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Explore This IssueNovember 2007
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When he walks to the podium in Boston for his first official duties, incoming ACR President David A. Fox, MD, will be treading familiar turf. The three-year prelude to presidency – when candidates serve as secretary-treasurer, vice president, and then president-elect – is designed to educate future officers about the full spectrum of the ACR’s membership needs and issues. Dr. Fox found this lead-in period a valuable opportunity to work with and learn from senior staff members and fellow officers. “ACR structures its officers group to include a mixture of those in academics and private practice, so that we complement each other’s strengths and learn from each other,” he says.
Dr. Fox is professor in the department of internal medicine, division chief of rheumatology, and director of the Rheumatic Disease Core Center at the University of Michigan Health System in Ann Arbor. He believes that attention to the needs of both academic and private practice members (the latter account for approximately 70% of the membership) has helped the ACR avoid the clinical-research division that occurs in other professional societies.
“The linkage between the practice side and the research side has so much to offer everybody,” he says. “The whole is greater than the sum of the parts. I think that’s what we see in our College, which is so valuable, is almost unique about rheumatology compared to other specialties in medicine, and is what we are very committed to preserving.”
Challenges in the New Year
Dr. Fox inherits a full agenda as incoming president. Topping that list is maintaining excellence in the ACR’s ongoing core activities (annual scientific meetings, journals, and periodicals) while responding to members’ needs.
The latter increasingly involves participation in public policy. It’s a challenge, Dr. Fox admits, to stay abreast of the many public policy arenas in which the ACR is now active. Fortunately, the executive officers have help: ACR senior staff and the Washington, D.C.–based lobbying firm Patton Boggs stay tuned to federal legislation and help ACR leaders prioritize their lobbying efforts. In 2008, the ACR will likely be involved in lobbying Capitol Hill about the sustainable growth rate; the Arthritis Prevention, Control, and Cure Act of 2007; and the NIH research budget. Dr. Fox notes that the organization now understands that “we have to create awareness among legislators, and we have to repeatedly visit Capitol Hill.”
Keep Rheum In the Game
Research funding for arthritis has declined in the last four years. “In terms of real dollars, we are probably just about back to where we were about 10 years ago,” Dr. Fox says. Vying for a share of the NIH budget will likely get even more difficult. That’s why the ACR Research and Education Foundation’s (REF) “Within Our Reach” RA research fundraising campaign, under the leadership of James O’Dell, MD, has been timely – not only because of the money but because of the awareness it has raised. “What the public as a whole perhaps does not appreciate is that arthritis is a leading cause of disability in the United States,” says Dr. Fox. “Its impact, economically and health-wise, is way beyond the proportion of the research budget that goes to arthritis.”
ACR’s Committee on Research, chaired by E. William St. Clair, MD, will be rolling out other initiatives within the next year. One is a new conference for advanced rheumatology fellows that will be held every other year (on alternate years from the Arthritis Foundation’s Research Conference). The first conference (scheduled for next summer) will allow fellows to present new research and network with established scientists and clinical researchers.
The Committee on Research is now considering possibilities for a future REF research program to launch after the RA initiative is complete. A leading researcher, Dr. Fox will work with the committee in formulating a research agenda. “I can imagine many different possibilities which would all be exciting,” he says. “I think when you do [initiate a new direction for research], you have to be shrewd, and you need to pick a disease or a theme in which there are opportunities and scientific potential to make rapid progress. Timing is really key. I’m looking forward to seeing what the talented people in the Committee on Research will bring up.”
On the Watch List
ACR committees, such as the Quality of Care Committee, will also monitor federal initiatives, including the quality movement and pay-for-performance. “We all know that quality can be a banner for implementation of cost-cutting and reduction of payments for services,” cautions Dr. Fox. “Our members believe that we have to make sure that quality is going to make a positive difference for our patients. They don’t want to participate in quality exercises that are just excuses for withholding reimbursement.”
In that vein, the ACR has been active in the quality measures creation process with initiatives like the second ACR Quality Summit, held in September, which brought together stakeholders from the ACR, insurers, and independent agencies. (Look for a report on the summit in a future issue of The Rheumatologist.)
Finally, Dr. Fox is concerned about shortages in the rheumatology workforce, particularly the crisis of maintaining the number of strong academic rheumatology units in the country. The ACR Committee on Workforce and Training will examine how to develop a base of support for these academic units – possibly by fostering ACR–university medical center interactions – so that they can thrive.
All in all, 2008 promises to be an exciting year for the ACR. Clearly Dr. Fox sees his presidency as a collaborative venture. “It’s not as if each ACR president comes in and sets a new direction, putting a totally different agenda in place.” The process, he says, is an evolving one. “A lot of thought and teamwork has gone into any actions that we take.”
Assuming the ARHP presidency will ramp up an already intense schedule for Kimberly Kimpton, PT, of HealthMark in Denver. During this past year as president-elect, she’s been an integral part of Executive Committee activities. And, with an eye not just to her upcoming term but also to the sustained growth of the organization, she has personally had a hand in reinvigorating the membership of ARHP’s other standing committees.
Craft Committees Carefully
Kimpton traces her involvement with the ARHP back to a letter she wrote to meeting organizers following her first contact with the program at an annual meeting. Her comments landed her an invitation to be on the program subcommittee. “I’ve been part of this organization for about 15 years,” she says. “I got drawn in early and I’ve been receiving value ever since.”
As the 2008 president, she’ll have a chance to further the organization’s reach and scope, a goal about which she is clearly passionate. That goal will be attainable due in part to the activism of her fellow ARHP members. “Over 10% of our membership is involved in leadership, committee membership, or representatives to ACR committees,” she says. Because health professionals are a diverse group – comprising nurses, physical therapists, nurse practitioners (NPs), and physician assistants (PAs), to name a few – it’s a challenge to address the needs of and provide professional support for each discipline. That’s why committee leadership recruiting efforts always emphasize both geographic and interdisciplinary distribution.
To broaden its support for diverse disciplines, the ARHP, through its Committee on Education and its Program Subcommittee, is developing products to “help people identify why this is their organization and how this can primarily benefit them,” says Kimpton. The ARHP will debut the fruits of the two year–long NP/PA Education Project at this year’s annual meeting. This Web-based rheumatology training course will be available in the spring. “When dollars to travel to face-to-face meetings are shrinking, we’re growing,” enthused Kimpton. “We’re throwing in Web-based education to fill that hole and take care of that need.”
2008 and Beyond
The ARHP is keenly aware of the need to attract and retain more members. “I would say the new generation is where we’re really headed,” says Kimpton. “We need to make sure that we integrate technology [into our efforts] so that we can reach those that cannot make face-to-face meetings, and find ways to support their educational needs.”
Accordingly, she has charged ARHP’s standing Committee on Practice and Membership to explore expansion of student memberships. The ARHP will also continue “stretching beyond our continental borders to embrace our international colleagues, and bring in their expertise,” she notes. For instance, the ARHP’s Clinical Care in the Rheumatic Diseases, 3rd Edition has been translated into several different languages.
Unique in Its Class
“The ARHP is the premier organization for rheumatology health professionals, and I don’t see that changing,” says Kimpton. While other specialty-specific rheumatology organizations exist, no other organization matches the ARHP’s collaborative approach.
“The health and wellness of someone with rheumatic disease can be managed optimally when all the relevant disciplines are involved,” she says. “It is so exciting that the professionals in our organization collaborate in patient care, rheumatology research, and in providing professional support. Even though it is a secondary or tertiary professional organization, ARHP is a professional home to so many people.”
Gretchen Henkel is a frequent contributor to The Rheumatologist.