When I was running International Business for the New England Journal of Medicine, Thomas Friedman's book "The World Is Flat" was on the bestseller list. The meme of the title had become a strategic calling card of sorts for people interested in international business. Since the Internet had flattened the commercial world, didn't this mean that we could do X and Y and Z for the first time ever?

Our experiences did not line up with the notion that the world had become flat, however. Because we had a tradition of holding half-day retreats annually to assess our situation and plan for the year, that year we discussed the cognitive dissonance we were experiencing around this "world is flat" notion. What we came up with still seems right to me:

The information landscape has flattened to a degree, but the business landscape is extremely hilly.

It's not an earth-shattering insight, but it was more accurate and useful to us than Friedman's simplified arguments that we were in a post-modern business era with fluid, borderless markets.

In the years since then, the hills have become steeper, both for information dissemination and for business practices. China is a particularly interesting example, as the Great Firewall makes it harder to get information in, hacker attacks make hosting more expensive and fraught than before, and Chinese business practices and market volatility continue to present moving targets and intricate puzzles. Geoblocking by companies like the YouTube, BBC, and Netflix is being challenged in Europe. And geotargeting of content and advertising is normal -- as I write this from Berlin, Germany, my Google results still lapse into German occasionally, and my iPhone presents information as if I'm a German-language speaker.

Other parts of the world have seen their share of distinct local problems. Spain took it on the chin in 2008, and is still reeling. Argentina continues to be unpredictable. The low prices of oil have made Saudi Arabia a more volatile place, with new payment problems and uncertainties. Various local approaches to open access -- the UK, the Netherlands most recently -- also create new regional business-and-information conundrums.

This is disappointing news for those envisioning a seamless approach to global business, with easy growth in highly accessible markets. The upshot is that partnerships at the local level, or with organizations with local expertise, are becoming more important than ever. Local knowledge continues to be a major advantage. Operating as if the world is flat is a perfect way to keep your growth curve flat, too.