2012 Blue Ribbon Panel Members
The ACR gratefully acknowledges the work of the members of the 2012 Blue Ribbon Panel on Academic Rheumatology, listed below:
- David A. Fox, MD, University of Michigan, Ann Arbor
- V. Michael Holers, MD, University of Colorado, Denver
- Abby G. Abelson, MD, The Cleveland Clinic, Ohio
- Hermine I. Brunner, MD, MBA, MSc, Cincinnati Children’s Hospital Medical Center, Ohio
- Gary Bryant , MD, University of Minnesota, Minneapolis-St. Paul
- Lindsey A. Criswell, MD, MPH, University of California, San Francisco
- Leslie J. Crofford, MD, University of Kentucky, Lexington
- Bruce N. Cronstein, MD, New York University, N.Y.
- Mary K. Crow, MD, Hospital for Special Surgery, New York, N.Y.
- Ellen Gravallese, MD, University of Massachusetts Medical School, Worcester
- William F. Harvey, MD, Tufts Medical Center, Boston, Mass.
- Elizabeth W. Karlson, MD, Brigham and Women’s Hospital, Boston, Mass.
- William J. Koopman, MD, University of Alabama at Birmingham
- Eric L. Matteson, MD, Mayo Clinic, Rochester, Minn.
- William Robinson, MD, PhD, Stanford University, Palo Alto, Calif.
- Daniel E. Schaffer, PA-C, Mayo Clinic, Rochester, Minn.
- E. William St.Clair, MD, Duke University, Durham, N.C.
- Maria E. Suarez-Almazor, MD, University of Texas MD Anderson Cancer Center, Houston
The challenges and the opportunities that confront academic rheumatology today are multidimensional and complex. Academic units strive to nurture and balance their multiple missions of research, clinical care, and teaching in a rapidly changing environment in which the economic viability of rheumatology is far from secure. Academic rheumatology is the essential pipeline for the development of rheumatology practitioners in the community, and issues that affect the vitality of academic rheumatology have broad implications for the viability of the greater profession. The availability of a sufficiently robust academic workforce for the future, especially at the leadership level, is uncertain. At the same time, the potential for transformative basic discoveries and clinical advances that lead to better prevention, treatment, and even cure of adult and pediatric rheumatic diseases has never been greater.
Why Did the ACR Convene This Panel?
Recognizing the challenges and opportunities described above, the ACR convened a review of the state of academic rheumatology in the U.S. and charged a Blue Ribbon Panel—the first in 15 years—with making recommendations to address the key issues. The ACR has grown enormously since the last Blue Ribbon Panel (convened in 1997 and chaired by Eng Tan, MD), and, in many respects, the first panel’s recommendations pointed the way to this growth.
What Resulted From Past Efforts of This Type by the ACR?
The 1997 panel’s report was divided into four sections: research, training and education, patient care, and partnerships with the pharmaceutical industry. Some important outcomes of key recommendations include the following:
- Recommendations to strengthen the Rheumatology Research Foundation, previously the ACR Research and Education Foundation, and develop a mechanism for “block grants” from the pharmaceutical industry became the basis for the development of the Corporate Roundtable. This has allowed for exponential growth of Foundation funding and programs, allowing the Foundation to fund more than $12 million in research grants this fiscal year.
- The recommendation to devise a mechanism for support and cultivation of rheumatology clinician scholar educators led directly to the development of the Rheumatology Research Foundation’s Clinician Scholar Educator Award, which has contributed to career development and retention of an important subset of academic rheumatology faculty. Fifty-five notable scholars across the U.S. have received support from this program since its inception in 2000.
- The suggestion to restructure the ACR/ARHP Annual Meeting into distinct modules that would appeal to either researchers or clinicians, while not fully implemented, led to the creation of the highly successful basic and clinical research preconference courses. These courses have helped to augment the participation of researchers in the annual meeting, which has grown considerably and now includes specialized tracks for clinicians, educators, researchers, etc.
- The panel recommended development of training standards for fellowship programs, and this was addressed with the creation of a core curriculum and an in-training examination. Much more support is now available for fellows to participate in professional meetings, and these programs have become a funding priority for the ACR.
What Process Did This Current Panel Follow?
In order to develop recommendations relevant to the ACR today, the 2012 panel implemented methodology commonly used in strategic planning to: 1) analyze the current state of academic rheumatology in the U.S.; 2) set strategic directions and goals to ensure its success in the future; and 3) develop an action plan with projected benchmarks and outcomes to ensure that these goals are met and that accountability is maintained.
The panel was carefully constructed to involve representatives from a variety of constituent groups within the academic rheumatology community including: academic clinical practice, pediatrics, basic science, clinical investigation, health information technology, training programs, and health professionals. The nature of the process was highly collaborative, with input solicited from a variety of committees as well as the membership at large.
What Was the Outcome?
The panel envisions a new role for the ACR as a much closer partner of academic divisions of rheumatology in the future. This partnership will encompass the development of tools that academic units can use to demonstrate their economic value, assess and strengthen their financial health, improve and expand training of both rheumatology fellows and mid-level providers for evolving career opportunities within the field, expand research across the discipline, and enhance quality of patient care. The partnership will involve a sharper focus on advocacy related to issues critical to the future well-being of our academic rheumatology divisions. It will also include significant investments by the ACR and the Foundation in rheumatology career development, ongoing analyses of the effectiveness of external governmental and nongovernmental research funding for academic rheumatology units, and a comprehensive program of leadership development.
While the charge to the task force was to focus on academic rheumatology, the panel quickly recognized that the historical lines dividing academics and various types of private practices have become increasingly blurred. In an effort to comprehensively address appropriate training for physicians and health professionals for a variety of careers, including community practice, education, research, and industry, a comprehensive review was conducted and broad-reaching recommendations were included with the panel’s report. These recommendations, when implemented, should not exclusively benefit academic units, but rather should affect the entire rheumatology community.
What Are the Recommendations?
The final report is available on the “Outreach” page at www.rheumatology.org/about and contains a summary of the critical issues identified within academic rheumatology, across the domains of training, practice, and research. Specific recommendations to address these issues over the short and long term are detailed within. Briefly, the recommendations are:
- Address the funding crisis for rheumatic disease research and training.
- Redefine the scope of rheumatology.
- Develop research infrastructure and consortia.
- Expand our clinical data infrastructure.
- Address regulatory burdens.
- Develop and promote the adoption of new technologies.
- Develop the future workforce and maintain the current workforce.
- Develop future rheumatology academic faculty and retain current faculty.
- Develop future leaders within the ACR, the global research community, and academic centers.
- Formally demonstrate the value of academic rheumatology.
What Are the Next Steps?
The final report and recommendations have been accepted by the ACR Executive Committee and presented to the ACR Board of Directors and committee chairs. The recommendations are now being considered as part of the ACR’s strategic planning process.
We are grateful for the opportunity to work on such important issues as these, and appreciate your attention and thoughtful feedback. We are confident that these recommendations will help advance rheumatology.
Dr. Fox is professor of internal medicine and division chief of rheumatology at the University of Michigan in Ann Arbor. Dr. Holers is professor and division head in the integrated department of immunology at the University of Colorado in Denver.
