicism.

The good news for us: we are growing — but crucially, we’re finding that our employee satisfaction scores are improving as well. That tells me our approach is sustainable.

The need to grow isn’t going away, and neither is the pressure. But that tension doesn’t have to be resolved at the expense of the people doing the work.

Someone once described veterinary medicine to me as one patient and three hearts — the animal’s, the doctor’s and the owner’s. To me, that framing applies to all people-based businesses.

The work is relational, not transactional. And you can’t scale relational work by burning through the people doing it. The organizations that respect this truth are the ones capable of sustaining high performance over the long term. That starts with a simple leadership choice: deciding that your people aren’t just the means to growth — they’re the reason it’s possible at all.

Burnout is often framed as a workload problem. But in high-performing organizations — especially those that are people-based — that’s rarely the full story. I’m seeing this play out daily in veterinary medicine.

One vet I recently spoke to was seeing 20-plus patients a day, and the mission that drew her to the field had been buried under performance targets. She walked away for one simple reason: everyone she worked with was unhappy.

In vet medicine, it’s been a perfect storm: a shortage of skilled professionals, growing patient demands and emotionally intense work are pushing teams to their limits. The broader economic environment (rising costs and pressure to expand services and revenues) has only added to the strain.