But, somewhere around 20 people you should have some excess time and money and choosing what not to do becomes just as important as what to do. Let's not do this manually, let's not build this in house, let's not piss off our customers, let's not stagnate, etc. At scale the minefield grows exponentially and it's not getting stuff done that's the core problem it's getting the right things done while not wasting resources.
Remember hiring people is easy, having them be a net gain is the hard part.
The CEO at my previous employer successfully took 3 companies to exit, each at around the 300 mark. Terrific starter and operator capable of making really tough calls (like saying no to ominous AAPL supplier terms despite the obvious upsides), but quite bad at delegating.
Still wondering many years later if there are any predictors for someone who can make this transition.