As I sat down to write my final column as your president, I reflected on the past year—the work that we have done, the plans that we have made, and the seeds that we have sewn. I now have a deeper appreciation for the enormous scope of work that the capable, creative staff and the many hundreds of passionate ACR, ARHP, and Rheumatology Research Foundation volunteers are engaged in each year—and that scope continues to grow. We often wonder if the external pressures on the field will overwhelm us, or if our young colleagues will have the passion and commitment to write the next chapter in our profession—to continue to write the history of our great College. The recent past has been dotted with complex issues and uncertain solutions, and I sometimes hear senior colleagues discouraging young people who are considering a career in medicine. Still, I find myself encouraged by the enormous progress we have made as a united voice to advance rheumatology!
There is safety, comfort, and even power in numbers. When we brainstorm on our list serve, in our practices, and at meetings to try to find possible solutions to our challenges, it is reassuring to know that we are not alone in one crisis or another, and that help may be on the way. Through all of the uncertainty, and more than occasional frustration, I am still left with the feeling that there is no greater calling. At the end of the day, our real impact is on our patients’ health and quality of life. As Martin Luther King, Jr. said, “The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy.” I’d like to use my final column to celebrate some of the strides we’ve made against the challenges we face every day, and the people who drive our success, now and for the future.
Strategic Planning: Our strategic planning (SP) effort has set a course that will allow us to face our most complex challenges head on. Sharad Lakhanpal, MD, and William Harvey, MD, led an energetic, forward-thinking SP Task Force representing the full spectrum of our membership. The survey of the membership that created the core of this planning process sent a loud, clear message that issues related to the changing landscape of payment reform weigh heavily on the minds of all of our members. One bold new initiative has emerged, thanks to collaborative brainstorming efforts of our Committee on Rheumatologic Care and Quality of Care Committee (QOC) chairs, Charles King II, MD, and Kenneth Saag, MD, MSc, respectively: the multidisciplinary Council on Healthcare Economics (CHEC). Under the direction of Neal Birnbaum, MD, the CHEC has been charged with helping us navigate evolving payment reform, hopefully leading to unique tools to optimize rheumatology practice efficiency, and ultimately helping us improve the quality of care that we provide for all of our patients. Representatives from key committees will gather in this council to share their unique perspectives to arrive at collaborative, comprehensive solutions.
Advocacy: Targeted, coordinated, and tireless efforts led by Tim Laing, MD, chair of the Government Affairs Committee, Edward Herzig, MD, chair of RheumPAC, Adam Cooper, ACR director of government affairs, and our lobbyists, including former Senator Tim Hutchinson at Dickstein Shapiro, have succeeded in finding support for our key issues, with legislation being introduced to limit coinsurance for Tier IV medications (H.R. 460, The Patients’ Access to Treatments Act of 2013), and to exempt physician-administered drugs from sequester cuts (H.R. 1416). We continue to work with key committees in Congress, as well as with the Centers for Medicare and Medicaid Services (CMS), to ensure that the Sustainable Growth Rate formula will be repealed and replaced by a menu of options that allow for the appropriate management of patients with chronic, disabling, and life-threatening conditions. Ongoing efforts of the highly successful Simple Tasks campaign facilitate our interactions with Congress, and have worked hand in hand with our robust advocacy efforts. Those of you who know me well have come to expect a healthy dose of skepticism at every turn, but even I am encouraged by the willingness of the staff and leadership of key committees in Congress and CMS to listen to—and even to incorporate—our crucial feedback.
Quality: We look forward to the implementation of our revolutionary electronic health record–enabled registry, RISE, in early 2014. We expect that our unique registry will play a critical role in the design of the practice and payment interface of the future, while it facilitates improvement in quality of care and advances in our understanding of key clinical questions. Our QOC activities will continue to inform the development of RISE and to set the standards for care in our field—critical to our reputation as the principal professional home and quality standard–setting body for the field of rheumatology.
Education and Publication: While we are navigating the complex waters of the heathcare environment, we maintain an unwavering commitment to excellence in feeding the minds of the lifelong learners in our discipline. Positioned as the premier source of education for rheumatology professionals, our education enterprise embraces a philosophy of continuous quality improvement. Our programming offers a broad range of opportunities to review, renew, and update, with networking opportunities at our signature Annual Meeting, our State-of-the-Art Clinical Symposium, or the smaller, more personal Winter Rheumatology Symposium. We have developed a new certification program for musculoskeletal ultrasound, and are providing training programs for varying levels of skill. Education for Maintenance of Certification (MOC) has a home at the ACR, with original programming designed to meet the full range of needs for our members seeking both CME and MOC credit. Web-based programming continues to grow, so busy schedules, varying educational needs, or even location in the world does not limit access to the best education in the field. As our website and learning management technology is enhanced in the coming year, we will have the capability to expand the range and creativity of the programming that will be available worldwide. Similarly, our journals, Arthritis & Rheumatism and Arthritis Care & Research, continue to attract the best science in our field, and they will renew and grow to meet the changing needs and expectations of our members and of our discipline.
Leadership Development: Emphasis on defining and supporting the future for our practicing community must be paired with a commitment to advance rheumatology through growth in our research enterprises, training programs, and career development programs that work in concert to advance discovery and ensure that we will have a strong, capable workforce. As a result of recommendations from the 2020 Task Force and the Blue Ribbon Panel on Academic Rheumatology, our Strategic Planning Task Force recommended the creation of a robust leadership development program. Under the leadership of past ACR presidents Peggy Crow, MD, and Sherine Gabriel, MD, MSc, the planning for this critical program is well under way—stay tuned! While our Committee on Rheumatology Training and Workforce supports the work of our dedicated network of program directors to a degree that is the envy of many specialty and subspecialty societies, they work with the Accreditation Council for Graduate Medical Education and American Board of Internal Medicine to define the scope of our discipline and the competencies that our trainees must acquire to become independent practitioners.
Research: The Committee on Rheumatology Training and Workforce and the Committee on Research work in concert with our Foundation to provide career development opportunities, define the research agenda, and provide much-needed funding. The future of rheumatology relies, in large part, on the success of these efforts and on our ability to share our passionate message and expand our reach to attract potential new trainees, and to motivate more of our colleagues, patients, and others to become donors in our Journey to Cure, and to advocate to increase National Institutes of Health funding.
People Are the Heart of the ACR
As I reflect on my past year and on each of our critical missions, I see no simple tasks. As I look towards the future, I am confident that the strength of our College and our commitment to excellence and innovation at every turn will serve us well.
I am encouraged by the energy, vision, and dedication of our young colleagues—Dr. Harvey, the Young Board of Directors member, (BOD), Erin Arnold, MD, a BOD member, Elizabeth Perkins, MD, chair of the Insurance Subcommittee, Peter Embi, MD, chair of Registry and Health IT, and Zsuzsanna McMahan, MD, incoming young member of the BOD, to name just a few.
I have been fortunate to have been a member of an amazing Executive Committee: Joseph Flood, MD, E. William St.Clair, MD, Joan Von Feldt, MD, MSEd, Jan Richardson, PT, PhD, OCS, David Daikh, MD, PhD, and David Karp, MD , MD, PhD.
I am in awe of the dream team of senior staff that our Executive Vice President, Mark Andrejeski, has assembled, and I owe each of them an enormous debt of gratitude: Colleen Merkel, operations and finance; Donna Hoyne, education; Jane Diamond and Nancy Parker, journals; Rachel Myslinski and Amy Miller, practice, quality, and registry; Adam Cooper, government affairs; Mary Wheatley, research and training; Steve Blevins, IT; Joan Roth, communications and marketing (stay tuned for a new website!); Erin Latimer, Simple Tasks; Lisa Amaker, The Lupus Initiative; David Haag, ARHP; Steve Echard and Paula Reed, the Foundation; and last, but certainly not least, Julie Anderson, governance. I am confident that the vision, passion, and commitment of our volunteers and staff place us in an excellent position to advance rheumatology. The future is bright!
Dr. Uknis is professor of medicine and senior associate dean for admissions and strategy at Temple University in Philadelphia. Contact her at email@example.com.