Commentary

Abstract

No political, economic, or cultural segment of society has escaped the universal impact of recent cataclysmic change. Physicians were no exception. During the 20^th century, all members of society, including physicians, have experienced change of enormous speed and magnitude. Futurist Alvin Toffler noted that global societal transformation has created a “future shock” of personal malaise that poses difficulty for both individual and group adaptation. Toffler further described current change as a fundamental shift and conflict in all aspects of civilization (how we live, work, and relate to each other). Toffler also noted major alterations in the basis for distribution of societal power (who controls what, why, and how). One manifestation of recent change directly affecting all members of society, including physicians, has been the social transformation of medicine that has been a power shift from the individual physicians to control by organizations and management.