Every quarter of high-output performance extracts a biological cost. That cost is not recorded on any balance sheet, not visible in any blood panel, and not addressed by any business tool currently in use. Biological Business Design exists to measure it and work with it directly. The person and the business treated as one system, because they are.
Most business tools intervene at Strategy or Execution, Steps 3, 4, and 5 of the causal chain. They leave the decision quality and the biology underneath untouched. This is why they produce temporary relief. The intervention addresses the symptom. The cause continues accumulating underneath it.