No political, economic, or cultural segment of society
has escaped the universal impact of recent cataclysmic
change. Physicians were no exception. During the 20th
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.