An importance emphasis in lean is a focus on the customer.  Dev Patnaik has released a book called "Wired to Care: How Companies Prosper When They Create Widespread Empathy" (web site, book).  I’ve just read one of the sample chapters online (introduction), and in that section highlights how the bigger an organization gets, the more difficult it becomes to maintain the focus on customer empathy:

Simply put, we’re wired to care. We rely on those instincts to help us make better decisions in situations that affect the folks around us. Unfortunately, that instinct seems to get short circuited when we get together in large groups. We lose our intuition, our gut sense for what’s going on outside of that group. Corporations become more insular. Colleges start to feel like ivory towers. Political campaigns take on a “bunker mentality.” That sort of isolation can have disastrous effects because these same institutions depend on the outside world for revenues and reputation and votes.

So what’s the solution?  How do you keep your organization to maintain its focus on why you’re even in business?  I don’t know yet, but you can check out some more excerpts or buy the book!