The Alternative Culture inevitably creates and needs a community of believers. Whether this is a Tai Chi club, a group of people dedicated to eating a particular diet, or an institution formed around a set of spiritual beliefs, there is a clear set of beliefs and a community that provides support. Members of the Alternative Culture focus on the retention of flexibility and the promotion of continuing dialogue and innovation, while also demonstrating thoughtfulness and credibility in a still-skeptical outer world. McKenna and Pugno (2006, p. 94) offer a telling observation about the challenges and opportunities faced by pioneer leaders:
“Many physicians, in fact many people in general, find rapid change unsettling and sometimes quite stressful. But disequilibrium can also be a good thing. . . . [D]isequilibrium can be a catalyst for positive improvements to come about. Without disequilibrium, most of us would become too entrenched in the status quo to take risks and consider fundamentally new perspectives or, as some would say, to “think outside the box.’”
The inevitable disequilibrium also requires the pioneer to create or find a community of believers who provide both support and guidance. It is not advisable for any pioneers to “go it alone.” Collaboration and the honoring of diverse resources are prerequisites for viable and successfully sustained innovation.
Perhaps in part because of the disequilibrium, the Alternative Culture has always played a marginal role in the North American healthcare system. The “pioneering” villages have been populated by faith healers, herbalists, and foreign-trained practitioners of ancient healing arts. Alternative healers have operated spas, provided massage, and offered televised instruction regarding new models of health and happiness. Some of these practitioners have been charlatans, while others have been visionaries and insightful innovators—including pioneering physician leaders. Alternative healers and their often-controversial methods have usually served as counterpoints to the dominant medical orthodoxy of their time. Much as the Advocacy Culture stands in opposition to the Managerial Culture, the Alternative Culture stands in opposition to the Professional Culture. Both the Advocacy and Alternative Cultures find that their raison ‘d-etre is based on this opposition.
Specifically, alternative medical practices have often been set against those medical practices that are represented in and by the Professional Culture and, to a varying extent, also represented in and by the Managerial Culture. When we move past this theme of contention and anti-establishment opposition, we discover that alternative practitioners—and pioneer physician leaders–find meaning primarily in formulation of new programs and activities. Meaning is particularly centered on innovative programs that provide comprehensive healthcare that crosses traditional healthcare boundaries. It is assumed in the Alternative Culture that a patient’s community and support systems can be engaged to make a difference in how the patient copes with illness and creates health. Those medical practitioners aligned with this culture focus on empowering each individual to find and understand what illness, death, and pain actually mean for them. Alternative practitioners encourage their patients to listen to their own voices and create their distinctive mode of healing and health.
