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Why the REF?
by Leslie Crofford, MD
I am delighted to use the occasion of this inaugural REF president’s column to share a vision of the future and describe the exciting developments that will allow us to meet the challenges ahead. Although most of you know that the ACR is associated with a foundation, I find that many of our members wonder what the REF does that is different from the mission and activities of the ACR and the ARHP. In the simplest terms, the ACR and the ARHP are engaged in improving the quality of our professional lives as rheumatologists and rheumatology health professionals, while the core mission of the REF is to ensure the future of our specialty.
Why Support the REF and Its Core Mission?
One could answer that by posing another question: Who will treat our patients with rheumatic diseases in 2025? The ACR rheumatology workforce study of 2006 estimates that the supply of rheumatologists will increase by 1.2% based on current trends, while the number of patients with rheumatic diseases will increase by 46%. To meet the coming challenges, it is essential that we attract the best and brightest young physicians to rheumatology and support the development of health professionals to enhance our capabilities to deliver care. As we all know, it is difficult to recruit young people—of the caliber we want—and to train them to join our practices, take care of our patients when we retire, and teach the next generation how to practice the art and science of rheumatology.
In almost all cases, individuals come into rheumatology as a result of interactions with charismatic teachers who energize trainees around the truly fascinating diseases that form the core of our specialty. We must also find a way to encourage those who wish to pursue a career in academia to engage in teaching and basic, translational, and clinical research to make that commitment. In the present environment, it is imperative that young educators and researchers can see a way to have a successful career in rheumatology. They must be comfortable that there is a reasonable chance to obtain funding, starting early in their careers and continuing until they become senior educators and basic or clinical scientists. I suspect that most of us can name at least one individual that strongly influenced our career choice, be it clinical or research, and it is likely that a valued mentor was affiliated with an academic rheumatology unit. It is essential that these units stay strong and vibrant.
The core mission of the REF is to support the recruitment, training, and career development of rheumatologists by raising funds and awarding grants. By any measure, the REF has been extraordinarily successful. We have gone from providing $500,000 in total grants supporting our core mission in 1998 to more than $4.5 million in 2008. The grants provide the opportunity for medical students and residents to be exposed to our field, and they support rheumatology fellow salaries. The increase in support has been associated with an increase in the number of graduating fellows from a low of 105 in 2000 to 173 in 2007.
The REF also provides clinician scholar educators—the core of our teaching faculty—with awards for innovative teaching, and provides visiting pediatric rheumatologists to the many institutions without pediatric rheumatology expertise. For those individuals wishing to pursue a career in academia, the REF supports early training and mentored career development for physicians and health professionals. It is absolutely essential for the REF to support our young basic and clinical scientists as it is an increasing struggle to obtain funding through the National Institutes of Health (NIH)—the source of funding ultimately required to support an academic research career. While the REF clearly cannot provide the totality of research support for any individual or program, our focus is on preparing young scientists for success and providing support during first applications to the NIH.
How Do We Raise Money to Support These Goals?
At present, the majority of funding comes from industry sources, which have been essential to move the REF from its beginnings to where we are now. We are grateful for the support of our industry partners and believe that we have used their investment wisely. In my view, however, it would be foolish for the REF to depend on industry support for the future. Through annual giving, ACR and ARHP members will provide approximately $600,000 to support REF programs this year alone. We are grateful to all of our donors, especially the almost half of our members who currently each donate up to $200 annually to the REF. It is my goal as REF president to increase awareness of our outstanding programs and of the opportunity we all have to support the core mission of the REF.
In addition to our annual giving program, we are delighted to add a planned giving program to the REF. Arthur L. Weaver, MD, chair of the planned giving program, has worked closely with the REF staff to create a program that you can now use while you are planning your legacy. I encourage you to visit the REF Web site at www.rheumatology.org/REF for more information. With the advent of our improved annual giving and planned giving programs, we all have the opportunity to use our resources to support the future of our profession.
Stay tuned for my next column in the coming months to hear more about REF activities, additional ways to support the REF’s core programs and the Within Our Reach: Finding a Cure for Rheumatoid Arthritis campaign to raise $30 million for rheumatoid arthritis research.
Dr. Crofford is president of the ACR’s REF and chief of the division of rheumatology at the University of Kentucky in Lexington. Contact her at email@example.com.