This week’s photograph confirms Richard Florida’s research (just a little) about extroverted types being closer to the Atlantic than the Pacific Ocean.

Frozen yogurt is back. In a big way. As a Generation Y customer in line told me, “(large ice cream chain) is doomed.” I really enjoy a place where people are easy to engage, and they walk to get places. In this case it’s to one where the product sold is only 25 calories per ounce. Not bad! (More pictures of the atmosphere are here, this place is Web2.0 enabled)

• This Old Healthy House : University of Utah News Release : July 28th, 2008 - People living in walkable neighborhoods are less likely to suffer from obesity.

click on the image to see it full size

I took this photograph as I was walking to Georgetown and noticed the Ghost Bike placed in Dupont Circle by the Washington Area Bicycling Association. The ghost bike was placed in a ceremony on July 10 (more information here) following the death of 22-year old Alice Swanson, who was killed by a garbage truck while riding her bike to work on July 9, 2008, in Dupont Circle.

As I walked by, I noticed the words written on the tire by Alice’s mother. They had an impact on me. They will on you too. Click on the image to see them for yourself.

The world is not flat; place matters.

I couldn’t agree more with the latest work by Richard Florida. This book looks at the importance of place not only in the global economy but in a person’s life. I personally had a good idea that this made a huge difference some time ago, despite living and working in a world where colleagues work for organizations for which home base is irrelevant.

On this, my 300-day DCVersary, I can confirm that my experience bears this out. Moving from one of the smaller “mega-regions” (Cascadia, Portland, Seattle, Vancouver, 9 million people, $260 billion light-based regional product) to the second largest one in the world (Bos-Wash, Boston-Washington, DC, 54 million people, $2.2 trillion LRP) has undeniably made a significant difference in everything I do, even in a technology-related occupation. As Florida describes, people cluster:

(There is) the tendency of creative people to seek out and thrive in like-minded groups, and (there is the) self-perpetuating economic edge that comes from doing so.

Florida does a good job of reviewing the evidence that place matters, and the idea that its impact on personal and professional happiness has been underemphasized. He combines original research as well as data currently available to create a compelling picture of both the importance of place and the factors about it that matter. One of the interesting explorations in the book is about the personality of cities - extroverted people and agreeable people tend to be localized east of the Mississippi, where “open to experience” people tend to be localized to the coasts, with dominance in California and Bos-Wash (okay, maybe the extroversion doesn’t stretch as far east as DC, and maybe the “open to experience” doesn’t stretch as far South, but I’m pretending they do - you always see the best in something you like).

Throughout, It’s nice to imagine where you might “fit” but also how your own experience stacks up, because an important criteria of a place its aesthetic.

I have been using a curious measure for the past few years to judge aesthetic, the “touch-down” measure. It is, “In what city do you say to yourself, ‘I’m home,’ when the plane touches down on the runway.” I think you can’t fake that. Alternately, it’s the city that when the plane touches down, you say to yourself, “I can’t believe I don’t live here.”

I give strong kudos to Florida for acknowledging the role of diversity and tolerance in a place, not just for minorities, but for all people. He says:

It’s not about tolerance for tolerance’s sake. As my previous research has shown, places that are intolerant simply do not grow. And, as the Place and Happiness Survey confirms, people in intolerant places are less happy and less fulfilled than those in tolerant an open-minded ones.

This finding is similar to research that shows the same thing about organizations. As a patient said to me a very long time ago, “We don’t tolerate diversity (within the organization I work for). We LIVE diversity.” That describes a place that has a better chance of thriving, and one that most people (including me) want to be involved with.

A book by an author that writes a blog is a better read

It is worth mentioning that as I read the book, the positive impact of Florida having experience writing a blog came across, because (a) he brought his personal experiences and those of his colleagues into the story and (b) he crowd sourced several of his ideas, bringing in commentary from blog entries. This made for a much more engaging read, and I can’t help thinking that without this experience, the work might feel less connected to the experience of real people. I think this is an interesting way that blogging is changing traditional publishing because those who blog are forced to become more personal in their communication to be successful. I like it. A lot.

And the winner is…

I have experience living in three mega-regions described in the book: Bos-Wash, Nor-Cal, Cascadia and it was interesting for me to compare the decisions I’ve made with the characteristics of each. All of them offer so much. My recent experience with Bos-Wash has been, well, fantastic, both in terms of livability, ability to be extroverted, and exposure to diverse populations and cultures. Nor-Cal scores high in my book as well as it shares many of the livability and diversity attributes, as well as strong dominance in technology and innovation. Cascadia was definitely enjoyable for the time I spent there.

Who’s Your City? Feel free to post your experiences…

JAY PARKINSON + MD + MPH

How long before HelloHealth comes to Washington, DC, with the most regional-serving walkable urban places per capita in the country?

Note: There’s been some buzz about walkability for other cities as well, also fine choices for those who love living in places that support walking.

• Walk Score - Helping homebuyers, renters, and real estate agents find houses and apartments in great neighborhoods. - A website that promotes walking (and indirectly property valuation) by what's nearby. DC does quite well. Type in your address and see where you fall.

Remember that I started the defining in anticipation of talk I am giving? That talk is happening next week, in collaboration with the California Healthcare Foundation, who are working to foster next generation ideas for health care.

Based on the comments I’ve read to date, here’s what I put together:

Health 2.0 is participatory health care. The combination of content and community enables the patient to be an active partner in their own health care and the citizen to be an equal partner in improving the health system.

Here’s a summary of the improvements suggested:

Dave: add “When patients meet Web 2.0″
Andre: add “Social Media”
Jen: “Content and Community” (commerce coming)
Deborah: “Strike transition, promote participation”
Lodewijk: “Not a transition; Health 2.0 defines the combination of health data and health information with (patient) experience through the use of ICT, enabling the citizen to become an active and responsible partner in his own health and care pathway”
Gilles: ” Add ‘and equal’, add ‘informed’”
Dave: “Lodewijk + is the combination of new Web tools, health information, and patient awareness, enabling the citizen”
Susannah (offline) : “Participatory medicine”
Matthew: “Good luck”

Here’s the original:

Health 2.0 is the transition to personal, participatory health care. Everyone is invited to see what is happening in their own care and in the health care system in general, to add their ideas, and to make it better every day.

Better? Easy to discuss in an elevator, or on your way to a walking meeting?

A lot.

When I first read this story: Slashdot | U. of Chicago Law School Blocks Internet Access, and followed the comments, I realized that this is a symptom of a much larger issue. Notice especially what people say they are doing with their laptops while their professors are droning on. It might seem alarming, but I think it’s just a variant on what generations of students, young and older, have been doing for generations - doodling, playing pong, thinking, dreaming, daydreaming, you name it. This is incredible creative energy, all being wasted.

This story is playing out in adult education, medical education, and the business world in a big way.

The question asked in the Slashdot article and in every other space is, “should people pay attention better, or should there be something better to pay attention to?”

I think the latter question is the better one to ask. If we have known for a very long time that continuing medical education is largely ineffective (at enormous cost to US taxpayers who are subsidizing the travel deductions), we have a great opportunity to innovate, have fun, and learn a ton at the same time.

In the past, I have arranged convergences in a LEAN way that involved creative problem solving - no powerpoint slides. There are now unconferences, World Cafe (which I have never tried but looks interesting), BarCamp (same), and whole rooms of meeting attendees with laptops connected to the Internet that could be engaged beyond checking their e-mail. There are now options like a conference blog, wiki, and social networking site. The Health2.0 Conference did the latter in March, and I thought it was very effective.

Perhaps future CME accreditation requirements could mandate an alternate approach to meeting management. When I was in medical school, we called the easy way out the “parade of slide carousels” (I’m dating myself). I’m ready to try the more difficult way out, to inspire people to bring every ounce of creativity to the table when they are at the moment they are ready to learn. This includes social networking, walking (what a treat for an eager student to get coaching from an expert in their field), simulated (or real) rapid process improvement. This should also include the voice of the customer - in medicine, the patient.

What if the physician attendee at a conference was asked to walk with a patient for an hour, to learn about how they manage their health (I have always dreamed of a medical visit that involved a walk with a patient, maybe this the next best thing).

If we do this, we’ll then take the next step, which is harness peoples’ creativity every day, in everything they do, where they work. It will be the norm. No conference needed.

Those are my ideas off the bat. I welcome yours. And then let’s try them.

March 12th through March 13th:

• DCist: Columbia Heights Target Crime Update - There’s an interesting debate going on about the value of big box retailers in urban areas. I believe a similar debate has been in play in Seattle for some time. DC is growing up. Oh, and this Target is walking distance from me.
• Business Technology : Why Businesses Banish Cool Technologies - These businesses, unlike the ones in the next link, are the ones that may find themselves challenged when it comes to recruiting GenX and GenY staff and leaders. Maybe there’s a way out, see the next link.
• Why a worker says ‘it feels like I just got out of IT prison’ | Technology | The Guardian - Employee asset ownership may be a good way for IT to support innovation in large organizations. Ask BP and Unisys. And the GenX and GenY staff that will expect to use technology to its fullest.
• AHLTA 2008 - National Forum on the Future of the Defense Health Information System; supporting care for a vulnerable population (the enlisted and returning veterans).
• Developing Rails Applications on Mac OS X Leopard - Nice guide to R on R on Leopard

March 4th through March 6th:

• Steve Jobs speaks out - On his marathon Monday meetings (9) - FORTUNE - a weekly check and adjust at Apple
• S.F. equity firm launches health initiative with CalPERS, GE, others - San Francisco Business Times: - Maybe this will help California lead in Health IT.
• AMNews: March 10, 2008. Insurer finds EMRs won’t pay off for its doctors … American Medical News - Less health plans are requiring EHR adoption for P4P, and the AMA doesn’t have a policy requiring physicians to adopt them either.
• Virgin HealthMiles - As demonstrated at Health 2.0 - a pedometer program that includes a pedometer that uploads data to the Virgin HealthMiles website
• i2y - As featured at the Health 2.0 Conference. For the 68,000 GenX and GenY individuals who are diagnosed with cancer every year.