When I talk about our consulting focus on global business strategies and processes, many of my friends and neighbors’ eyes start to glaze over. (Yes, I know I need to work on my elevator pitch!) But I think there’s another reason, which is that a lot of us believe we live and work in a local market, and changes in global businesses don’t really affect us. Sure, we all hear the drumbeat of increasing globalization, but in our day-to-day lives, it doesn’t really have much impact, does it?

Actually, it does. I really can’t think of a single business that isn’t affected in some way by changes in global businesses and economies. The local pizza parlor has to deal with competition from global fast food restaurant chains and the increasing costs of ingredients, a global economic trend. Meanwhile, our community supported agriculture farm sells out its shares faster every year – partly because they’re doing a fantastic job, and partly because people are increasingly concerned about the costs and problems of a global food system that typically transports food hundreds and thousands of miles.

The CEO of Harvard Pilgrim Health Care wrote in his blog recently about a new report on medical tourism from Deloitte. He then goes on to sketch out the impact on the United States health care industry in a number of dimensions: loss of revenue from both foreign patients traveling to the U.S. for care, and from American patients traveling to other countries for care; fewer foreign medical practitioners coming to the U.S. for their careers, and potential staffing shortages; and an increasing number of joint ventures between US and international health care providers. He ends with this statement:

So — is this [medical tourism] “bleeding edge” or “leading edge”? I don’t know. But it does raise interesting questions about whether or not health care in the future — which everyone’s always called a “local market” — will continue to operate that way down the road.

I think the answer is clear: health care is already both a local and a global market. Local differences in culture, language, economics, infrastructure, political and regulatory environments, etc. are very significant, and health care in the US and Europe and Asia will continue to operate very differently. At the same time, it is increasingly rare to find a truly local market, and even seemingly local businesses need to incorporate changing global environments in managing their operations.