From the challenges of rheumatic fever to evaluations of how to wisely and cost effectively use treatments for rheumatoid arthritis (RA), the ACR has contributed to the enormous changes and advances that have taken place in rheumatology in the past 75 years. The ACR will be feted for its contributions as the organization celebrates its 75th anniversary at this month’s annual meeting in Philadelphia.
“We can look back and see how far we’ve come, but we’re also looking forward,” says David Pisetsky, MD, PhD, professor of medicine and rheumatology the Duke University Medical Center and chief of rheumatology at the Durham VA Hospital, both in Durham, N.C. Dr. Pisetsky also is editor of a commemorative book that honors ACR’s anniversary and the medical editor for The Rheumatologist.
A number of activities are planned in order to recognize ACR’s anniversary at the annual meeting. A three-dimensional art piece done by artist Lawrence Romorini, to be unveiled at the meeting, incorporates carefully positioned objects—such as documents, books, photos, and even CDs—that are important for the organization’s history.
“All meeting attendees and ACR members will receive the commemorative book chronicling the history of the ACR,” says Lisa Amaker, director of administration and governance for the ACR. The approximately 200-page book chronicles the organization’s history, including the ARHP, the history of the Research and Education Foundation, milestones from annual meetings, and changes in rheumatology practice over the years. Other chapters will address science and treatment areas, such as methotrexate and tumor necrosis factor blockers, Dr. Pisetsky says. The book will also consider the future of rheumatology. “The goal was to be broad and address changes affecting all aspects of rheumatology,” he says.
A number of contributors wrote chapters for the book. “The writers are participants in these advances and people from practice,” Dr. Pisetsky says.
There is also an anniversary-themed annual report to wrap up celebrations planned for ACR’s diamond anniversary, Amaker says. The report will include a timeline of seminal events in the organization’s, as well as rheumatology’s, history.
And Yet More Celebration
In addition to the meeting, the ACR has made other moves to celebrate 75 years. You may have noticed trivia questions on the organization’s Web site this summer to test your knowledge of ACR history. Questions include when and where the first formal business meeting of the American Rheumatism Association took place (answer: June 10, 1934, in Cleveland), where the first academic center in rheumatology was established (answer: Massachusetts General Hospital), what the most popular drug therapy for RA is (answer: methotrexate), and when the ACR’s Web site officially launched (answer: 1995).
The ACR also has a 30-minute commemorative DVD with member recollections and photo montages. The DVD will be distributed to rheumatology training directors to help them recruit physicians in their residency and fellowship programs, Amaker says. A number of distinguished rheumatologists took part in interviews for the DVD, says Shaun Ruddy, MD, professor emeritus at Virginia Commonwealth University in Richmond and chair of the ACR’s 75th anniversary task force.
Looking at ACR’s history
Those who helped plan for ACR’s diamond anniversary celebration acknowledge that the organization has experienced rapid growth and played a key role in the remarkable changes within the specialty.
The ACR began in 1934 as the American Rheumatism Association (ARA) with only a couple of hundred members; there are now more than 7,000 members in the ACR and just over 1,100 members in the ARHP.
The program for the first formal business meeting of the American Rheumatism Association listed 11 papers. As the meeting and the association grew in popularity, other spinoffs grew. For example, the Arthritis and Rheumatism Foundation was incorporated in 1948 as a voluntary health agency with ARA stimulus and sponsorship. In 1958, the ARA published the first issue of Arthritis & Rheumatism.1
After some discussion, the ARA merged in 1965 with the Arthritis and Rheumatism Foundation (by that time called the Arthritis Foundation [AF]).
The specialty began with a membership that was almost exclusively men; now, more than half of the trainees are women, Dr. Ruddy says.
When Dr. Ruddy began working in the field in the 1960s, there was no board examination; the ACR helped advocate for the creation of such an exam, he says. “I’ve benefited greatly from the organization,” he adds. In 1972, the first Rheumatology Subspecialty Board Examination was administered by the American Board of Internal Medicine.
The same year as its 50th anniversary, 1984, the ARA decided to end its association with the AF as a section and became its own independent organization, although the two organizations still have close ties. The ARA changed its name to the American College of Rheumatology in 1988. In 1994, health professionals in rheumatology decided to join with the ACR and ended their association with the AF—at which point they changed their name to the Association of Rheumatology Health Professionals.
Meeting the Challenges
One of the positive aspects of the ACR is that it leads rheumatology without splintering rheumatologists into subgroups, Dr. Ruddy says. “We probably have more academics percentage-wise than other specialties,” he says. Even still, both physicians in practices and those who work in higher education are well represented in the ACR, he believes.
The ACR also has witnessed enormous change in a short time period, Dr. Pisetsky says. “It started as a small organization during a tough time, and with primitive treatments,” he says. “I give the founders enormous credit for their vision and faith.”
At the time the organization began, rheumatic fever was a major challenge. Today, many problems faced 75 years ago are no longer problems. Instead, rheumatologists concentrate on more focused treatment questions for conditions such as RA, Dr. Pisetsky says. “We’ve made big advances in bone disease, but again, there are new questions. There are more public health questions now,” he says. “Any time you have a lot of success, there’s always the question of how you build on it.”
Vanessa Caceres is a medical writer and editor in Florida.
- American Rheumatism Association. A 50-Year Retrospective, 1934–1984. ARA; 1984.