Editorial: The 'flattening' of ob/gyn practice

June 1, 2007

The Internet has empowered individuals who can now access a huge treasure chest of information quickly. This new age has extraordinary implications for ob/gyns.

Friedman also points out how the Internet has empowered individuals who can now upload sophisticated software to do their taxes, compose and produce their own music, author and publish their own books, share photos and music, and collect detailed information on an almost infinite variety of topics. They can even contribute their own entries to a global on-line encyclopedia. Moreover, these tools have been amplified by an assortment of handheld devices-which Friedman refers to as Internet "steroids." I witnessed a vivid display of these "steroids" on a recent bareboat sailing trip in the Caribbean with three other couples. Everyone was armed with MP-3 players, the latest digital cameras, and sophisticated cellular phone/PDA/camera combinations. Hooking the MP-3 players to the boat's FM stereo allowed us to choose between thousands of different songs. We were all able to take numerous digital photos, which were then pooled on-line, allowing us to select from hundreds of images. As we sailed, professional photographers took pictures of our boat, and posted them on-line where they could be purchased. The "crew" was able to check their e-mail, send photos, and make calls while at sea. For my part, I was able to navigate with an inexpensive handheld GPS whose charts and depth findings were far more accurate than the paper versions.

THE DAWN OF THIS NEW AGE has extraordinary implications for our domestic economy. Freidman notes that the outsourcing and off-shoring of service industries could not occur if there were not a virtually endless supply of incredibly hard-working, ambitious, and increasingly well-educated and technologically adept workers in Eastern Europe, China, India, and parts of southeast Asia. He also rightfully points out that America is in danger of losing its dominant economic role because of our failure to train adequate numbers of scientists, engineers, mathematicians, and computer specialists. However, he also argues that we have greatly benefited from global "flattening." Companies like Wal-Mart and Home Depot have perfected highly-tuned supply chains that have dramatically reduced the cost of providing a host of household products. This has dampened inflation and allowed less affluent people to have access to a far greater range of consumer products. The "great flattening" has also generated a host of new niche companies employing not only underpaid Third World workers but also very well paid employee/owners in the developed world. Friedman posits that a flat world will ultimately reduce global conflicts by integrating economies, reduce poverty by creating new jobs and enhancing the spread of knowledge, and even reduce energy consumption by allowing us to work at home, in houses run by energy conserving computers. On balance, Freidman argues that the flat earth will be beneficial to Americans as long as we adapt our educational system and regenerate our "Puritan Ethic" of ambition, discipline, hard work, frugality, and love of learning.