The public mind has been changing dramatically over the past five decades. In reality it has been continually changing since the beginning of time, but because of the availability of information, the concentration of people, and the ability to compare experiences, the change has moved ahead at warp speed during the second half of the twentieth century.
Take your mind back to the late 1940s. The United States had emerged from World War II as the victor, the righteous conqueror who vanquished the Hun and stopped the advance of the imperialistic intent of the orient. The world was orderly. Everyone had a place and everyone stayed in their place.
A decade later, things had already begun to change. By 1957, cracks were starting to show in the armor of the nation that was galvanized by the war effort of fifteen years earlier. We started to turn inward and began feeding on each other. The McCarthy era was upon us. We were questioning each other and we were reacting to our fears. About the same time we entered the Korean conflict. This wasn't a war, it was a "conflict." It lacked the cohesiveness of the nation, and for the first time in our history, people were questioning why we were involved in a military action in Korea.
By the mid 1960s, the nation was in the throes of two movements that would alter the future of the nation and of each and every one of us. The civil rights movement and the anti-Vietnam War sentiments were in the process of shaping our lives and reality. As diverse as these movements were, they reflected a similar need and desire of the society. What had begun in the Korean War and the McCarthy era as rumbling and grumbling in isolated circles was now exploding as nationwide movements that were straining the fabric of American society.
The 1970s were marked by a transition of the political houses of our nation. In years gone by, it was a mark of greatness to be considered a statesman. A politician was perceived as a servant of the public, and a level of respect existed that we would not know how to recognize today. The 70s saw the resignation of a vice president, the resignation of a president, and the disgrace of the torchbearers of the political framework of our system.
The 1980s saw another set of transitions take place and another class of our culture fall from grace. The scandals of Swaggart and Baker and the revelations of errant clergy of all denominations were responsible for shaking the faith of the nation.
In the 1990s, a change of profound importance to chiropractors is underway. The class being called to task represents the medical establishment. The inadequacies of the system that has been developing for over 5,000 years are being revealed and reviled as never before. The system and providers are being questioned at equal levels.
The next decade will see education being called on the carpet. Traditionally accepted concepts will be discarded, and time-honored practices and procedures will be left behind as the folly of another time.
All of these processes have many elements in common. The most important of these is the withdrawal of culturally granted authority. That authority has allowed each of the groups involved -- government, racial bigots, the military, politicians, clergy, physicians and educators -- tremendous protection and insulation in a societal sense. Prior to the removal of this authority, we as a society were incapable of asking certain questions and demanding certain levels of responsibility and responsiveness.
Think back to the Camelot days of John Kennedy and compare them to the reality of Bill Clinton. Can you imagine a reporter sticking a microphone in John Kennedy's face and demanding an answer to the rumors about Marilyn Monroe? In 1997, can you imagine a reporter not pressing the issue about Paula Jones and Bill Clinton? What has changed? Perhaps Paula is no Marilyn, and Bill may not be a John Kennedy either, but the bottom line is that the insulation and protection of office once granted by the culture has been withdrawn, and in turn, accountability has replaced it with a capital "A."
Similarly, this is what has happened to each of the groups outlined above. Authority, insulation, and protection have been withdrawn and accountability has filled the void. The population will no longer tolerate the racist attitudes of decades ago. Racism still exists, but it must be carefully cloaked to avoid the wrath of the society. Politicians are now assumed to be crooks; we expect misdeeds and we are vindicated, if not gratified, when we learn of impropriety. Physicians have had their role as deity withdrawn; their decisions are being questioned as never before, their judgment is being called to task as never before and more accountability is being demanded of them as never before in their five millennia history.
So what, you say? What protection did this culture give you as a chiropractor? What deference were you given by virtue of your education and training? If your experience has been like mine, the answer is none. We fought, scraped, cajoled and otherwise wrangled for everything we have attained in this society. So when the insulation and protection is withdrawn from our colleagues in medicine, what is going to be taken away from you? Nothing, nada, zip. It is hard to take away something you were never given in the first place.
What cultural force came with your opinion of anything, let alone a health-related matter? How many times have we been turned inside out at hearing some medic espouse some outrageous view we know is not supported by logic, fact, or literature, only to have it lapped up by the waiting public? Those days are going, if they are not already gone. Physicians are being pressed for answers. Hard questions are being posed for which the answers of days gone by simply don't cut it. The accountability of outcomes studies has invaded the peace and quiet of the physician's lounge at the hospital. Decision-making has been taken out of the hands of the physician, and power is now being shared in an equation that is being rebalanced almost daily, with the physician's grip loosening with every recalculation.
Not only has accountability replaced authority and privilege, society has consistently replaced the authority with a sense of anger and contempt. Think of the reaction today toward military persons, politicians, and the clergy in general. As the insulation and pedestal status was withdrawn from each group, suspicion and caution have welcomed them to their new reality. This same process is happening to medicine, and it is happening with more intensity than ever.
The reason for the intensity is the universal nature of the circumstances. A few people were fully caught up in McCarthyism, many more were concerned about the Vietnam War, and still more were impacted by civil rights issues. By the time we move on to politicians the percentage of society affected is growing larger. However, Nixon was a Republican, and I am a Democrat; Swaggart was in the Assembly of God, and I am a Baptist; and Catholic clergy have gone astray, but they weren't of my faith. When we get to medicine, we realize that their association with the population has been virtually universal in this society. So when doubt and related negatives enter the discussion, everyone is affected in some way to some degree. Further, the emotional effect of having placed yourself in someone's care is one thing, but if you have placed your child or your elderly parent in a doctor's care and had that trust violated or misplaced, you become angry -- very angry.
The people of this nation are realizing something is amiss. They are experiencing it on a visceral level and have not allowed themselves to experience it on a larger, intellectual level. The time is not far away. The signs of angst are everywhere when you begin to become aware of them. I suggest to you that "health care reform" is not about money and economics. As any person married more than a month knows, money is what a couple fights about because it can be counted and measured, but it is rarely, if ever, the issue. In a similar fashion, our present focus on funding schemes is a symptom of the problem that, like in the troubled marriage, the parties are not being addressed. With a little more therapy or a little more pressure, the general public will come to grips with it.
People also seem to be agog over "alternative health care." There is nothing new on that plate. Acupuncture has been around for thousands of years. Spinal care (in one form or another) has also existed for thousands of years. Herbal treatments, appreciation of mind body relationships and other "alternatives" have all been with us forever. What is new is the ability to ask questions, to demand answers and to make your own choice when the answer doesn't make sense to you.
As you read this, the movement of thought, information and understanding over the last 50 years is conspiring to level the playing field upon which we play out our part. Our greatest days are yet to come. I am so excited about it, I get goose bumps just thinking about it all!
Gerard Clum, DC
President, Life Chiropractic College West
San Leandro, California
Dr. Clum can be contacted at Life Chiropractic College West, PO Box 367, San Lorenzo, CA 94580, or by e-mail:gclum@lifewest.edu. This article will be archived as a portion of the Life West Web page at [url=http://www.lifewest.edu]http://www.lifewest.edu[/url] under the hypertext heading Dr. Clum.
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