i'm not sure how you arrived at the "surgeon model" being the "standard MBA solution".
my mba program emphasized that (1) effective teams can be built from a diverse variety of people and organized in many different ways, and (2) the effectiveness of the team rests on trust and honest communication between team members (technical skill is rarely the limiting factor of a team).
Being alpha geek and able to code well doesn't correlate at all with the kind of management and people skills required to run a team. There's a ton of Daily WTF as examples of team "leaders" who are great coders but cannot communicate at all.
The standard MBA solution for this situation is the "surgeon model" used by medical teams. The tech lead makes all the technical decisions, but there's a team leader or manager who makes all the leadership decisions, and does the "people stuff".
That "people stuff" totally includes firing team members who the technical lead doesn't like, for whatever reason.