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It is a great honor to serve you as the 80th president of the American College of Rheumatology (ACR). The ACR is a leader in the world of rheumatology. Therefore, with this privilege also comes enormous responsibility.
A Brief History of the ACR
The first efforts to study and control the rheumatic diseases in the U.S. started in 1928 with the formation of a 15-member American Committee for the Control of Rheumatism (ACCR). The first scientific meeting of the American Rheumatism Association (ARA) was held in Cleveland in 1934 and was attended by 75 people. The name of the organization was changed to the American College of Rheumatology (ACR) in 1988. The ACR membership now stands at close to 9,500 and the ACR/ARHP Annual Meeting proudly hosts more than 16,000 attendees representing more than 100 countries. We have come a long way, indeed.
During my service on the Board of Directors, I also chaired the Quality Recognition Program Task Force and co-chaired both the Strategic Planning Task Force and the International Task Force. In 2010, along with colleagues, we initiated the Rheumatology Society of North Texas (RSNT), which I chaired until 2015. The RSNT led the initiative to bring rheumatologists from across Texas to form the State of Texas Association of Rheumatologists. It has been an exciting and educational experience thus far, and I look forward to the year ahead with much anticipation.
I am pleased to have had the opportunity over the years to work alongside my peers & gain new friends, share memorable experiences & participate in the growth of the ACR.
I am also a member and volunteer of the American Association of Physicians of Indian Origin (AAPI), including service as AAPI president from 2003–04. The AAPI provided a great learning experience in working in organized medicine, advocacy and the political process of this country. The AAPI is the largest ethnic medical association in the U.S., which, today, represents the interests of 90,000 physicians of Indian origin.
For almost 30 years, I have been in private practice in a single-specialty rheumatology group in Dallas and am an investigator at the Metroplex Clinical Research Center, which performs phase 1 through phase 4 clinical drug trials. I am also a clinical professor of internal medicine at University of Texas Southwestern Medical Center. I did basic bench work research early in my career. Thus, I have been personally involved with the ACR’s triad of education, treatment and research. Advocacy has also become an increasingly important function of the ACR, and that is something that I have substantial experience and interest in.
Challenges & Opportunities for the Coming Year
The practice of medicine is forever evolving. However, the current times are especially trying. We should consider the present challenges as potential opportunities to improve the delivery of healthcare for our patients.
Implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the Merit-Based Incentive Payment System (MIPS) will be front and center for our members as the new year starts. The MACRA final rule is massive. Our regulatory team has reviewed the final rule and prepared a summary for us focused on the members’ needs and the impact on rheumatology. This information will be translated into detailed user resources for our members. The ACR is also investigating the feasibility of a physician-led healthcare future by designing an alternative payment model (APM) for better patient care, lower spending and financially viable physician practices. If successful, this could provide our members another avenue for practice besides either joining ACOs or participating in MIPS.
Speaking of MIPS, the ACR’s Rheumatology Informatics System for Effectiveness (RISE) Registry is also a Qualified Clinical Data Registry, which is approved by the Centers for Medicare & Medicaid Services. Therefore, participation in the RISE Registry can help members fulfill some of the MIPS requirements under MACRA. Another benefit of participating in RISE is the ability to get feedback on one’s practice compared with that of colleagues, both regionally and nationally. Participation in RISE is a valuable member benefit.
Outside of MACRA, with a new administration in Washington, D.C., starting in January, additional changes will be proposed to the healthcare delivery system in our country. The ACR will stay vigilant in watching new developments. As these developments arise, it is imperative that the ACR have access to our elected officials to share the rheumatology voice on what is best for our patients. To gain this access, it is critical that we all support RheumPAC. Our contributions to RheumPAC come back to help our practices and improve the care of our patients.
The past two decades have seen a paradigm shift for the better in care of patients with rheumatic diseases. We do not see waiting rooms full of patients in wheelchairs anymore. The research and subsequent development of new treatments for rheumatic diseases have been incredible. But more needs to be done.
The support by government agencies for rheumatology research and training is not growing at the pace it deserves. The Rheumatology Research Foundation (the Foundation) has become the biggest supporter of rheumatology research and training in the country outside of federal government. The Rheumatology Workforce Study reveals the dire need for training more rheumatologists and healthcare professionals. As the population of our country is increasing and people are living longer, many more rheumatology professionals are needed. The Foundation funding and support has almost doubled the number of rheumatology trainees in this country. It is critically important that we all contribute to support the Foundation. It is a lifeline for the future of our specialty.
The ACR has enjoyed increased participation by our international colleagues at the ACR/ARHP Annual Meeting. There has been growing interest by them in the work of the ACR. Two international exchange fellowships between the Pan American League of Associations for Rheumatology and the Indian Rheumatology Association were started last year. This is in addition to the ACR/EULAR Exchange Program, which has been fruitful for more than 10 years. We intend to expand on existing relationships, and also explore new partners and fresh areas of mutually beneficial engagements.
The ACR is successfully concluding its work on the 2013–16 strategic plan, and it’s time to start thinking about what’s next for the ACR and our specialty. We shall be taking a fresh look at the needs of our members and goals for the ACR over the next three years as we develop the new strategic plan. One goal will be to consider the transitioning of the specialty to the next generation of rheumatologists.
With all the changes in the practice of rheumatology, not just what is highlighted above, the ACR is fortunate to have a most dedicated group of highly qualified volunteers and staff. They are acutely aware of the responsibility they carry and share. In my years of attending the ACR Board meetings, I have been impressed by the commitment of the board members, committee chairs and staff toward the ACR’s mission of Advancing Rheumatology!
Success is a journey and not a destination. The ACR has had a successful journey, and together, we need to ensure it stays that way. As we move forward into this next year, contact me at [email protected] with your comments, questions and feedback.
Sharad Lakhanpal, MBBS, MD, is in private practice at Rheumatology Associates and a clinical professor of internal medicine at the University of Texas Southwestern Medical School, both in Dallas, where he has lived and worked since 1986. He is also the 80th president of the ACR, for 2016–17.
