If someone had told me that one day I would serve as the 82nd president of the ACR, I would have thought it as likely as lassoing the moon. Now, with the gavel passed to me at our 2018 Annual Meeting, I assume this role in awe of the enormity of this honor, as well as the enormity of opportunities and challenges that lie ahead for the field of rheumatology and for the ACR, which serves us all.
How Did I Get Here?
My road to becoming a rheumatologist was hardly direct. In college, I was an English major, inspired by sublime and ethereal ideas and the prose and poetry that gave them form. At the time, I was not as enamored of the study of science, although I was always fascinated by the story of scientific discovery, particularly when a hypothesis had been proved through a series of elegant experiments. But what ultimately compelled me to apply to medical school was its guarantee that with enough hard work I would gain the necessary credentials for a meaningful career in which the basic job description was helping others through the acquisition of knowledge and the cultivation of intuition.
I feel incredibly fortunate to have attended New York University (NYU) School of Medicine and to have done all my professional training there, especially with its long and outstanding history as a pioneer in the study of rheumatic diseases. Despite the strong research focus of the division, I knew from the start that I was heading toward clinical practice, while keeping an academic foothold at NYU and enjoying the enrichment of teaching and interacting with house staff and students. I have, thus, spent my entire career in private practice, initially solo for eight years and then as part of a large, multispecialty group practice, for which I have been the CEO and managing partner for the past decade.
As I assumed more management responsibilities for my group, I again felt compelled to obtain the necessary credentials to do this job well—hence my path to an MBA and the study of business, which, given my undergraduate predilections, had never even remotely interested me. But I soon realized that almost all business is driven by a few basic principles or big ideas, which seem simplistic and obvious when stated, but are far more nuanced, complex and elusive in their application.
Of these ideas, two in particular stood out, as I think they would for all of us in healthcare who strive to be data driven, patient centric and best in class at what we do. First, to improve performance, you have to measure it (hence the importance of understanding financial statements, which are the report cards of any organization); and second, to do well in business, you must seek to understand and serve the needs of your customers (who, for us, are primarily our patients, but also our students and our colleagues). In learning to view our work from a business perspective, I made another unexpected, but natural, segue in a career that has turned out quite differently from anything I would have originally imagined.
ACR: Our Promise
As part of the development of our current strategic plan, the ACR put forth for the first time its brand promise: We are here for you, so you can be there for your patients. How will the ACR strive to deliver on this broad promise? As it turns out, in some of the same ways that we as rheumatology professionals strive—by being data driven, customer centric and best in class.
The evolution of ACR as a data-driven organization is rapidly taking place, not only inwardly, but also from our outward-facing activities. Chief among these has been the continued expansion of the RISE registry, which has now enrolled approximately 30% of practicing rheumatologists and collected data on more than 1.6 million unique patients in almost 10 million patient encounters. The power of this tool to advance clinical research, improve patient care and serve our members by tracking and reporting their quality performance is staggering—and we are just getting warmed up.
From the inward perspective, the ACR is committed to implementing data-driven approaches in all that we do through the development of operational and strategic dashboards. These will allow us to measure our progress in reaching our strategic goals and, as we move forward, to validate whether the resources allocated to achieve these objectives are leading us to the desired outcomes.
Defining the ACR customer is no simple task, especially when one considers that ACR is home to all constituencies residing within the house of rheumatology, from bench to translational researchers, community to academic practitioners, and 22 types of rheumatology professionals within the ARHP. Further complexity enters the mix when we consider our millennials, whose preferences regarding how they acquire knowledge and interact socially open up whole new aspects to our understanding of the needs of our customers. Likewise, our many international colleagues bring yet another dimension to this all.
Where do we start? For now, we are building on what we do best: delivering state-of-the-art education in our field, further enabled by technology and by the creation of alternate learning platforms. We are improving and expanding ACR Beyond for on-demand virtual access to our meetings. We continue to seek new ways to use social media to heighten engagement and communication among those attending or following. And starting this year, the ACR is exploring its potential as a truly global organization by holding its first overseas meeting in Dubai, in collaboration with the Emirates Society of Rheumatology.
To improve performance you have to measure it (hence the importance of understanding financial statements, which are the report cards of any organization); & … to do well in business, you must seek to understand & serve the needs of your customers (who, for us, are primarily our patients, but also our students & colleagues).
Best in Class
Aristotle once said that excellence is never an accident but always the result of high intention, sincere effort and intelligent execution. We need only look at the dedication of our ACR staff to understand the basis for achieving excellence in our organization. Likewise, the pursuit of excellence is seen in the efforts of our amazing corps of ACR volunteers, whose enthusiasm and diverse perspectives help set and propel our priorities. Here, we have given our fellows in training a place at the table on each of our committees as we recognize they are the future of our profession and their voices must be heard.
With so much talent on hand, our challenge is to continually exceed our own personal best in service to our members, especially as the healthcare landscape changes, often unpredictably. In this regard, our remarkable advocacy team repeatedly steps up to draw the attention of our nation’s leaders to issues that threaten our ability to care for patients or to pursue research into the diseases that afflict them.
Getting our message heard is an enormous task, not only in government affairs, but also in communication to our members about ACR initiatives to support their day-to-day work and in broadcasting to everyone the value of our specialty.
As I look to the year ahead for the ACR, I know we have a promise to keep: to be here for you. Together, we will work tirelessly to deliver on that promise. We never know what is within our reach. We may even lasso the moon.
Paula Marchetta, MD, MBA, is a rheumatologist in New York City and the CEO and managing partner of Concorde Medical Group, a multispecialty private group practice affiliated with NYU Langone Health. She teaches at NYU School of Medicine, where she is a clinical professor. Dr. Marchetta is the 82nd president of ACR.