Looking Ahead to 2009

Pearl S. Buck once said, “One faces the future with one’s past.” As I look forward to the upcoming year of my presidency and prepare for the challenges the ACR will face in 2009, I have also spent time reflecting back on what initially attracted me to rheumatology and why I still believe it to be a unique and rewarding specialty.

Like many of you, I chose a career in rheumatology during internal medicine residency. I loved rheumatology because the clinical challenges it posed were complex, chronic, and multidisciplinary. I learned that rheumatic diseases were complex, often perplexing syndromes rife with many unanswered questions regarding their pathophysiology, underlying disease mechanisms, natural history, and long-term outcomes. I learned that these conditions persisted for many years, often several decades, providing rheumatologists with the opportunity to develop unique, long-lasting relationships with their patients. And I learned that caring for patients with rheumatic diseases was a multifaceted, multidisciplinary effort, typically necessitating the creation of a diverse team of healthcare providers all focused on the patient. I suspect many of you were attracted to our discipline by these very same attributes.

Over the ensuing 21 years of my rheumatology career, I have had the privilege of working in a variety of roles. My first career priority was clinical care, later followed by clinical research and, most recently, education and administration. Each role introduced me to a different group of interesting and extremely talented people in our profession, and each taught me something new about rheumatology. However, the element that tied all of these roles together has been my strong commitment to rheumatology. I believe that, regardless of your professional focus, we are all united by a common purpose: to improve the lives of people with musculoskeletal and rheumatic diseases and to strengthen the rheumatology specialty.

Strength Through Diversity

One of the comments that has stuck with me from the recent ACR membership survey was the repeated assertion that “the ACR leadership is not like me.” I have thought about those comments a lot over the past several months and concluded that they represent not only a potential weakness but also a core strength for the ACR. A core value of the ACR is the principle that the college represents and includes all rheumatologists regardless of their professional backgrounds. The ACR is enriched by the varied perspectives that this diverse group of talented professionals bring because they are united by the common goal of improving the rheumatology specialty and the lives of those who are affected by rheumatic disease. As other societies have become fragmented into multiple smaller groups (i.e., groups for clinicians, clinical researchers, basic researchers, those with interest in one disease, et cetera), the ACR recognizes that rheumatologists represent many different walks of professional life and works to leverage those differences for the benefit of the organization. Although it would be easier to reach consensus if everyone involved shared the same ideas and opinions, we believe that the best solutions emerge from the collective insights, wisdom, and experience of a diverse group of talented individuals working toward a common goal. The ACR board is made up of just such a group—very motivated and devoted rheumatologists from a variety of personal and professional backgrounds who all have very different perspectives but who also share a core commitment to learn from the perspectives of others and to address the strategic direction of the organization together. The ACR’s competitive advantage is in the fact that it does not allow minor differences in opinion among members or volunteers to divert us from our true mission to advance the specialty. Instead, it encourages all of us to engage in open discussion and debate about our differing viewpoints and be active participants in the direction of the rheumatology specialty. This is a constant challenge. The ACR will continue to strive for balance and diversity of backgrounds, viewpoints, and talents among its leaders to reflect the rich diversity of the membership.

So, I acknowledge that my career path differs from some of yours. However, I do share your love for rheumatology and your commitment to better the lives of patients, both in my clinic and around the world, who are affected by rheumatic disease. I share a passionate enthusiasm for helping the rheumatology profession to thrive. I also share a commitment to making sure that those of us who are treating patients in any practice setting and who are performing the research that will improve the treatment of musculoskeletal disease are able to be financially successful, support our families, and enjoy a fulfilling and rewarding career. I am willing and eager to listen and to learn from you, and I encourage you to speak up and let me, or any member of the ACR’s leadership, know of your opinions and your ideas for the advancement of our specialty. As Lyndon B. Johnson said, “There are no problems we cannot solve together and very few we can solve by ourselves,” so please share your thoughts and ideas with us.

Plans for the Future

This upcoming year is an important year for the ACR and an important time to get involved. In addition to 2009 being the ACR’s 75th Anniversary (1934–2009) and a time to reflect on the accomplishments of the specialty thus far, it is also a time to look forward. In 2009, the ACR will engage in a comprehensive strategic planning effort that will shape the direction of the organization for the future. Although everything in our strategic plan will be carefully re-examined, I will focus on the following four priorities: 1) maintain our global leadership position as the source of the highest quality of educational offerings in rheumatology (especially our national meeting and our journals); 2) promote and advocate for the financial viability of rheumatology practice through our work in government affairs and quality measures; 3) ensure a healthy rheumatologist workforce to secure the future of our profession; and 4) promote rheumatology research. Emphasis will also be placed on cultivating and enhancing relationships with other organizations that will help promote initiatives that will benefit rheumatology. Current relationships with the National Institutes of Health and the Food and Drug Administration, as well as international collaborations with the European League Against Rheumatism and the newly restructured International League Against Rheumatism, will continually be built upon. We will also explore new relationships that can expand our influence within the field of medicine. Another focus will be to more effectively leverage the synergies between the ACR, the ARHP, and the Research and Education Foundation to ensure that the organization is comprehensively serving the needs of our diverse membership.

As with any move forward, it is important to look back on the experiences of the past to help ensure the success of the future. As we celebrate 75 years of excellence in rheumatology and plan for the future this year, I hope you will join me to guide the organization in the next steps to advance our specialty. Please continue to engage and participate in the discussions that will determine the direction of the organization. Whether it is by sending me an e-mail, posting on a list serve, attending a meeting, or serving as a volunteer on a committee, your input and engagement is welcomed and encouraged. I look forward to listening to your various ideas and diverse perspectives and to learning from you in the upcoming year.

Dr. Gabriel is president of the ACR. Contact her via e-mail at [email protected].