One of the most persistent myths I've encountered over the years goes something like this:
“Well, of course they can do Lean… they're Japanese.”
I've heard that said in healthcare and manufacturing alike. And honestly? It's a cop-out. It reflects a mindset that lets us off the hook rather than asking, “What would it take for us to do this here?”
In a recent podcast conversation with my friend and collaborator Dave Fitzpatrick, we talked about this very topic. Dave shared what many of our Japan study tour participants say after the trip:
“Before coming, I thought Lean worked because it's Japan. But now I know–we can do this too.”
That shift in perspective is one of the most rewarding outcomes from our time with leaders in Japan. The real takeaway isn't that success is cultural or genetic. It's intentional.
After six visits to Japan over the years, including both manufacturing plants and hospitals, I've come to believe this more strongly than ever:
Lean works in Japan not because of who they are–but because of what they do.
Even Toyota Wasn't “Born Lean”
During one of my earlier visits to Japan, I toured Toyota's Takaoka Plant–a facility where they build Corollas. Like many others, I expected to see flawless execution and high efficiency. I did. But what stood out even more was what made that performance possible.
At Toyota, workers pull the andon cord any time they see a problem or even suspect one. This triggers lights, sounds, and an immediate response from a team leader. It's an impressive system. But the backstory is even more instructive.
Our Kaizen Institute guide, Brad Schmidt, explained that speaking up doesn't come naturally in Japanese culture. There's a strong cultural pull toward harmony–toward not “rocking the boat.” In many cases, people might be more inclined to quietly work around a problem than to openly surface it.
That was a huge “a-ha” moment.
The system exists precisely because the behavior doesn't come naturally. Toyota didn't count on culture–they shaped it. They built tools, habits, and leadership systems to make speaking up safe, expected, and effective.
If you think Lean is “easier” in Japan because of culture, you're missing the point. If anything, it shows that no culture has a monopoly on improvement–but every organization can build the systems to support it. Toyota has done that exact same thing in their plants in the U.S. and around the world.
Hospitals in Japan Made the Same Choice
When I first visited Japanese hospitals in 2012, I saw a different but equally powerful version of sustained Lean thinking. These weren't organizations dabbling in tools–they had built cultures that engaged people in improvement daily.
Many had been running quality circles and TQM-style projects for 25 years or more. But here's what's important: that consistency wasn't the result of tradition–it was the result of leadership. These hospitals didn't inherit Lean. They chose it. They stuck with it. And they evolved it.
In fact, many hospitals we visit now are shifting toward more ongoing Kaizen-style engagement. They've realized that doing one or two large projects per year isn't enough. So they're involving staff more frequently and more broadly. That's not automatic. That's intentional.
It's Not Nationality–It's Psychological Safety
What really underpins the success we see in Japan? It's not nationality. It's not hierarchy. It's not discipline. It's a high degrees of psychological safety.
At the best sites we visit–whether it's a car manufacturer or a community hospital–we see people speaking up. Suggesting changes. Sharing what didn't work. And improving together.
That environment doesn't happen automatically. It's cultivated. Leaders create the space where people feel safe to raise concerns and confident that their ideas will be heard.
In too many organizations in the U.S. and elsewhere, fear and futility are the enemies of improvement. People stay silent because they're afraid of being blamed–or because they believe nothing will change anyway. Overcoming that isn't about copying Japanese culture. It's about changing our own.
Learning With Japan, Not From Japan
When we bring healthcare leaders on our Lean Healthcare Accelerator experiences–together with my colleague Dave Fitzpatrick and our translator and partner Reiko Kano–we're not just touring factories. We're engaging with peers. We're asking questions. We're reflecting deeply.
These trips are not about collecting tools. They're about building understanding. They're about returning home with sharper questions, not just neater notebooks. Every time, leaders tell us:
“This isn't about being Japanese. It's about being intentional.”
And that's exactly right.
The Takeaway
So the next time you hear someone say, “Lean only works in Japan,” consider this:
- It doesn't come naturally to them either.
- They've built systems that make it easier.
- They've committed to improvement for the long term.
- And we can too.
Let's stop using culture as a reason Lean won't work–and start using it as a reason to lead better.
Want to Experience This Firsthand?
Join us on an upcoming Lean Healthcare Accelerator trip in Japan. We go beyond sightseeing to help you explore what Lean looks and feels like when it's woven into the culture–and what it takes to bring that back home.
Learn more at JapanLeanTrip.com
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Let’s work together to build a culture of continuous improvement and psychological safety. If you're a leader looking to create lasting change—not just projects—I help organizations:
- Engage people at all levels in sustainable improvement
- Shift from fear of mistakes to learning from them
- Apply Lean thinking in practical, people-centered ways
Interested in coaching or a keynote talk? Let’s start a conversation.
