Can you get followers in toME 4?

If you can how and what can you do with them?

If you mean those randomly

If you mean those randomly encountered escort missions, such as "the lost paladin"s which seem so frequent, and suicidal... you can escort them to a purple mark on the floor, and they give you a permanent stat/skill up of your choice.

If you mean a permanent summon/familiar; play alchemist, you get a permanent golem companion from the start.

it could be nice

I think it would be cool to go to a tavern somewhere, like the unused building in Derth, and hire a mercenary.