Reports from American Medical Association delegates, Arthritis Foundation, ACR Research and Education Foundation, and ARHP were heard. Sharad Lakhanpal, MB, MD, chair of government affairs, reported the ACR advocacy issues for this year and the date for the Advocates for Arthritis event which was held March 9–10 in Washington, D.C. Karen Kolba, MD, chair of the Committee on Rheumatologic Care (CORC), gave her update on all the various CORC subcommittees and issues confronting practicing rheumatologists.
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ACR and the Medical Home Model
The BOD members also discussed the Medical Home Model. The ACR has been asked by the American College of Physicians (ACP) to support the Medical Home Model. The ACP, American Academy of Family Physicians, American Academy of Pediatrics, and others have proposed a major overhaul of the American healthcare delivery system, emphasizing primary care. In this Medical Home model, where the primary care provider becomes the central healthcare provider, it is hoped that healthcare would be better coordinated, more efficient, and more effective. There was spirited debate over the plight of primary care and also perceived shortcomings in that model from a rheumatology standpoint. For instance, it was noted that rheumatologists already provide primary care coincident with specialty care for patients with serious complex immunologic diseases. The Medical Home model, as currently constructed, would discourage that activity if reimbursement policies required that the patient go back to the primary care physician for every primary care problem. Patient care would suffer in that scenario.
Each of the chairs then presented new discretionary projects for funding consideration. The projects were graded by each board member. The grades will be tallied, projects ranked, and decisions made at the next BOD meeting in May as to which projects will be funded based upon the available funds. Because every project seemed thoughtfully developed and important, it is unfortunate that there will not be enough money to fund all of them.
A practicing rheumatologist has few other opportunities to meet and get to know many of the ACR staff and board members that represent other constituencies and functions within the organization. Thus, the lunches, breaks, and dinners were critical to network. It gave me the opportunity to present a “practice” perspective on issues to staff and other board members, as well as to hear other viewpoints that affect all of us involved in rheumatologic care.
The breadth and depth of the ACR’s activities became more apparent to me from attending this meeting, along with the remarkable abilities and intellect of the people responsible for these activities. Flying home from the meeting, I reflected upon the progress the ACR has made over the past six years of my personal involvement. What previously was an organization devoted primarily to education and research has evolved to become the guardian shepherd of our specialty. Rheumatology faces many challenges, and my involvement in the ACR’s attempts to confront the challenges facing the practice of rheumatology has been one of the most sustaining and fulfilling accomplishments of my professional life. To my colleagues in practice who feel the ACR does not do enough, I say the ACR needs you to get involved. We need your ideas and, just as importantly, we need your passion for our profession. We need a few good men and women.