The officers as a group—together with the terrific ACR staff led by Mark Andrejeski—truly function as a team. The accomplishments of any ACR president are always the result of a collective effort by many talented people. The chance to work closely with the recent ACR past presidents and with the current officers who will be ACR presidents in the years ahead has been a uniquely rewarding experience.
So hopefully I’m ready to be ACR president. The ACR has certainly done everything that it can to prepare me.
Big Plans for Small Improvements
The next question—What do you plan to do?—also needs to be placed in context. The ACR is in excellent shape. Its core functions, such as its annual meeting and its publications, have never been stronger. We have enough money in the bank to consider a range of new initiatives. The expansion of the ACR Research and Education Foundation (REF) to include a major targeted research initiative in RA, while continuing its unique and vital role in training and career development, has been spectacular.
Nevertheless, there is no shortage of challenges or concerns. Although available rheumatology fellowship slots are being filled, we know from the ACR’s workforce study that we face a worsening shortage of rheumatologists that seems to stretch permanently into the future.
Further, the inescapable impression is that many of our academic rheumatology units are in trouble, and that some have experienced a significant depletion of faculty. Slippages in research funding from the National Institutes of Health and from other sources during the past few years have hit academic rheumatology very hard and have contributed to an unprecedented efflux of talent from our academic units to attractive positions in industry.
Pressures on practice income challenge the great majority of our members—rheumatologists who deliver patient care—whether they work in private practice, academic units, or settings that are a hybrid of these two environments. The leadership of our academic health systems does not consistently value the role of the rheumatologist, and many of us are under pressure to justify our existence on the balance sheet while being denied credit for the procedural and downstream revenue that we produce. Healthcare issues are on the front burner nationally, and the 2008 elections could lead to major healthcare system reforms.
These issues will not be solved in one year, and there are limits to what any one ACR president can contribute to their resolution. From my perspective, an important goal is to balance the attention given to day-to-day issues with efforts to tackle the bigger problems in a way that produces long-term benefit. We have several important building blocks in place to tackle the workforce issues. These include the current ACR and REF strategic plans, the core career development programs of the REF, and a superb ACR Workforce and Training Committee led by David Daikh, MD
From my perspective, an important goal is to balance the attention given to day-to-day issues with efforts to tackle the bigger problems in a way that produces long-term benefit.
Ambitious Training and Advocacy Targets
Recent years have seen a new curriculum and in-service exam for rheumatology fellows, establishment of a rheumatology match for fellowship entry, development of outstanding and cohesive programs for our fellows at the ACR meetings, and other highly successful initiatives. In 2008 we will inaugurate a new ACR Research Conference, focused primarily on rheumatology fellows who are training in research. The Committee on Research, led by William St. Clair, MD, is supervising the planning for this initiative, and details will be available soon.