A recent survey by the Lean Enterprise Institute (LEI) finds that most middle managers are still selling Lean programs as a way to cut costs. When those cost savings don't magically appear in short order, senior management often pulls the plug on the programs, a state of affairs familiar to many pharma companies. Bill Swichtenberg analyzed the report and chatted with LEI Director Chet Marchwinski recently. For more, read on. The key may lie in handling performance reviews for these middle managers quite differently.