The answer for the ACR, he and others were convinced, was to enlist the services of a professional lobbyist and go to The Hill. In those pre-National Arthritis Act days [the legislation was signed by President Gerald Ford in 1975], Dr. Kaplan recalls, many rheumatologists were uneasy with the lobby effort. Many felt that retaining an organization such as The Lewin Group to help promote the needs of the field would taint their research integrity. With time, that attitude dissipated, and the ACR has been quite successful in advancing awareness at the national level.
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Explore This IssueOctober 2009
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The Public Sector
In his second related career, Dr. Shulman was responsible for many national initiatives thrusting arthritis and the rheumatic diseases into the limelight. In 1976, Dr. Shulman moved to the NIH to begin work in the federal research enterprise. Although he missed patient care and his relationships with young trainees, he approached his new position as associate director of arthritis with gusto, and found the NIH to be “an exemplary government agency.” Once he became the first director of the officially established NIAMS in 1986, he increased the visibility for arthritis and rheumatology, undertaking major initiatives in lupus, osteoporosis, and Lyme disease, as well establishing new research centers. “While at the NIH, I was able to have the challenge of raising money from Congress so all my colleagues in the medical schools could get supported. Every year I got to go represent the field and talk about what was going on. That was great fun!”
United on All Fronts
Growth in awareness and advancing science all contributed not just to better patient care, but to an increase in ACR membership. Another reason for the ACR’s success has been the ongoing cooperation with patient advocates, such as the Arthritis Foundation, says Dr. Kaplan. He has always believed that a united front best serves the field, and when the ACR split from the AF organization in 1986, he argued passionately against further bifurcation between the clinical and research communities. “Some of us saw a danger in a split between the academicians and the private practitioners, which was threatened on several occasions,” he recalls. “In order for me to take good care of my patients, I needed someone in the laboratory doing research. And the research people, if they wanted to raise money, needed to show what their efforts could produce—and they needed us to demonstrate that.”
The following was the result of many hours of discussion in the early 1990s and engraved, for posterity, on a memo pad given to Dr. Kaplan as a memento of his many years with the ACR.