Who Moved My Cheese is about change and how people react and respond to change.Briefly, the book talks about four people who find their way through a maze to a large cache of cheese. Each day they find their way back to the cheese and eat happily away. They become accustomed to finding the cheese in the same place, and come to expect it. One day, as you might have guessed, the cheese is gone. No more cheese. The four people, Sniff, Scurry, Hem and Haw, react quite differently to the new situation. As you read through the book, you see yourself in one or more of the people. It allows for some interesting reflection. I'm not going to tell you which one of the characters I saw in myself.
I'm sure you've noticed that chiropractic is changing. We've gone from being labeled an "unscientific cult," as recently as the late 1960s, to experiencing growth and prosperity in the 70s and 80s, to being left behind in the managed care horror of the 90s. Talk about moving the cheese! Now, at the beginning of the 21st century, with the increasing interest and respect for complementary and alternative medicine (CAM), we're becoming so mainstream that many are beginning to question whether we are still "alternative." For the past 15 years (sounds like a long time) I have taught an introductory course in chiropractic concepts to first-year chiropractic students. I've always stressed the differences between chiropractic and traditional medicine. For the most part, students have welcomed the chiropractic approach. This term, however, I noticed a distinct change in the attitudes of many students. When I talked about the rising interest in alternative medicine, a number of students asked if we were still considered an alternative. I have to rethink how I present my ideas for future courses. Somebody moved the cheese again.
My favorite response to change is to create it. As I mentioned in one of my earlier columns, I've gone back to school. I'm taking courses at Tulane toward an MPH degree. I'm also taking some courses at the University of Surrey in ergonomics. In the next 18 months or so, I'll have an MPH in occupational health and safety management from Tulane and a postgraduate diploma in ergonomics from the University of Surrey. I love learning, and I've long had an interest in occupational health issues, especially ergonomics. While I consider myself to be fairly knowledgeable in these areas, I've never had any formal training, so I thought it was about time that I got some. I'm thoroughly enjoying the experience. It makes me feel young again; I even enjoy the homework. (As a teacher for the past 20 plus years, it's been helpful to remind myself of what it's like from the student's perspective.)
My second reason for undertaking this educational endeavor, more important than my desire to learn, is to see an increase in the use of chiropractic in industry. I'm not just talking about increasing the number of workers' compensation patients that we see. I believe we have a great deal to offer in the areas of education and prevention, particularly of musculoskeletal injuries. I'd like to see companies routinely use chiropractors as company doctors, not as an alternative to the traditional occupational health team, but working side-by-side with the occupational health nurse; the occupational medicine physician; the industrial hygienist; and other health and safety specialists. Our insight and expertise can add immeasurably to the health and well-being of the worker of tomorrow.
To accomplish this will take a change in the way that chiropractic education approaches the subject of occupational health. In addition to discussing the diagnosis and management of musculoskeletal disorders, we must learn about the occupational and environmental risk factors that lead to the development of such problems. We must become specialists in the epidemiology of work-related musculoskeletal disorders (WRMDs). I'd like to see coursework in occupational health and safety in the chiropractic curriculum. I'd like to see specialty programs in these areas become as routine to chiropractic education as the interest in sports injuries has been. After all, athletes are nothing more than workers with glamorous jobs. When we see the attention paid to chiropractors that treat athletes, why not the same attention to chiropractors that treat laborers involved in manual material handling, or assembly line workers, or clerks at the local grocery store?
Finally, both of the programs I'm enrolled in are distance-learning programs, an educational tool that I'm very interested in (the cheese is moving again). Each of the programs is quite different in the way it approaches education. The Tulane program involves weekly classes that are held in a live, interactive format via the computer. Two evenings each week I sit in front of my computer and dial into the class. The instructor presents a two-hour lecture, and the students follow along with a graphic presentation that we have downloaded. Homework is sent via the internet to the instructor, and tests are taken via a live internet hookup. It's all high-tech, and allows folks like me to take coursework that I otherwise couldn't. The students are from all over the U.S. There are no international students, but it's only a matter of time. (While I was looking into going back to school, I found a program I was interested in at Edith Cowan University in Western Australia. (Imagine taking course work from a school in Australia while sitting at my computer in Whittier, California!)
The second program that I'm taking is also described as a distance-learning program, but it's very different from the course work at Tulane. At the University of Surrey, the course work is a series of self-paced modules, each consisting of a five-day intensive classroom session held at the university. All of the readings, assignments and tests are taken on the student's own time and from home. The modules are scheduled at different times during the year, so I'm going to have to make some regular trips back and forth. Tulane is easier in this regard, and I don't mind the travel. At any rate, my intent is to use what I learn about distance learning to develop a series of occupational health and safety courses at a chiropractic college. If any of you have an interest in such coursework in the future, please let me know and I'll put you in my database.
I'm thinking of a sequel to Johnson's book; The Cheese Keeps Moving. All the best.
If there are topics you'd like to see discussed in future issues, please let me know via email ( ).
Diamond Bar, California
Click here for previous articles by Paul Hooper, DC, MPH, MS.