A Look Back with Pride and Appreciation

It’s hard to believe that 11 months ago I was addressing you for the first time as president of the ACR and highlighting my priorities for the year, guided by the ACR strategic plan. As I end my presidency, I want to spotlight a selection of our accomplishments, while recognizing the future challenges that remain for our profession and the ACR. These projects show the ACR’s ongoing commitment to address the concerns of the profession, our membership of rheumatologists and rheumatology health professionals, and especially our patients.

Rheumatology at the Macro Level

The launch of Simple Tasks—the ACR’s first public relations (PR) campaign—was one of the ACR’s greatest accomplishments in 2011. One of the goals of the campaign is to increase understanding of the severity of rheumatic diseases and of the importance of seeing a rheumatologist in their treatment. The initial component of the campaign is aimed at “influencers,” the people and groups making significant decisions that affect the rheumatology community. These influencers are legislators and administration officials, referring physicians and physician groups, advocacy groups, and think tanks.

Given the legislative audience, the campaign launched in September in conjunction with Advocates for Arthritis in Washington, D.C. Member and patient advocates promoted the campaign on the Hill by wearing campaign buttons, distributing campaign materials, and discussing the importance of rheumatology. As we visited congressional offices, we opened newspapers like The Hill and Roll Call, highlighting the ads promoting the Simple Tasks campaign. The symbolism of the bent prongs of the fork was quickly recognized by legislators and staff members. The visuals helped make our message “real” to those who did not understand the disability associated with rheumatic diseases. I believe that this publicity effort is off to a great start. The challenge will be to continue to have the impact we expect over the subsequent four years of this effort. Someday the word “rheumatology” will be well known and we will not have to answer the question of, “Who are you?” Then we will know that our campaign has been successful. You can learn more about the campaign by visiting www.SimpleTasks.org.

The Simple Tasks campaign was featured on a billboard in New York City’s Times Square.

ACR Advocacy Making a Difference

Outside of promoting our new PR campaign, more than 100 rheumatologists, health professionals, and patients met with members of Congress during Advocates for Arthritis to share their stories and concerns about issues affecting our practices and patients every day, including:

• Preserving patient access to treatment;
• Maintaining funding levels for medical research; and
• Preserving patient access to care by permanently repealing the Sustainable Growth Rate.

From my experiences during the more than 12 years that I have been going to the Hill with the ACR, I can tell that progress is being made. Initially, we would need to spend valuable time at every office identifying our professional organization and the type of patients we treated. In 2011, the ACR is recognized by each legislative office as an informed medical organization that is knowledgeable of the health issues confronting our government. We are advancing rheumatology through our advocacy efforts and Congress is listening to us. They acknowledge that a 29.5% Medicare reimbursement cut is unacceptable and will affect our patients’ access to care. The future challenges for the ACR are to remain steadfast in its efforts to influence policy to the benefit of our profession and our patients in a constantly changing political climate. I encourage each of you to visit the advocacy booth at the ACR/ARHP Annual Scientific Meeting in Chicago this November and use the legislative action center—or better yet, call your senators and representatives today. Make your voice heard!

Pain Education and Relationship Building

Pain and pain management was another key area of focus for the ACR in 2011. Rheumatologists must consider pain in order to be proactive in meeting the needs of our patients. The ACR addressed this need by providing education that focused on pain and pain management. The 2011 ARHP Clinical Focus Course concentrated on pain management to help rheumatology health professionals be more effective in treating patients’ pain, and the ACR held 17 sessions related to pain at the annual meeting in Chicago. Outside of education, many ACR standing committees began incorporating pain issues into their program of work and provided updates at board meetings. The challenge is to continue this effort, because attention to the treatment of musculoskeletal pain will make us essential to the comfort of our patients and a valued resource at a time of limited finances.

Another important area in advancing rheumatology is continual relationship building and collaboration with external entities. The ACR addresses this on a global scale through relationships with African League Against Rheumatism (AFLAR), Asian Pacific League Against Rheumatism (APLAR), European League Against Rheumatism (EULAR), and Pan American League of Associations of Rheumatology (PANLAR). On a national level this year, the ACR joined the OA Action Alliance, a national coalition led by the Arthritis Foundation and the Centers for Disease Control and Prevention. Osteoarthritis (OA) is the most common form of arthritis and the OA Action Alliance is committed to elevating OA as a national health priority. We also helped sponsor the United States Bone and Joint Initiative Summit on the value of musculoskeletal care, which was held in October 2010. The summit allowed key stakeholders the opportunity to interact with leaders in the musculoskeletal care system, as well as to address the cost and cost effectiveness of musculoskeletal care. The challenge in this arena is to maintain the appropriate balance of cooperation with external entities while maintaining our focus on the primacy of the ACR in ensuring the future of our subspecialty.

The Lupus Initiative is another way the ACR is continuing to build relationships. This ACR-led educational effort aimed at eliminating ethnic, racial, and gender disparities in the diagnosis and treatment of lupus was approved for its third year of funding from the Department of Health and Human Services Office of Minority Health. The Lupus Initiative brings together private, public, and nonprofit entities as well as lupus experts and those well versed in cultural competency, disparities research, and patient awareness to address lupus disparities and ensure that appropriate messages and education about lupus are delivered in the most effective way. The challenge moving forward with this initiative is to assess the ultimate impact of lupus awareness on the general health community and the expansion of this effort to other rheumatic diseases that affect minorities disproportionately.

Moving Forward

I want to complete my summary by highlighting the enthusiasm of the 2020 Task Force in addressing the future of the ACR. This group, led by Peter Embi, MD, MS, was charged by the board to determine what the ACR, as an organization, will look like in the year 2020. The group met with a healthcare futurist in August at the ACR office to get an idea of environmental changes that could affect healthcare in the future. From that discussion, the group is focusing on how the ACR can advance rheumatology, taking into account changes in social, technological, economic, ecological, and political factors. They are looking into areas including whether structural changes are needed, if there will be a new type of volunteer base, and what additional resources will be needed and available. The final result of this task force effort will be a white paper that is scheduled for release in 2012. I want to encourage you to send any ideas about what the ACR should look like in 2020 to Julie Anderson, the task force staff liaison, at [email protected]. Let her know, so that your opinion can be shared with the group. The challenge will be in implementing the plan to get the ACR prepared for the rapid changes that will occur in our world over the next decade. To change is hard, but to remain the same is unacceptable.

I’ll conclude this column the same way I started my first one, by thanking each of you, colleagues and friends, for the honor of serving you during 2010–2011. To the volunteers and staff, I want to extend a special thank-you. The ACR is able to accomplish all that it does through the leadership of Mark Andrejeski, our executive vice president, and the dedicated staff he has assembled. You have been strategic and forward thinking in your work, and because of this, the ACR has advanced rheumatology in the last year. I also wish much success to Jim O’Dell, MD, as he embarks on his tenure as the 75th president of the ACR. the rheumatologist

Dr. Borenstein is clinical professor of medicine in the division of rheumatology at George Washington University Medical Center, in Washington, D.C., and in private practice at Arthritis and Rheumatism Associates there. Contact him via e-mail at [email protected].