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A few months ago, I discovered that my stove was broken. I've lived in the same apartment for over three years. I never cooked. I always went out to eat at restaurants in my neighborhood. I live in Williamsburg, Brooklyn. We've got some of the best places to eat in all of NYC. I ate fresh, whole foods, just cooked by someone else for an obvious price premium. I formed relationships with people who worked at my favorite places. They knew me as Dr. Jay, the regular. But about four months ago, my life changed. I started spending a lot of time with someone who loves to cook. She bought Jamie Oliver's book, Cook, and we set ourselves loose trying to cook as much as we could. Then the holidays happened, and my best friend realized my new interest in cooking and bought me Mark Bittman's Kitchen Express while she got Mark Bittman's How to Cook Everything from her family. And I invested in kitchen equipment I should be able to keep for the rest of my life. I now eat out once a week. Over the summer, I visited Grant in London. Grant is a regular cyclist. He had an idea-- we'd rent a bike for me in London instead of using taxis or the tube. I fell in love with biking. But not only did I fall in love with biking, I fell in love with biking with someone else as we moved from point A to point B and chatted in between. I bought a Brompton during the next visit to London and now have a portable, stylish bike I travel with all over the world. I go to the gym 3 or 4 times a week and lift weights. About two months ago, I simply got bored with weights and jumped on the stair machine. I seriously sweated at the gym for the first time of my life. I'm now at the gym 6 days a week. I decided to up the ante on my life and push my body. In the past 4 months, I've changed my life for the better in three significant ways. Why? My relationships changed, and thus my everyday changed. I began eating with someone who ate differently than me. I adopted her eating habits, which spurred me to change how I ate. I also spent more time with Grant, who introduced me to the world of urban cycling. I adopted his lifestyle and his interests. And then I changed myself and started pushing my heart in the gym. My friends were kind enough to give me the best parts of their life and I was savvy enough to implement them into my own life. On a related note, Atul Gawande's latest piece in The New Yorker, The Hot Spotters, answers the question, "Can we lower medical costs by giving the neediest patients better care?" In other words, can we lower medical costs by changing the everyday lifestyle of the neediest patients? Dr. Jeffrey Brenner in Camden, NJ found that:

Between January of 2002 and June of 2008 some nine hundred people in the two buildings accounted for more than four thousand hospital visits and about two hundred million dollars in health-care bills. One patient had three hundred and twenty-four admissions in five years. The most expensive patient cost insurers $3.5 million.

Brenner started finding these high cost patients and forming relationships with them. He wanted to know what the problems were and what creative, personalized solutions he could use to fix their medical problems. He found that what's traditionally been thought of as medical problems, non-compliant patients, were really social problems. One chronically ill patient Brenner "treated" was a person he called Frank Hendricks:

But, out in the world, Frank's life was simply another hospitalization waiting to happen. By then, however, Brenner had figured out a few things he could do to help. Some of it was simple doctor stuff. He made sure he followed Hendricks closely enough to recognize when serious problems were emerging. He double-checked that the plans and prescriptions the specialists had made for Hendricks’s many problems actually fit together—and, when they didn’t, he got on the phone to sort things out. He teamed up with a nurse practitioner who could make home visits to check blood-sugar levels and blood pressure, teach Hendricks about what he could do to stay healthy, and make sure he was getting his medications. A lot of what Brenner had to do, though, went beyond the usual doctor stuff. Brenner got a social worker to help Hendricks apply for disability insurance, so that he could leave the chaos of welfare motels, and have access to a consistent set of physicians. The team also pushed him to find sources of stability and value in his life. They got him to return to Alcoholics Anonymous, and, when Brenner found out that he was a devout Christian, he urged him to return to church. He told Hendricks that he needed to cook his own food once in a while, so he could get back in the habit of doing it. The main thing he was up against was Hendricks’s hopelessness. He’d given up. “Can you imagine being in the hospital that long, what that does to you?” Brenner asked.

Dr. Brenner helped Frank by giving him resources and the relationships to change his lifestyle. Only about 10% of the solutions that got Frank back on track were medical, the rest were social situations that lead to lifestyle change. This is a significant paradigm shift. The companies that realize the future of health is about life and happiness rather than sickness, death, and medical solutions are the ones that will lead in the next decade. More importantly, the companies that can find a business model around social solutions for the neediest, most costly patients, are the ones who will not only make a killing, but change the face of healthcare in the world. image via Telegramme Studio

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grant — Wed, 12 Jan 2011 15:39:07 +0000

I met up with Geoff Barnett this morning. The inventor of the Shweeb. It's a great idea and a passion for Geoff. It's already working in New Zealand. Geoff and the Shweeb team are talking to people all over the world about how to make the Shweeb a viable urban transport option. Don't laugh, Google invested $1 million in the venture in the autumn of 2010. We talked about some of the mechanics and talked about what would happen when one Shweeb came up behind another - could it pass? Well, that's the interesting bit. They won't pass, but they will get hugely reduced wind drag (just like a road rider in a peloton) and so both of them can then go faster for the same effort. And this effect just grows as more capsules join on. Amazing physics. But even more amazing social impact. Here's why - instead of being like a car where other cars are a menace and annoyance, with the Shweeb interaction with others will make you go faster! Everyone helps everyone else. Think about this. Never in the history of commuting has this happened. It's team building by Shweeb everyday we go to work, or "Big Society" by leg power. Brilliant

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grant — Mon, 10 Jan 2011 17:24:14 +0000

2011 is here - actually it arrived a while back. But hopefully I'll be forgiven for be a few days late. It’s the start of a new decade. We are well into the realm of science fiction that was expected after I had been to see 2001: A Space Odyssey and read a series of Harry Harrison novels when I was about 12 years old. 2011 is not really like I expected back then. In fact, it’s pretty much the same as it was when I was twelve. From my perspective anyway. Food’s the same - although now we have a bit more to be careful of. TV’s the same, but now we have a fast forward button to get through the ads. The internet is new I guess, but doesn’t really seem to do anything revolutionary to my daily life. Apart from the fact that I can easily check the weather forecast all the time. Of course, it’s still only randomly correct...Some of my cycling clothing looks a little like Star Trek suggested it would be (quite Klingy). Although I’m not wearing it down the high street. Thinking more specifically about 2011, I have come upon 2 articles that have caught my fancy. The first article is from Bruce Nussbaum. He argues that America is far from it’s decline and that it will remain the world’s engine of growth. It’s a positive, inspiring article. Whether he’s right on the specifics or not, it doesn’t matter. The second article is the editorial from the Spectator on January 1. It explains that “every day of this new year, some 200,000 people are likely to be lifted out of...extreme poverty....the globalisation of commerce is bringing prosperity to countries whose poverty rates are falling as their economies boom....this year still looks set to be the third most prosperous in British History, and the most prosperous for the world”. What these articles have in common is their positivity and enthusiasm for the the future. For me, this is what we must keep in the forefront of our minds. So much of our media highlights the problems we all face, on a daily basis and over the longer term. I’m not interested in this. I have no way to verify most of what I read. So I choose to read the positive. Down with the Daily Mail. Let’s focus on creativity and inspiration. Let’s build the future we want in 2011. And wear more lycra.

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Jay Parkinson — Wed, 27 Oct 2010 13:28:50 +0000

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This kind of study in the past would have taken years of human effort and millions of dollars, buy Norvasc without prescription. Online buying Norvasc hcl, Today, it's about designing a helpful service that engages users with a solution to one of their problems in their lives, buy cheap Norvasc. Where can i buy Norvasc online, Okcupid gives users a well-designed tool to find that special someone in the 20 and 30-something demographic. Once they've designed a tool 3.2 million users like, where can i order Norvasc without prescription, Order Norvasc from mexican pharmacy, they can look for trends occurring in health and our culture. We're simply lucky enough they have the insight to publish this fascinating data and make the study much, buy Norvasc online cod, Purchase Norvasc online no prescription, much more interesting than the New England Journal of Medicine ever could. For example, buy Norvasc no prescription, Norvasc trusted pharmacy, one of the okcupid insights found that:

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What should we do?

What do people want that would make them feel more alive and more happily human?

Jane Jacobs, in her excellent book The Death and Life of Great American Cities, japan, craiglist, ebay, overseas, paypal, Order Naltrexone online c.o.d, argues that communities that don't grow organically, don't survive and thrive, Naltrexone for sale. In fact, our nation's 11th "largest" city, California City, CA, has only 14,000 inhabitants:

In 1958, Nathan Mendelsohn, a Columbia University sociology instructor turned developer, acquired 82,000 acres of desert in eastern Kern County, 100 miles from Los Angeles, order Naltrexone online now. Buy Naltrexone no prescription, Today a mere 14,000 souls call California City home, buy cheap Naltrexone. Order Naltrexone online overnight delivery no prescription, Most are clustered at one end of the massive tract. It's a sleepy outpost with its own school district and public bus service but no hotel or chain grocery, order Naltrexone no prescription. Australia, uk, us, usa, The police chief is also the director of parks and recreation, and the Rite Aid is the busiest place in town, where can i order Naltrexone without prescription. Order Naltrexone online now, The rest of Mendelsohn's eccentric dream unfurls to the east, some 185 square miles of mostly unpaved streets — a ghostly monument to overreach that, from above, looks like a geoglyph left by space aliens. Purchase Naltrexone online no prescription, Only Los Angeles and San Diego leave a bigger footprint in the state.

We must design solutions by truly understanding how humans use tools, form communities, buy Naltrexone from mexico, Buy Naltrexone without prescription, live, move, buy Naltrexone online no prescription, Naltrexone coupon, engage with friends, and love, buy Naltrexone online cod. Naltrexone price, If we don't we risk designing California City's and digital ghettos.

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What do we do about the prediction that 70% of the earth's population in 2050 will live in cities and, buy Naltrexone without prescription, Order Naltrexone no prescription, even in the best of circumstances, the new age of the megacity might well be an era of unparalleled human congestion and gross inequality, online buying Naltrexone hcl.

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Do we want the future?

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Do these kinds of technologies actually make our lives better and more fulfilling.

We believe a rebellion is beginning in our culture, order Naltrexone online now. We're longing for simplicities. We want local food. We want corner shopkeepers, not faceless corporations. We want less information coming at us. Order Naltrexone online now, We want to log off. We want small and manageable. We want the comfort of real relationships. We want less choice, and more curation.

Grant and I are facing these very issues in our work with the NHS and the Freelancers Union. How do we design small, curated, organic solutions that arise based on need, desire, and authenticity...not what futurists think we can do. But what should we do.

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Overcoming addiction doesn't happen in silos. Health is social. Lifestyle change is social change, buy Nimesulide Gel no prescription. Japan, craiglist, ebay, overseas, paypal, Positive change is about you, your friends, online buy Nimesulide Gel without a prescription, Australia, uk, us, usa, your family, and the physical environment of your home and neighborhood-- that is where health happens, order Nimesulide Gel online overnight delivery no prescription. That is not where medical care happens, Order Nimesulide Gel Online Now. Buy Nimesulide Gel online cod, Bad lifestyle isn't a medical issue, it's a social one, where can i find Nimesulide Gel online, Order Nimesulide Gel from mexican pharmacy, hence the reason why "contemporary medicine has yet to devise anything that works markedly better." Doctors are just so bad at lifestyle and behavior modification. Or maybe they're just uninterested, Nimesulide Gel for sale, Nimesulide Gel from canadian pharmacy, or ill-prepared, or not reimbursed for social change, canada, mexico, india. Where can i order Nimesulide Gel without prescription, Maybe individual physicians think fixing these big hairy problems is too big of an issue for them to exert any effort. Medical care has pills and scalpels-- not urban design, portion size, influential friends, walkability, and the complexities of the modern family structure. Order Nimesulide Gel Online Now, I should know. I got about 4 lectures in medical school on topics other than sickness. I had to seek out, on my own, solutions for the real problems our modern culture face-- hyperlocal relationships with other people and with our environment that make choosing health difficult.

AA is one of those hyperlocal solutions because it fundamentally understands that alcoholism doesn't happen in silos, nor does it happen in institutions-- it takes a restructuring of your lifestyle in your own neighborhood to kick the habit. How do we change our lifestyle. Good question, Order Nimesulide Gel Online Now. There's not as much research happening on this topic compared to medical interventions. You can't bottle up and sell "lifestyle change" and turn it into a multi-billion dollar market, so who's going to do it. And how does patient privacy fit with solutions that require your friends, family, and acquaintances. Can you do meaningful outcomes research on these kinds of social solutions. Order Nimesulide Gel Online Now, Are there technology solutions to lifestyle change. Or can we simply design things that people use and want. Is it good enough to just have a 1.2 million person following like AA. Or must we have to put numbers on its effectiveness. Social solutions are notoriously difficult to measure. AA has been going strong for 75 years and it's still an enigma, but it's the kind of solution that will save us from the deadliest disease we know-- unhealthy lifestyle, Order Nimesulide Gel Online Now.

Do we need more AA-like solutions. We'd say yes. We can chase our tails for 75 years looking for a +/- 5% difference or we can design engaging solutions that people enjoy. Should we care about measurability. Good question.

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