Leadership Culture Change: A Case Study in Scaling Smarter

Organizational change is rarely easy — especially in high-growth medtech companies where rapid scaling can lead to misalignment, inefficiency, and decision-making bottlenecks. Without a clear framework, leadership culture change can feel like an uphill battle.

At LSI USA ’24, Todd Powell, President and CEO of RefleXion Medical, and Ed Muzio, President and CEO of Group Harmonics, took the stage to discuss a real-time case study of culture transformation at RefleXion Medical. Their conversation highlighted the importance of a structured problem-solving methodology — one that ensures alignment, accelerates decision-making, and creates a system that gets faster as a company grows.

The Challenge: Scaling Without Chaos

RefleXion Medical, a company pioneering a novel radiation therapy for cancer treatment, has grown significantly since its early days as a two-person startup. With over $650 million raised and a transition into commercial treatments, Powell recognized the need for structured decision-making before organizational complexity took hold.

“It was clear that if we did not embrace a proactive, deliberate management methodology, one would form organically — but it would be a chaotic mix of well-intentioned but inconsistent approaches,” said Powell.

His concern was common in fast-scaling companies: as teams grow, decision-making slows down instead of accelerating. “If we didn’t implement a strategy early on, we would get bogged down in inefficiency,” he added.

Enter Ed Muzio, a management methodology expert known for helping organizations scale faster by making decisions smarter.

Leadership Culture Change: Building a System That Moves Faster

Muzio’s approach focuses on creating decision-making systems that keep organizations agile — even as they scale.

“I’ve spent my career studying how to make companies move faster, not slower, as they grow,” Muzio explained. “Most organizations hit a point — somewhere between 25 and 50 employees — where decision-making shifts from fast and flexible to bureaucratic and fragmented. That’s when leadership culture change is needed.”

This blog is originally published here: https://www.lsiusasummit.com/news/leadership-culture-change-a-case-study-in-scaling-smarter