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Explore This IssueDecember 2013
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What better place to hand out awards than a city known for being 75 degrees and sunny?
And so, at the 2013 ACR/ARHP Annual Meeting in San Diego this fall, the ACR and the ARHP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education, and patient care. The Rheumatologist spoke with the winners about their individual contributions to advancing rheumatology. This month, we’ll meet the ACR award winners, and in a future issue, we’ll meet the ARHP winners.
ACR Distinguished Service Award
Robert Lloyd, MD Retired in 2013 from private practice and his role as Clinical Associate Professor in Medicine, Rheumatology, Georgetown University, Washington, D.C.
Background: Thirty-eight years in private practice is a long time, but Dr. Lloyd never had the time to notice. Early on in his career, he became involved in advocacy issues for what was then called the American Rheumatism Association (ARA). He never looked back. After graduating from Georgetown University’s medical school in 1968, Dr. Lloyd completed his specialty training at Georgetown, entered private practice, and began a career in advocacy for what has become the ACR. One of the first policy issues he recalls was the successful push to have rheumatology designated as a distinct subspecialty of internal medicine. Other battles included alternative payment arrangements and coding issues. In 1990, he received the Clinical Faculty Award from Georgetown, and five years later earned the Vicennial medal for 20 years of services. He chaired ACR’s Legislative Affairs Committee from 1992 to 1995 and has been on innumerable other committees. An ACR Master, Dr. Lloyd was given the ACR’s Paulding Phelps Award in 2002.
Q: What about advocacy appeals to you?
Why fight these fights? A: I think when we began, the existing system of coding and payment was unfair to medical subspecialists. By chipping away at this inequity over the last 20 years, we have managed to level the playing field. This battle will continue, but it has always been one worth fighting. I didn’t mind doing it … to tell the truth, I rather enjoyed most of it.
Q: What stands out most about your career?
A: The patients have afforded me the most gratification. I have patients who I have taken care of for over 30 years. You certainly can build a real relationship in that time: who they are, who their family is, what their problems are, what happens to their children, etc. Many of these patients have become good friends on a professional level.
Q: Why did you retire?
A: There have been many problems with the electronic medical records and documentation. These problems basically involved having to spend twice as much time documenting a procedure as actually performing it. It just became an overwhelming hassle. The best part of being a rheumatologist was seeing the patients. Take a person who had a severe disease like rheumatoid arthritis. Thirty years ago, this person had a very good chance of winding up disabled. Now, we can assure him or her a reasonable quality of life. That is the fun part.
ACR Distinguished Service Award
Christy Sandborg, MD
Professor of Pediatrics at Stanford University, Palo Alto, Calif.; Vice President of Medical Affairs, Lucile Packard Children’s Hospital, Stanford
Background: A born-and-raised California girl, Dr. Sandborg is in it for the kids—literally.
Dr. Sandborg earned her medical degree from UCLA, her residency in pediatrics, and followed up with training in pediatric rheumatology at Children’s Hospital of Los Angeles. While her early career work focused on the role of interleukin (IL) 1 and related cytokines in HIV, she shifted that in the mid-1990s when she saw issues threatening the future of pediatric rheumatology. She moved to Stanford in 1997, where she increased her efforts in clinical research and the development of clinical research infrastructure for pediatric rheumatology. Along with like-minded colleagues, she cofounded the Childhood Arthritis and Rheumatology Research Alliance in 2002.
Dr. Sandborg has long volunteered for the ACR, with participation on multiple committees.
She has been a member of the American Board of Pediatrics Sub-board on Pediatric Rheumatology and is actively involved with the Arthritis Foundation and the National Institutes of Health (NIH).
Q: What are you most proud of?
A: I’m most proud of a significant contribution to the field of rheumatology in general, and specifically pediatric rheumatology at a very critical point in our development. Pediatric rheumatology is one of the smallest subspecialties—even in pediatrics, let alone compared to adult rheumatology—and because of its size and the scarcity of pediatric rheumatologists, and that it’s rare diseases, making an impact on the health and welfare of pediatric rheumatology as an entity on behalf of our patients is a wonderful feeling.
Q: What would you say to younger physicians about getting involved as pediatric specialists?
A: It is more than just a viable career choice. It is an incredibly rewarding and successful career choice. So, you ought to do it!
Q: What is the rewarding part of it?
A: The ability to really change the trajectory of these children and adolescents who have a significant, sometimes life-altering and life-limiting chronic condition for the better is very exciting and rewarding. Intellectually, the scientific advances, the treatment, the immunology that is behind how we treat these children is academically and professionally very satisfying. But then to see that we can actually prevent disability, organ damage, and death, and help these kids live really essentially normal and productive lives is something worth getting up every morning and looking forward to.
ACR Presidential Gold Medal
Paul Plotz, MD
Senior Clinician and Scientist Emeritus, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH
Background: The question was never whether Paul Plotz, MD, was going to enter medicine, it was how he’d make his mark.
Winning the ACR’s Presidential Gold Medal is certainly one way to do it.
The road to the College’s highest award began at Harvard Medical School, where he earned his medical degree in 1963 with a thesis called, “Studies on the actions and interactions of streptomycin and penicillin.” He completed his internship and residency in Boston and moved to Washington, D.C. in 1965. And, except for two years in London for a formative turn as a Helen Hay Whitney Foundation fellow and a sabbatical year at the Kennedy Institute of Rheumatology in London, he’s been there ever since.
He has been involved with NIH for his entire career, a mutually beneficial relationship that has provided him with freedom and steady research funding and given the NIH an award-winning scientist. His prize mantle includes the Paul Klemperer Award, the Carol Nachman Prize, and the 2003 Distinguished Clinician Scholar Award from the ACR.
Q: In a career of accolades, where does this one rank?
A: Very high indeed! I have one that I would mention in the same breath, and that is that I have an honorary doctorate from the University of Athens. But you could certainly say that this award ranks highest.
Q: What does this award say to you about your career?
A: I think the thing that characterizes my career is that I have worked substantially in both science and in clinical work. And the other is that I have trained many terrific people. Did I make them what they were? Of course not. I picked them well, and I gave them the opportunity to do their stuff. I’ve published papers with a hundred people who have been either directly in training with me or in training with labs I collaborated with. Those two things I’m very proud of.
Q: What does this award mean to you?
A: When you receive an award like this, you think of the people who have influenced your life the most, about the people whom I consider to have been my mentors. All of my teachers and mentors now are younger. I may be the occasional mentor for somebody who’s in the learning phase that I was in 40 or 50 years ago—or even 30 years ago—but now I’m learning from young people there is an ongoing learning process that we never leave in medicine. It’s wonderful.
ACR Paulding Phelps Award
Harry Gewanter, MD
Pediatric and Adolescent Health Partners, PC, Richmond, Va.; Clinical Professor of Pediatrics, Virginia Commonwealth University (VCU) Health System
Background: Dr. Gewanter says he goes to the office every day to play with kids and then “I run my mouth on behalf of them.” But, when you’re born in Brooklyn, N.Y., it’s no surprise to make a career out of standing up for the little guy.
Dr. Gewanter majored in Psychology at Duke University in Durham, N.C., and earned his medical degree from Wayne State University School of Medicine in Detroit. He completed pediatric residency at the University of Rochester (N.Y), and a Robert Wood Johnson General Pediatric Academic Fellowship in rheumatology. He currently works as a pediatrician in private practice in Richmond, Va., and spends two days a month at the Children’s Hospital of Richmond at VCU. He is a board member of the Mid-Atlantic Region of the Arthritis Foundation, a past recipient of the ARA Senior Rheumatology Scholar Award, and a RheumPAC board member.
Q: Why did you choose a career in pediatric rheumatology?
A: A lot of where I come from is personal experience as a parent. Three of my four children had Individualized Educational Plans, all for various reasons. I’ve been on both sides of the fence dealing with schools, special education issues, mental health issues, etc. Much of what these kids need are systems issues. Getting to school, appropriate school services and accommodations, paperwork.
Q: What systemic changes are needed for pediatric rheumatology patients?
A: There needs to be recognition that chronic illnesses are chronic illnesses, and they need to be treated appropriately and vigorously. Take, for instance, the biologic medications. If you can treat someone aggressively early on, and you can keep them in school or in work, even if that medicine costs a whole lot, the societal benefits are a great return on the investment.
Q: What does being a RheumPAC committee member mean to you?
A: The sarcastic answer is I get to hang out with some really cool people. Being on the RheumPAC committee has been exceptional. I’ve always been willing to talk to legislators and push the College’s goals for people with rheumatologic diseases.
Q: What does an award for service mean to a veteran clinician?
A: It’s an incredible honor. The folks in the trenches, as a rule, don’t get as much recognition. To have your peers say what you have done is special is an amazing thing.
ACR Henry Kunkel Young Investigator Award
Chyi-Song Hsieh, MD, PhD
Alan A. and Edith L. Wolff Professor in Rheumatology and Associate Professor of Medicine, Pathology, and Immunology, Washington University School of Medicine, St. Louis, Mo.
Background: Dr. Hsieh joined the faculty at Washington University in 2005 and this summer was appointed to the Wolff Professorship in Rheumatology. His research laboratory includes eight graduate students and two technicians—but he’s quick to point out he’s never had a postdoctoral fellow.
“That keeps it very fresh and young,” he says. “At the same time, graduate students tend to have a warm-up period, where they are not especially productive. That can be frustrating, but that also is really fun to watch and see them develop. They bring an incredible amount of energy to the lab.”
Dr. Hsieh graduated from the University of Chicago and earned his medical degree and doctorate from Washington University. He completed his residency, fellowship, and postdoctoral fellowship at the University of Washington in Seattle. His interest in T-cell differentiation began early in his research career. As a graduate student, he demonstrated the role of IL-12 induced by bacterial products in T helper 1–cell differentiation. As a postdoctoral fellow, he showed that T-cell receptor specificity is important for the development of regulatory T cells. “The thing that was a revelation to me is that normally you think of T cells as sitting around waiting for bad guys to come … then they get activated and attack them,” he says. “But they are generated in the body and they are required to prevent spontaneous autoimmune disease. So, essentially, they are a negative force on activation of the immune system.”
Q: What are the long-term goals of your research?
A: We are trying to understand how these cells develop, and trying to figure out whether or not we can harness these cells to treat autoimmune disease. I think that involves knowing how to recognize the cells and the signals that cause their development.
Q: As a young investigator, what is the value of a good mentor?
A: They teach you a whole hell of a lot. They teach you how to think. They teach you how to write. And then they keep helping you, even when you are no longer in their lab.
Q: What does this award mean to you?
A: It’s an incredible honor. It’s so nice to be recognized by my colleagues in this way. It’s the first award I have received of its kind, so it’s really quite special.
ACR Excellence in Investigative Mentoring Award
Kenneth Saag, MD, MSc
Jane Knight Lowe Professor of Medicine, Division of Immunology and Rheumatology, University of Alabama at Birmingham (UAB); Director, Center for Education and Research on Therapeutics of Musculoskeletal Disorders, Center of Research Translation in Gout and Hyperuricemia, and Center for Outcomes Effectiveness Research and Education
Background: A Chicago native, Dr. Saag earned his medical degree and did his residency at Northwestern University’s Evanston Hospital. He followed that up with his rheumatology fellowship at the University of Iowa Hospitals and Clinics in 1993 and joined UAB in 1998. His research focuses on the epidemiology of osteoporosis and gout, new methods for designing clinical trials in rheumatic disease, and testing methods for translating evidence into practice. Many of his studies “focus on understanding the comparative effectiveness and safety of drugs and biologics,” he says. The chair of the ACR’s Quality of Care Committee the past four years, he was recently elected to ACR’s board of directors. He is also a board member of the National Osteoporosis Foundation and the Gout and Uric Acid Society, and sits on the Advocacy Committee of the American Society of Bone and Mineral Research. He’s published more than 220 peer-reviewed articles and recently authored the first edition of the clinical handbook Diagnosis and Management of Osteoporosis.
Q: What did you learn most from your mentors?
A: The need to prioritize mentees’ projects and to get protected time for junior investigators. This ensures an institutional commitment to their research, and allows them to cultivate ideas with lots of one-on-one interactions, including serial review of grants and reports, and the ability to receive feedback from investigators in multiple disciplines.
Q: How gratifying is it to see your mentees succeed?
A: It’s right up there with success of your kids. It’s really exceptionally satisfying to see the accomplishments of some of the people I have played a role in helping mentor.
Q: What advice do you have for the next generation of researchers?
A: Perseverance is probably the key. If you have a good idea, work hard at developing it, and if you are not too put off by some periodic rejection, then over the long run you have a high probability, if you are in a good environment like UAB, to be successful.
Q: What does this award mean to you?
A: I am very honored and humbled by the award. It’s really not about me, but it’s about the institution, the leadership, and the mentees I have had an opportunity to work with over the past 15 years at UAB.
ACR Distinguished Fellowship Program Director Award
Michael Pillinger, MD
Associate Professor of Medicine, Biochemistry, and Molecular Pharmacology and Program director, Rheumatology, NYU School of Medicine/NYU Langone Medical Center; Section Chief, Rheumatology, New York Harbor Health Care System, New York Campus; Department of Veterans Affairs.
Background: Dr. Pillinger was born in New York City, graduated from Harvard University, and then returned to Manhattan for medical school, residency, and a fellowship before taking a faculty position at NYU in 1992. His research has focused on innate immunity and signal transduction in cells involved in arthritis. More recently, he has studied gout and the effects of gout and hyperuricemia on cardiovascular and other comorbidities. He has served as NYU Fellowship Program Director since 2001, during which time eight of his fellows have received the ACR Distinguished Fellow Award. A past winner of the ACR Clinician Scholar Educator Award, he has served the College in various leadership roles. He recently completed his term as chair of the Rheumatology Research Foundation Study Section B for educational grants.
Q: What is the value of mentoring?
A: Mentoring is a complex process, and its value is different in every relationship. But, some of the most important parts of mentoring are at the beginning of a relationship, when you primarily are a teacher and role model.
You want to help people get their career started, and you want make them think that the career they want is possible. As the mentoring relationship moves on, you go from being more of a teacher to a guide, and, ultimately, to a facilitator. A successful mentor leads their mentees to independence. After that, you become friends and colleagues, if you’re lucky.
Q: How has your administrative role evolved the past decade?
A: It’s been professionalized. There is more paperwork than there used to be. It’s become more important to have help and support to do the job. At the same time, I do think that there are positive benefits from the professionalization of the role. I think that the rules have helped us get rid of our blind spots, helped us recognize where we have had inadequacies.
Q: A number of your graduates have become program directors. How gratifying is it to see fellows grow and succeed?
A: I think that’s how every program director thinks. If you don’t, you probably shouldn’t be a program director.
The mentees need to succeed on their own terms. They can’t have my success; they have to have their own success. I honestly am most gratified that most of the people who trained 10 or 15 years ago with me still have an affinity for NYU. That means is it was a good time for them, and it wasn’t like they were just moving on. They left with appreciation, and that’s really gratifying.
ACR Distinguished Clinician Scholar Award
James Rosenbaum, MD
Chair of the Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University (OHSU), and Chief of Ophthalmology at Legacy Devers Eye Institute, both in Portland, Ore.
Background: It’s often difficult to call somebody unique—but Dr. Rosenbaum is exactly that.
How many rheumatologists are the child of a rheumatology doctor so famous his memoir was turned into a movie named “The Doctor”? And, if that’s not enough, how many of those folks also serve as chair for an ophthalmology department?
“I have a unique niche,” Dr. Rosenbaum says. “I’m one of the few people in the world who have approached eye inflammation from the perspective of rheumatology, and that’s enabled me to see things a little differently, to use an ophthalmic verb.”
After graduating with honors from Yale Medical School, he pursued rheumatology, as had his father, Edward Rosenbaum, MD. He did his internship and residency at Stanford University and took his first faculty appointment at the University of California, San Francisco.
He’s been at OHSU since 1985.
He is a former president of the American Uveitis Society and has authored more than 400 papers and book chapters dealing primarily with the interface between ophthalmology and rheumatology.
Q: You’re the only practicing rheumatologist in the world to head a department of ophthalmology. How did this happen?
A: Well, not by design, because I thought that I would never go into a field where I couldn’t spell the word.
When I was a fellow, which started 35 years ago, I was trying to develop a rat model of reactive arthritis … when the pathologist said to me that the rats had developed uveitis, I didn’t know the definition of that word. Uveitis refers to inflammation inside the eye, and it’s because of the rat’s disease that I’ve devoted my career to understanding eye inflammation. I am truly a doctor whose career has been under the direction of some rats.
Q: What do you want people to know about you?
A: My father was rheumatologist. I now hold a chair that is named for my dad. My dad started the division that I now head, and he did it as a volunteer. It wasn’t unusual for many medical schools, once upon a time, to not have a division of rheumatology.
My father was the first rheumatologist in the state of Oregon and built the division enough that the school went out and hired a full-time leader, and I eventually inherited the division. I think I’ve been especially fortunate to have such a role model.
ACR Distinguished Clinical Investigator Award
Jeffrey Katz, MD, MSc
Professor, Medicine and Orthopedic Surgery, Harvard Medical School; Professor, Epidemiology and Environmental Health, Harvard School of Public Health; Director, Orthopedic and Arthritis Center for Outcomes Research, Brigham and Women’s Hospital, Boston
Background: Dr. Katz graduated from Princeton University and Yale Medical School, completed his residency at Yale–New Haven (Conn.) Hospital, and completed a rheumatology fellowship at Brigham and Women’s Hospital. Seeking training in clinical research methods, he earned a master’s degree at Harvard School of Public Health. He says the field of rheumatology appealed to him because it, “placed a great deal of emphasis on longitudinal care, and relied upon history and the physical exam more so than costly technology for assessing patients.”
He is principal investigator of the MeTeOR Trial, a multicenter, randomized controlled trial of the efficacy of arthroscopic partial meniscectomy, and principal investigator of Brigham and Women’s Multidisciplinary Clinical Research Center. Regarding MeTeOR, Dr. Katz says his research, “doesn’t tell patients what to do. Life is never that simple. But our data help to frame decisions.”
An ACR member since 1987, he previously received the ACR’s Henry Kunkel Young Investigator Award.
Q: What advice do you have for those considering a career in clinical research?
A: Try to acquire expertise in cutting-edge clinical research techniques, so as to be able to answer questions as rigorously as possible. Also, for rheumatologists who work primarily as clinicians but would like to engage in research, there are a lot of wonderful opportunities for collaboration. We researchers need the advice and perspectives of excellent clinicians about the most important problems they face.
Q: What is most satisfying about your research?
A: All researchers love to see the data as they come in, after you have worked really hard to produce them. It’s fun and exhilarating. We have done a lot of work on the relationship between volume and outcome of different orthopedic surgeries. I think some of the most exciting moments were seeing the very first printouts that showed these relationships that we expected, and the data actually showed them to be true.
Q: What does this award mean to you?
A: I find the most satisfying parts of my career have been working with young people, helping them advance their careers and knowledge. This award reminds me of how fortunate I have been, and that those who have enjoyed successes have a responsibility to share their insights with the next generation of investigators.
ACR Distinguished Basic Investigator Award
Anne Davidson, MBBS
Professor, Molecular Medicine, Hofstra-North Shore-LIJ School of Medicine, Hempstead, N.Y.; Investigator, Autoimmunity and Musculoskeletal Diseases Center, Feinstein Institute for Medical Research, Manhasset, N.Y.
Background: Dr. Davidson’s route to rheumatology started in her native Australia. She received her medical degree from the University of Melbourne and completed her residency at the Alfred Hospital in Melbourne. She did her rheumatology fellowship at Monash University in Melbourne, but decided she wanted laboratory experience and came to New York to work in the lab of Betty Diamond.
That was 1984, and she’s still in Manhattan.
“The career opportunities were much better in New York,” she says. “And then I met my husband, and once that happened, it became a whole different ballgame in terms of where we were going to live.”
Staying appears to have been the right choice. Dr. Davidson’s award-winning research has focused on pathogenesis of and therapy for systemic lupus erythematosus (SLE). More recently, she has worked on mechanisms of inflammation with the SLE kidney. Dr. Davidson is on the medical advisory board for the New York SLE Foundation and a standing member of the grant-review committee of the Lupus Research Institute. She is a past winner of both the Kirkland Scholars Award and the Dubois Award.
Q: What motivated your research focus?
A: I had worked on lupus during my postdoc and wanted to do something different from my mentor, so I spent several years studying B cells in human rheumatoid arthritis. There was not as much understanding of the importance of B cells in rheumatoid arthritis at that time. However, there were a number of investigators in the rheumatology community that had difficulty obtaining research funding for looking at the role of B cells in rheumatoid arthritis, because funds were very tight at that time and the general feel was that B cells were not important—which turns out, ironically, to have completely turned around now.
Q: What do you see as the practical application of your work?
A: We would like to continue to translate mechanisms that we learn of in the animal models to a better understanding of human disease and better use of therapeutics. Obviously it’s all very well to study a mouse, but the most important part of this is to translate what is relevant from that work to the human diseases.
Q: What’s more important: awards or grants?
A: Awards are very nice, but grants are more important. The ACR has done a tremendous amount to support research in the community, and without the Rheumatology Research Foundation and without the foundations that support lupus research, we just wouldn’t be able to keep going.
Richard Quinn is a freelance writer in New Jersey.