Growth Health Diagnostic
"I'm growing but something feels wrong"
A growth health scorecard identifying whether growth is healthy or pathological, which specific dimensions are failing, and what interventions are needed — with urgency classification from 'monitoring' to 'emergency intervention required.'
When to use this
When revenue is growing but operations feel strained. When headcount is doubling but output is flat. When the team feels burned out despite hitting targets. When investors are celebrating but employees are leaving. When you sense something is wrong but cannot articulate what. Run quarterly as a comprehensive growth health check.
The process
Growth Plate Concentration Check
30-45 minutesQuestions to answer
How to do this
What you'll need
- Complete list of growth initiatives with resource allocation
- Budget breakdown by initiative
- Headcount by growth initiative
- History of killed or paused projects
What you'll have when done
- Growth plate map with concentration ratio
- Stem cell flexibility score (people, capital, product)
- Contact inhibition assessment: Can you stop failing growth?
- Explicit trade-off documentation: what are you starving to feed growth?
Operating Temperature Reading
20-30 minutesQuestions to answer
How to do this
What you'll need
- Financial metrics: burn rate, revenue growth, CAC, LTV, runway
- HR metrics: hiring velocity, time-to-fill, turnover rate
- Product metrics: release velocity, incident rate, bug count
- Customer metrics: churn rate, NPS trend
What you'll have when done
- Temperature score (1.0-5.0) with interpretation
- Individual indicator scores identifying specific hot/cold spots
- Action trigger: warming needed / maintain / cooling needed / emergency
- Trend analysis: is temperature rising, stable, or falling?
Root-to-Shoot Ratio Assessment
45-60 minutesQuestions to answer
How to do this
What you'll need
- 12-month spending breakdown by category
- Critical relationship inventory with depth assessment
- Documentation audit of top 5 processes
- Competitive moat assessment
- Employee values survey (10 random employees)
What you'll have when done
- Root-to-shoot ratio with stage-appropriate benchmark
- Root Strength Index (0-100) across five categories
- Gap analysis: which root categories need investment?
- Reallocation recommendations for next quarter
Scaling Trajectory Analysis
30-45 minutesQuestions to answer
How to do this
What you'll need
- Revenue and headcount at two or more historical points
- Meeting hours per employee at different company sizes
- Feature/innovation output at different sizes
- Decision cycle time at different sizes
What you'll have when done
- Scaling exponents for revenue, coordination, and innovation
- Current scaling inflection point diagnosis
- Classification of each property: favorable / neutral / unfavorable scaling
- Structural recommendations to improve scaling trajectories
Growth Wall Identification
30-45 minutesQuestions to answer
How to do this
What you'll need
- Decision velocity metrics (time from proposal to execution)
- Meeting load data
- Product output per engineer trend
- Market share and CAC/LTV trends
- Revenue age analysis (% from recent vs legacy products)
What you'll have when done
- Primary wall identified: Structural / Metabolic / Competitive / Senescence
- Supporting evidence for diagnosis
- Misdiagnosis risks: what would happen if you treated the wrong wall?
- Intervention recommendation matched to wall type
Growth Health Synthesis and Prescription
30 minutesQuestions to answer
How to do this
What you'll need
- All outputs from Steps 1-5
- Leadership team assessment and alignment
What you'll have when done
- Unified growth health diagnosis: Healthy / Strained / Pathological / Failing
- Priority intervention list (maximum 3 items)
- 90-day action plan with specific metrics to track
- Next quarterly diagnostic date
- Escalation criteria: what would trigger emergency reassessment?
Why this works — the biology
Coast redwoods grow to over 100 meters — the tallest organisms on Earth — through an architecture that maintains health at every stage of growth. Their root systems spread laterally up to 30 meters, intertwining with neighboring redwoods to create a shared support network. Their bark thickens to 30 centimeters, providing fire resistance. Their vascular system uses a combination of capillary action, root pressure, and transpiration pull to move water against gravity to the highest branches. At every scale, the support infrastructure matches the visible growth — the ratio of root mass to canopy mass stays within biological limits. When redwoods grow too fast relative to their root system (as in plantation conditions with heavy fertilization), they become top-heavy and vulnerable to wind throw. The metabolic scaling component draws from Geoffrey West's research: organisms scale their metabolic infrastructure according to predictable power laws. An elephant's heart beats slower than a mouse's heart because metabolic rate scales as body mass raised to the three-quarter power — the organism's operating temperature is regulated by its scaling architecture, not by running faster on the same infrastructure. Organizations that double headcount but keep the same coordination infrastructure are an elephant trying to run on a mouse's heart. The contact inhibition component draws from cancer biology: normal cells stop dividing when they contact neighboring cells. Cancer cells lose this inhibition and grow without stopping signals. Organizations that cannot kill failing projects have lost contact inhibition — growth continues regardless of whether it creates value.
See it in action: wework
WeWork is the definitive case study in pathological growth — growth that looked impressive on every visible metric while the invisible infrastructure was collapsing. A growth health diagnostic run at any point from 2016-2019 would have identified every failure mode. Growth plate concentration: severely diffuse. WeWork was simultaneously expanding into new cities, launching WeLive (apartments), WeGrow (schools), Powered by We (software), and acquiring companies like Meetup and Conductor. Growth plates were scattered across real estate, education, software, and community — with no single initiative achieving critical mass before resources flowed to the next. Stem cell reserves were near zero — every dollar was committed before it arrived. Operating temperature: above 4.5 consistently. Burn rate exceeded revenue growth every quarter. Hiring velocity was unsustainable (headcount grew from 1,000 to 12,500 in three years). Infrastructure incidents (lease renegotiations, construction delays, operational chaos) were mounting. Customer churn was masked by aggressive new acquisition. Root-to-shoot ratio: approximately 95/5 in favor of shoots. Almost all spending went to visible expansion (new locations, marketing, acquisitions) while investment in operational systems, documentation, process maturity, and cultural infrastructure was negligible. The root system could not support the canopy. Scaling trajectories: coordination costs scaling superlinearly (every new city required HQ involvement), revenue per location declining (later locations performed worse than earlier ones), decision-making concentrated in a single individual (Adam Neumann) creating a bottleneck that worsened with scale. Growth wall: primarily metabolic (could not process resources efficiently enough) combined with structural (organizational architecture was CEO-dependent, not systems-dependent). The IPO filing revealed what the diagnostic would have caught years earlier: growth without proportional infrastructure is a tumor, not a tree.
Adapt to your context
seed stage
Monday Morning Audit format is your primary tool — 90 minutes covering all five seedling survival factors. Root-to-shoot ratio should be 70/30 (mostly growth). Operating temperature can run hot (3.5-4.0) because speed matters more than efficiency. Growth wall identification is premature — you have not hit walls yet.
growth stage
Full diagnostic is essential. This is where most pathological growth begins — the transition from 50 to 500 people. Root-to-shoot ratio should be approaching 50/50. Operating temperature should settle to 2.5-3.5. Scaling trajectory analysis becomes critical as you pass Dunbar's number. Growth wall identification helps prevent the 'throw more people at it' mistake.
scale stage
Scaling laws diagnostic and growth wall identification are primary. Root-to-shoot ratio should favor roots (40/60). Operating temperature should be tightly controlled (2.5-3.0). Contact inhibition is critical — large organizations lose the ability to stop failing initiatives.
post crisis
Run the full diagnostic but weight operating temperature and root strength heavily. After a crisis, the temptation is to resume growth immediately, but roots may have been damaged. Ensure root strength has recovered before redirecting resources to shoots.
acquisitive growth
Growth plate concentration check is essential after every acquisition. Acquisitions often create diffuse growth — multiple uncoordinated growth plates that compete for resources. The root-to-shoot ratio typically worsens because acquisitions add shoots without proportional root investment.