ARHP President’s Award
Daniel Battafarano, DO
Chief, Rheumatology Division, San Antonio Military Medical Center (SAMMC), Fort Sam Houston, Texas
Background: Dr. Battafarano was honored and surprised to earn the vaunted ARHP President’s Award, but it’s not in his personality to take too much time to congratulate himself.
“I’m just sort of a high-energy, hard-charging guy,” he says. “I’m passionate about what I’m doing, whether I’m seeing a patient or teaching, and I’m just trying to contribute to the ARHP, but I didn’t realize that I had separated myself enough to be recognized.”
Dr. Battafarano graduated from the Philadelphia College of Osteopathic Medicine in 1983 with a direct commission to the U.S. Army. He completed his rheumatology fellowship at Fitzsimons Army Medical Center, affiliated with the University of Colorado Health Science Center, in 1992. Col. Battafarano retired from the Army in 2004, and then joined SAMMC.
He is a member of the ARHP Practice Committee and the ACR Committee on Training and Workforce Issues. He’s received more than 10 teaching awards, and has written more than 50 publications in peer-reviewed journals, book chapters, and educational articles.
Q: How has the military shaped your practice?
A: I had many leadership opportunities in the military, and I always work from a selfless service intent with a team approach. No matter what I’m doing, I’m always thinking about how we can have the best outcome, best policy, or best success story collectively. I think that when you have served in the military as long as I did … you realize that there’s a lot of delayed gratification. Recognitions like the ARHP award just come as a surprise, since this was never a goal.
Q: What does this recognition mean to you?
A: I have been overwhelmed in the last year with various recognitions, and it has been humbling and exciting to be recognized when you’re contributing at a high level. Many attendees at the [annual] meeting congratulated me for my award, many of whom I had never met before. And I really appreciated their feedback.
Q: Given your workman-like attitude, how comfortable were you in a position where people were congratulating you? Was it fun?
A: I like to think of myself as a “blue-collar scholar,” meaning I roll my sleeves up, work hard, and try to contribute my maximum effort in the spirit of helping the team, improving the goal, or whatever the mission may be. But when you contribute long enough and you gain experience, you can actually make a difference.
Q: Where do you find the time for all your activities?
A: I think that all successful people work very hard. When you combine hard work with tremendous commitment, you get success. I don’t get up in the morning wondering how hard I’m going to work; I’m just ready to contribute.
Ann Kunkel Advocacy Award
Carole Dodge, OTR, CHT
Division of Occupational Therapy and Physical Therapy, University of Michigan Hospital and Health Systems, Ann Arbor
Background: When she was a 16-year-old volunteer in a rehab clinic, Dodge knew she wanted a career in healthcare. It didn’t take long until the diminutive teen realized physical therapy likely wasn’t the path.
“I realized that my size was going to be a limitation, in terms of standing and walking and moving people,” says Dodge, who admittedly stands shorter than 5 feet. “I walked over to the occupational therapy clinic and saw that they were using a lot of activities to reach patient goals. I was immediately intrigued.”
Dodge started her career in adult rehab, working with patients who suffered brain injuries, strokes, and other neurological diseases. In the 1990s, she began specializing in outpatient arthritis. In 1997, she joined the multidisciplinary team at Michigan, and, in 2007, became a certified hand therapist. She currently has both clinical and managerial responsibility for three outpatient clinics, with about 75% of her patients having rheumatic conditions. She created the American Occupational Therapy Association’s first nationally accredited hand residency program at the University of Michigan.
“I will be an occupational therapist until I retire, because with our career, there are just so many different avenues you can go, in terms of specialization, that you could never get bored,” she says.
Dodge has served on various ARHP committees, has presented several times at annual meetings, was a moderator for the 2007 ARHP audioconference series, and was the ARHP liaison to National Committee for Quality Assurance for developing criteria for reporting on patients with rheumatoid arthritis for the Physician Quality Reporting Initiative in 2008. She currently serves as an ARHP liaison to the ACR’s Communications and Marketing Committee.
Q: What has ARHP meant to your career?
A: My involvement with both the ARHP and the ACR has allowed me to facilitate relationships and contacts, which has taken my career to places that it never would have been if I had not been involved with the organization or the rheumatologists here at Michigan. Michigan has always helped support me to attend the meetings, and it has given me the opportunity to meet colleagues from across the country doing similar work. The ARHP helped me to establish really significant relationships that facilitated my career. I got involved with one professor from New Mexico, and she and I have collaborated on some research. We also presented at not just the ARHP together, but also at the American Occupational Therapy Association.
Q: How has patient care in your sphere of influence advanced since you first started?
A: We’re much more evidence based. We always did things because we thought they worked, but now there’s a real push, in the last 10–15 years, of really becoming accountable, objectively, in the change that we facilitate. That said, we have had to learn how to treat patients in a more effective manner, because the amount of time we have to treat these patients is less and less.
Q: What does an award for advocacy mean to you?
A: I was quite humbled, because when I look at ARHP as an organization, there are a lot of very accomplished clinicians, incredible researchers—a lot of different people that make the ARHP a premier organization.
ARHP Distinguished Scholar Award
Monique Gignac, PhD
Senior Scientist, University Health Network , Institute for Work and Health, and Associate Professor, Dalla Lana School of Public Health, University of Toronto in Ontario
Background: Dr. Gignac is an expert in the areas of health and social psychology—rheumatology just kind of happened. She was interested in how patients with arthritis managed the stress in their lives and never gave up the hunt, particularly as people seemed to wonder why the condition would be that difficult to deal with at all.
“Over the years, I’ve had a lot of people who don’t understand why this condition would be stressful at all,” she says. “They see this as something that is mostly affecting older adults. They remember they had a relative who had these kinds of aches and pains, and they don’t see the stress or understand it.”
In particular, Dr. Gignac’s work focuses on helping patients continue to work despite the severity of their condition. She became co-scientific director of the Canadian Arthritis Network in 2008. She also chairs the advisory board for the Institute of Musculoskeletal Health and Arthritis at the Canadian Institutes of Health Research. She has won several Canadian health awards, including a 2013 Queen Elizabeth II Diamond Jubilee Award from the Governor General’s office.
Q: What does this award say to you in terms of validation of your work?
A: I think the word validation is perfect for this. Funding is very difficult for researchers these days. I know a lot of young researchers are thinking twice about staying in the area. I think getting something like this, it validates the area of research that you work in. I went into this area because I thought there were important questions that needed to be answered, and I think that winning this gives me the ability to say that this is the right path, this is important.
Q: How do you encourage younger physicians, researchers, and scientists to get into this knowing that it’s a rocky road?
A: I really believe that we need to train a different type of researcher. I encourage trainees to take advantage of opportunities to work with stakeholders, clinicians, people with arthritis. You can get their insights right at the beginning of your research so that it is more relevant to the groups that you want to help upfront, and you learn from that. I think that really helps researchers to be smarter about their grants, to have a goal, to be able to know where they plan to go with the research. The days of “we’ll explore something for the sake of exploring it” are pretty much over. You really have to have a more targeted research question, and I think it’s really all about thinking about research teams to move research forward.
Q: With a health-psychology background, did you expect your career to focus on rheumatology?
A: When I started expanding it into employment, that’s when I really noticed that people’s heads were turning, and there seemed to be a real gap here. At that point, I felt that this is probably the area I should stay in.
ARHP Master Educator Award
Michael LaValley, PhD
Professor of Biostatistics, Boston University School of Public Health, Boston
Background: Dr. LaValley was a budding statistician at Penn State University in State College, Pa., using standard survival analysis skills to study the stars when he stumbled into rheumatology.
“My advisor suggested I look into the applications of this in health, as well, because there weren’t really all that many positions open as a statistician to astronomers,” Dr. LaValley recalls. “So I did a postdoctoral fellowship at Harvard School of Public Health, where I started working with health data. And I never left.”
In 1995, he joined Boston University Arthritis Center as a biostatistician and the Boston University School of Public Health as an assistant professor of biostatistics. That was 35 full semesters ago. Now he’s a full professor, and three years ago, he added the title of research director of the Center for Enhancing Activity and Participation among Persons with Arthritis (ENACT) at Boston University to his list. He has served on the ARHP’s Research Committee and the ACR Subcommittee on Clinical Research.
Q: What satisfaction have you gotten from working on rheumatologic issues?
A: I work with a lot of rheumatologists who deal with osteoarthritis, which is very common and very prevalent. It’s very satisfying to work on that because it’s such a common condition. Any small advance can really change a lot of people’s lives. But, I also work with people who look at rare rheumatologic conditions. I’m working with Alfred Mahr in France, who’s looking at Behçet’s Disease, which isn’t very prevalent, at least in the United States. It’s a totally different set of challenges, partly because it’s so rare it’s difficult to study. I think there are a lot of interesting challenges in various aspects to rheumatology.
Q: When you made the decision to go into the School of Public Health, did you see yourself staying in that niche forever?
A: At the time, we were all warned as graduate students that it’s unlikely you’ll get a lifetime job; you’re going to have to move around a bit, maybe you’re going to be in academia or maybe in companies. I’ve been extremely fortunate that things have worked out so well for me. I really haven’t had to move around. I’ve been able to work with a lot of people and do interesting things as well as teach, and I think I’d really miss the teaching if I were to go somewhere where there was no teaching.
Q: How has technology changed interacting with students?
A: As a graduate student, I was used to going to seminars where speakers would present using transparencies. I remember one time a guy came from a math department and used chalk on the chalkboard, and we were like, “How old-school is that?” But these days, transparencies are long since gone. Everybody’s using PowerPoint to teach. In terms of connecting with the students, still being up there on your feet in front of the class is very important. It’s really the eye contact and talking directly with them that gets the ideas across the most.
ARHP Distinguished Scholar Award
Brett Thombs, PhD
William Dawson Scholar and Associate Professor, Faculty of Medicine, McGill University and Senior Investigator, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal
Background: Dr. Thombs graduated from Northwestern University in Evanston, Ill., in 1989 with a bachelor’s degree, obtained a master’s degree in special education from the University of Arizona in 1996, and completed his doctorate in clinical psychology at Fordham University in the Bronx, N.Y., in 2004. He completed his postdoctoral fellowship at the Johns Hopkins University School of Medicine in Baltimore two years later.
He’s published more than 140 peer-reviewed articles focused on depression screening, research methodology, and the psychosomatic aspects of living with scleroderma. But the bulk of his time is now spent directing the Scleroderma Patient Intervention Network, or SPIN, a collaboration of more than 40 investigators from centers in the U.S., Canada, Mexico, and five European countries. Funded by a Team Grant from the Canadian Institutes of Health Research and utilizing novel trial methods, SPIN is developing a large cohort of multinational patients to conduct psychosocial and rehabilitation intervention trials in a “rare disease context.”
“For example, one project team is building an intervention toolkit to work with body image and appearance issues that come with this disease,” he says. “Eventually, the programs will come together and we will test them in large-scale trials.”
The long-term goal is to provide patients free online toolkits similar to interventions and resources available to patients with more common conditions, such as arthritis.
“It’s a real challenge. No one has ever run large-scale trials like this with psychosocial and rehabilitation interventions in any rare disease,” he says. “I think we are going to be able to continually develop and test a variety of intervention resources that are going to help people cope with the disease.”
Dr. Thombs joined the ARHP in 2007, is a member of the editorial board of Arthritis Care & Research, and is a past member of the ARHP Research Committee.
Q: What advice do you have for the next generation of researchers?
A: Find a good mentor. Shop around and ask some good questions when you are looking for a mentor. Ask people where their trainees have published and where they have gone when they were finished.
Q: Any advice for those thinking about a career in research?
A: Collaborate. Sometimes, academia can emphasize going solo and proving you can do it on your own. I think that is an outdated model. People need to expose themselves to as many kinds of different people as they can, with various kinds of expertise. For psychologists like myself, get around epidemiologists, rheumatologists, statisticians, and methodologists, and get as much input as you can.”
Q: What advice do you have for rheumatologists who encounter scleroderma patients?
A: As much as you can, help patients connect with other people with this disease. The Scleroderma Foundation in the U.S. is a tremendous resource, as are other national patient societies. Patients with rare disease often don’t even know other people with the disease and generally don’t have a lot of resources to help them cope.
ARHP Master Clinician Award
Jennifer Trizuto, MPT
Senior Physical Therapist, Mills-Peninsula Health Services, Arthritis and Osteoporosis Center, San Mateo, Calif.
Background: Trizuto never planned on a career working in rheumatology. She was doing inpatient physical therapy at Mills-Peninsula around 1995 when a supervisor asked her about the Arthritis and Osteoporosis Center staff needing help. She started helping out two days a week and the bug was caught.
“We had weekly rounds where we really focused on the patient as the center of our model, and that is really what hooked me—the team approach,” she says.
Trizuto now serves as the Arthritis and Osteoporosis Center’s program coordinator, teaches the Arthritis Self-Management Class, and runs the center’s support groups for osteoporosis, arthritis, and fibromyalgia.
She has been an active ARHP member since 1995 and has served on multiple committees, including the advocacy committee.
Q: To earn the award of master clinician, what does that mean to you in terms of your career choice?
A: For me, it really means that the passion I’ve had for the past 20 years has really come to life. It finally just made me feel like people value what you do. So it just made me feel a little bit validated that I’ve worked so hard to keep the programs and my passion going.
Q: Is the fact that your patients suffer from chronic conditions a frustrating side of the job? Does that ever get to you?
A: Of course it does, because you spend your day trying to help people feel better, and sometimes you hit a wall. Sometimes you need to work with your other healthcare team members to see if there’s something that can get [the patient] past that little bump in the road, and that’s why a healthcare team approach is so important with these people—because you can never do it alone. You need to rely on your physician, nurse, psychologist, and the occupational therapist, people who work as a team to help manage these patients. You need them.
Q: How much have you seen the evolution of care change from the physical therapy perspective?
A: When I first started, we were dealing with a lot with people who already had a lot of malformations and disabilities. And now the biologic drugs have created a situation where we’re not dealing with a lot of people who have those. What we do in therapy now is help teach them to manage their symptoms. We also work on overall general strengthening and conditioning with these folks, because they don’t need us to teach them how to use a walker or cane or push a wheelchair anymore, because the biologic drugs have made it so much better for them. It’s vastly changed with the biologic drugs.
Q: How satisfying is that change?
A: It’s such joy for me knowing that I’m not going to see them in 20 years and they’re going to have malformed fingers, inability to walk, or that they’re going to have hip replacement, knee replacement, because that doesn’t necessarily happen anymore. It’s a really interesting time to be in rheumatology.
ARHP Addie Thomas Service Award
Sandra Mintz, RN, BSN
Division of Rheumatology, Children’s Hospital Los Angeles
Background: Mintz joined Children’s Hospital Los Angeles (CHLA) in 1995, and for the past 12 years has worked as nurse case manager for the Pediatric Rheumatology CORE at CHLA. She has served on a number of ARHP and ACR committees, and currently is a member of the ACR Committee of Education, the ARHP Executive Committee, and is invited guest to the ACR/ARHP Annual Scientific Meeting Planning Committee.
Diagnosed with multiple sclerosis in 1997, Mintz uses her own personal battles with autoimmune disease to relate to patients and their caregivers. “Many of my patients are learning to take injections for the first time and are very anxious,” she says. “I can talk to them about the fact I have been self-injecting for 15 years now. I tell them that I have stayed on top of it, have done my follow-up, and have learned a lot of techniques that make the process easier.”
In 2009, Mintz and colleagues developed support and education groups at CHLA. The forums meet every other month and help patients and caregivers better understand their diseases, as well as the importance of nutrition and exercise.
“We’ve had drum circles, yoga, and other young adult guest speakers who have lived with these conditions since childhood,” she explains. “The focus is teaching both kids and their parents how to live with their rheumatic disease. In the beginning, we had one organization, Lupus LA, supporting us. Within a year, we received a quality-of-life grant from the Arthritis Foundation to study and expand the program. Now, we’re completely funded through philanthropy from a number of donors and organizations.”
Q: What is the most fulfilling part of your job?
A: I love working with my patients and their families. I really enjoy being able to help them. It’s great when a patient says, “I get it now. I’ve never understood this, and now I get it.” … The most rewarding thing for me is when I can help them learn how to live with the disease better, learn how to understand it, how to make decisions with it, and not have it be the total focus of their life. And, essentially, live successfully with it.
Q: Any advice for adult rheumatologists caring for pediatric patients?
A: Really, it is about having good, collaborative relationships between adult and pediatric rheumatologists.
Q: What does the future hold for pediatric rheumatology?
A: We’ve seen so much happen in the age of biologics that we’ve also seen a number of challenges—battling insurance, getting treatments for our patients. I think rheumatologists have always been trendsetters, leading the way. I hope that, through ARHP and other organizations, we can find methods to get medications for our patients and continue to lead the way. We’re not the only condition these drugs are used for, but we are the leaders. I think that is the future.
ARHP Lifetime Achievement Award
Marilee K. Phillips, RN
Rheumatology Nurse Specialist, Louisville, Ky.
Background: Phillips graduated from Charity Hospital School of Nursing in New Orleans in 1964 and spent the early part of her career working in a variety of hospital specialty areas. In 1974, she moved to Louisville and attended a course at the University of Louisville entitled, “New Directions for Women.” There she met Carolyn Neustadt, wife of David Neustadt, MD, then chief of the division of rheumatology at the university. The meeting set Phillips’ new career direction in motion.
“Dr. Neustadt had gotten a grant through [President] Nixon’s $4.5-million grant for arthritis research,” she said in a 2007 interview with The Rheumatologist. The funding was intended to spark the development of clinic and home care programs for financially disadvantaged people with arthritis. Although Phillips had little knowledge of rheumatology practice or patient care, Dr. Neustadt hired her as coordinator of the program. When grant support ended in 1976, Phillips joined Dr. Neustadt’s private practice. She worked there for more than three decades, retiring from full-time practice in April.
Phillips served for many years on the executive board and many other committees of the Arthritis Foundation’s Kentucky chapter. She has also chaired and coordinated several rheumatology symposiums. In 1991, she received the Arthritis Foundation Outstanding Professional Education Award. She has been an ARHP member since 1974, serving on multiple committees as both chair and member. “I give the ARHP high marks for teaching me what I need to know to grow in the field of rheumatology,” she said in a recent synopsis of the ARHP. “My clinic role varies pending the need, but I always feel prepared to meet the challenge because of my learning opportunities at the annual meetings. I’ve had a meaningful and fulfilling career. I think 38 years with the same perfectionist rheumatologist confirms my value to both him and our patients.”
Semi-retired, Phillips is working part time in a new rheumatology practice—enjoying what she refers to as “the benefits of both worlds, time for new ventures and time to stay involved in rheumatology.”
Richard Quinn is a freelance writer in New Jersey.
