What happens when a world-class surgeon steps into the C-suite?

That’s the story of Dr. Leo Spector, CEO of OrthoCarolina, who takes us inside his remarkable journey from the operating room to the boardroom—revealing both the stark contrasts and surprising similarities between surgical precision and executive leadership.

For over 20 years, Dr. Spector performed complex spinal surgeries where decisive, command-and-control leadership was essential. But when he became CEO of one of the nation’s largest independent orthopedic practices, that same leadership style became a liability. In our conversation, he candidly shares how he had to unlearn ingrained habits, adopt new ones, and fundamentally reinvent himself to succeed as a leader.

This episode of The Dr. Doug Edge: Real Talk with Real Leaders is especially meaningful for me. Leo isn’t just a guest—he’s one of my closest friends. We went to college together, stood by each other at our weddings, and have stayed connected for more than 30 years. Watching his evolution from gifted surgeon to high-impact CEO has been both inspiring and deeply personal.
Leo’s core motivation remains unchanged: “Why I get up every morning to do what I do is very clear—it’s to care for patients.” For decades, he lived that purpose through the hands-on art of spinal surgery. Today, he fulfills it by leading OrthoCarolina with vision, empathy, and resolve.

We explore his philosophy on building teams, where he draws on lessons from competitive rowing: peak performance comes not from a few all-stars but from the perfect synchronization of the entire crew. And perhaps most powerfully, Leo reflects on one of his hardest leadership lessons—letting go of a C-suite executive. In that moment, he discovered the difference between being nice and being kind: “Sometimes you can’t be nice, but it’s always important to be kind.” It’s a profound insight, echoing what leadership coach Kim Scott calls Radical Candor: delivering direct feedback anchored in genuine care.

This conversation is filled with leadership gems, but more than that—it’s a glimpse into the mindset of a leader who continues to evolve, adapt, and inspire. I’m honored to share it, and I’m confident you’ll walk away with practical, actionable leadership lessons from my friend, Dr. Leo Spector.