In this episode, I sit down with Dr. Leo Spector, practicing surgeon and CEO of OrthoCarolina, to talk about what happens when physicians step into real leadership. Dr. Spector shares his path from the OR to the executive seat, why he pursued an MBA, and what it feels like to learn administration the same way we learn medicine: through a kind of internship and residency in real time.

We get into the hard parts quickly: how to invite younger physicians into leadership when they don’t want “extra stuff,” how to engage smart people without chasing consensus, and how to make decisions that half the room may dislike. Dr. Spector lays out a simple anchor that keeps him steady: please the purpose, not the people. We also unpack why good leaders protect the decision-making process—clear problem definition, real input, transparent criteria—because outcomes can get hit by factors you can’t control, but a strong process is repeatable.

Dr. Spector also talks candidly about ego, people-pleasing, and the need for thicker skin. We explore what a real apology looks like (no rationalizing, no defense), how trust is built with peers who can match you step for step, and why emotional intelligence is not “soft”, it’s the foundation for self-awareness, reading the room, and leading humans who bring their whole lives to work.

Finally, we address a real tension in healthcare today: the OR demands command mode at times, but people can still feel unsafe. Dr. Spector offers practical guidance on how surgeons lead firmly for the patient in the moment and then circle back after to check in, reset, and keep the team intact.

Subscribe to Karl’s Leadership Writing.

👉 Who is Karl Pister?
👉 Follow us on LinkedIn.
👉 Have access to leadership materials that will level up your game.
👉 Contact us on our website.
👉 Subscribe to Karl's YouTube channel.

Ready to level up your leadership skills? Sign up for The Coaching Group's leadership courses.