"The art world has changed out of all recognition in the last twenty years." These are the opening words of a book I stumbled upon at the makeshift bookstore in a low-budget art gallery in Amsterdam not long ago. The Murmuring of the Artistic Multitude: Global Art, Politics and Post-Fordism, by cultural sociologist Pascal Gielen, attracted my gaze because of the term Fordism, but also because we have all heard the same assertion about the transformation of medical care in the last 20 years. Might this tome address some relationship between art and production science? Indeed, post-Fordism is a work ecosystem that selects for people and jobs exhibiting communication skills, eloquence, creativity and authenticity, temporary projects, and flexible work hours-not the Ford assembly-line shift work. Post-Fordism is also called "Toyotism." I was on vacation, squired around various art galleries and museums in Amsterdam, Florence, and Bologna by my good friend Geir, a modern art museum curator. My son warned me that this would be an "artsy-fartsy" journey. Instead, this foray into modern art stimulated intrusive thoughts about our work in medical care. Through the Murmuring book and our cobblestone walks, I learned that modern art is a social laboratory, promoting change from the fringes of the art world-experiments to see which new art forms can provoke thought in our multitude. Modern artists like Geir seek to unsettle us with videos and images of things of beauty or ugliness or injustice to provoke empathy, outrage, compassion, or action. Surprisingly, this sociology book describes a multitude of people at work in systems that are burning them out, a definite parallel to contemporary medical "production." Flexibility, language, communication, and affective relationships are increasingly required on everyone's "shop floor." We work in "immaterial labor" in sociologic terms. We do not make a material product with our nervous systems and hands. Increasingly we take work home, tethered to our software, creating a hybrid sphere of private and work lives. The work ecosystem becomes oppressive, a constant introspective journey of inventiveness, so busy that we can't find the next creative idea hidden in our brains. The sociologists of art see a multitude of workers murmuring about burnout. Sound familiar? We lean practitioners have a lot to offer in this ecosystem. We see medical care as a social laboratory in which we use our method to tap our "multitude's" creativity, finding countermeasures to burnout and mediocre medical care. Lean's fundamentals yield countermeasures to overly complex and cluttered processes that rob us of our joy in work. We liberate creativity in our client teams. We value curiosity and hopeful opportunism. We test new hypotheses with PDCA (plan-do-check-act, a cyclical four-phase application of the scientific method). No wonder our clients tell us we give them hope. We find ways to banish their loneliness in the murmuring multitude of medical teams. Like modern artists, we provoke innovation, empathy, and relentless improvement.
