What if the single greatest unlock for scaling your company has nothing to do with strategy, and everything to do with how much you care?

In this gut-level conversation, Sivana Brewer sits down with Amit Shah, COO of Virta Health, a company on a mission to reverse metabolic disease in a billion people. They reveal the raw mechanics, hard decisions, and emotional realities of building a culture where real feedback, personal mission, and relentless impact actually drive bottom-line results. Expect stories that challenge your comfort zone, a blueprint for turning skeptics into true believers, and a rare glimpse into what makes teams (and COOs) last a decade or more through hyper-growth.

If you’re tired of surface-level advice and want the proven, exclusive tools to protect your culture (and your soul) as you scale, hit play now. The risk of mediocre leadership has never been higher, and these lessons simply can’t wait.

Timestamped Highlights

[00:00] – The rebel truth about why people don’t care what you know until something shocking happens

[00:03:23] – Inside Virta’s billion-person mission and the radical evidence that built unwavering belief

[00:06:57] – The jeans, Disneyland, and moment a clinical trial changed thousands of lives

[00:13:17] – The single conversation that blew away a hardened healthcare skeptic

[00:17:13] – Why LIVE patient stories kick off every company meeting and what that does to culture

[00:21:24] – How Virta built a team that actually sticks (and outgrows their own roles)

[00:25:41] – When your job changes every 12 months: The hidden playbook for surviving hyper-growth

[00:33:24] – The care vs. candor tightrope—how to love your team while pushing for relentless results

About the Guest

Amit Shah is the Chief Operating Officer of Virta Health, where he leads growth, product development, and patient care delivery for a hyper-growth company that’s transforming metabolic disease care. With a track record spanning executive roles at Paladina Health, McKinsey, and Amazon, plus roots as a mission-driven entrepreneur, Amit is known for building high-performance teams that scale with heart and precision.

🔗 LinkedIn | Website

Mentioned Resources

About the Co-Host

Sivana Brewer is a Fractional COO for Remote Teams and former COO at Closers.io, where she helped scale the company to multiple eight figures and built over 500+ sales teams in just 2.5 years. She specializes in leadership development, remote operations, and systems that empower teams to grow sustainably.

🔗 Connect with Sivana on LinkedIn

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The Second in Command Podcast is an original production hosted by Cameron Herold. Brought to you by COO Alliance. Production and editing by Podcast Your Brand.

Ep. 566 - Virta Health COO Amit Shah - Exclusive Lessons from Scaling a Mission-Obsessed Team

Second in Command: The Chief Behind the Chief with Cameron Herold