Great discoveries and improvements invariably involve the cooperation of many minds.—Alexander Graham Bell
A recurring theme in my previous columns has been the importance of working together as a specialty and the fact that this organization has a stronger voice because it represents such a diverse group of rheumatology professionals. Another example of our strength in diversity is the alliance between the ACR and the ACR Research and Education Foundation (REF). REF President Leslie J. Crofford, MD, and I are co-writing this column about the relationship between our organizations because we believe that this strong partnership is fundamental to realizing our shared vision of advancing the rheumatology professions.
As the economics of medicine become increasingly challenging, and in the context of impending healthcare reform, the ACR recognizes the importance of sharply maintaining our focus on advocacy, practice, quality of care, and education. At the same time, data collected by the ACR demonstrate that our future holds significant challenges in the areas of the workforce, training, and research. To ensure the future of our specialty we must continue to develop vibrant educators and successful researchers in academic settings in order to attract the best and the brightest students and residents to our specialty. Our success in this endeavor will benefit our members and our patients. The strong relationship between the ACR and the REF allows the ACR to maintain its focus on the urgent matters of today, while simultaneously building our future through its alliance with REF.
As the REF continues to evolve and mature, it is important to emphasize that it exists for the sole purpose of supporting the mission and goals of the ACR. Because of this, leaders from each organization serve on the boards and executive committees of the other.
Long History of Cooperation
The ACR is celebrating its 75th anniversary this year and the REF will celebrate its 25th anniversary in 2010. For almost one-third of the ACR’s existence, the two organizations have had a mutually reinforcing relationship. The REF was created by the ACR. By 1985, ACR leaders recognized that the goals of other funding agencies did not optimally serve the needs of rheumatology professionals. Recognizing its responsibility to promote and advance its membership, the ACR created a funding agency that existed to specifically support the recruitment, training, and career development of rheumatologists and rheumatology investigators. At its inception, there were few staff and little money to provide awards to achieve REF goals. From its inception through the year 2000, the REF funded rheumatology research at a level of approximately $500,000 per year. During this time, the REF increased its focus on grants that support fellows in order to respond to the decrease in rheumatology fellow applicants.
Recognizing the need to grow the capacity of the foundation, ACR and REF leaders and staff created the Industry Roundtable (IRT) in 1999. The support of the IRT allowed the REF to develop a substantial portfolio supported by extensive peer review to meet the goals of the college. The REF’s portfolio of core awards is designed to promote the specialty to students and residents, provide financial support for subspecialty training in rheumatology, and fund career development for those rheumatologists and health professionals who aspire to a career in basic or clinical research. Education awards support senior clinical scholars in order to develop a new cadre of educators within academic rheumatology units, with the ultimate objective of accomplishing ACR and REF goals. In 2009, more than $5 million will be provided for these core awards, programs that support the future of our specialty and remain the top priority for the foundation and the ACR.
Leadership Council Ambassadors
- William J. Arnold, MD, Illinois Bone and Joint Institute, Wilmette
- Alfonso E. Bello, MD, MHS, Illinois Bone and Joint Institute, Glenview
- Melvin C. Britton, MD (retired), Palo Alto Medical Clinic, Calif.
- Joseph D. Croft, Jr., MD, Arthritis and Rheumatism Associates, Chevy Chase, Md.
- Alan W. Friedman, MD, Medical Clinic of Houston
- Norman B. Gaylis, MD, Arthritis and Rheumatic Disease, Aventura, Fla.
- John A. Goldman, MD, Emory University, Atlanta
- Joel M. Hirschberg, MD, Arthritis and Rheumatic Disease Center, Rancho Mirage, Calif.
- Emily M. Isaacs, MD, Fort Worth Clinic PA, Texas
- Stuart S. Kassan, MD, Colorado Arthritis Associates, Denver
- Joel Kremer, MD, The Center for Rheumatology, Albany, N.Y.
- Jeffrey G. Lawson, MD, Piedmont Arthritis Clinic PA, Greenville, S.C.
- Robert D. Leff, MD, Duluth Clinic, Minn.
- John and Betsy McLinden,* Winnetka, Ill.
- Steven S. Overman, MD, MPH, The Seattle Arthritis Clinic
- Barry M. Schimmer, MD, Pennsylvania Rheumatology Associates PC, Philadelphia
- Larry J. Silverman, MD, West Bloomfield, Mich.
- John R.P. Tesser, MD, Arizona Arthritis Rheumatology Associates, Paradise Valley
- Robert J. Tierney, MD, Park Nicollet Medical Center, St. Louis Park, Minn.
- Katherine S. Upchurch, MD, UMASS Memorial Medical Center, Worcester, Mass.
*Lay member
Ambitious Joint Efforts
However, additional forces threatened to undermine the future of our specialty. In 2005, ACR and REF leaders recognized the impending shortfalls in research funding from federal and other foundation sources. There was also an alarming migration of important rheumatology research, as reflected by publications in Arthritis & Rheumatism and presentations at our Annual Scientific Meeting, to countries outside the United States and to the pharmaceutical industry. To regain international leadership in rheumatology research and to assure that the top investigators continue to engage in basic and clinical research that can lead to major breakthroughs in rheumatic disease, the ACR and the REF established a disease-targeted research initiative. The two organizations worked together closely throughout the development and implementation of what is now the Within Our Reach: Finding a Cure for Rheumatoid Arthritis campaign. The ACR’s Committee on Research was charged with recommending the disease target to the REF board of directors. With the goal of capitalizing on knowledge gained from recent research advances in rheumatoid arthritis (RA) and creating a long-range plan for funding rheumatologic research, the ACR and the REF convened a group of the world’s leading rheumatologists, representatives of the National Institutes of Health (NIH), and the Arthritis Foundation for a scientific forum to design an RA research program that would generate the greatest impact for our patients. The ACR’s decision to charge the REF with implementing this bold new initiative was evidence that the foundation had matured into an organization capable of raising substantial funds and administering a complex portfolio of awards.
In 2006, the REF launched a national multi-year campaign to raise $30 million—the largest private fundraising campaign in the REF’s history. The ACR, in turn, became the first supporter of the Within Our Reach campaign with a pledge of $5 million, which created substantial early campaign momentum and inspired additional high-level support. Within Our Reach has made tremendous progress in a relatively short period. To date, $24.9 million has been raised toward the $30-million campaign goal, enabling $18 million to be awarded to 45 notable investigators across the country. The participation of a core group of ACR members from the private practice community has enabled the REF to build a new source of support from research-minded individuals, including patients and patient families. (See “Leadership Council Ambassadors,” above, for a list of these volunteers.) To date, more than $2 million has been raised from 51 lay donors—all first-time gifts. The growth in giving to the REF from research-minded individuals is testament to the substantial interest and extraordinary potential in major support from the lay community.
While the success of the Within Our Reach initiative is a tremendous achievement for both the ACR and the REF, throughout the process, both organizations have worked together to ensure that these efforts do not hinder the success of the core education and research awards. It is now clear that the development of this campaign and expansion of our fundraising capabilities have actually strengthened the REF’s core programs. In fact, by 2008, the REF had become the second-largest funding source of research and training grants for rheumatology investigators in the United States, behind the NIH.
It should also be emphasized that, because the REF shares many support services with the ACR, this economy of scale allows the foundation to designate more of its funds to programs and services, rather than to administrative costs. As a result, the REF has surpassed industry standards, consistently earning a minimum of three out of four stars from Charity Navigator, the largest independent charity evaluator in the United States. On average, 90 cents out of every dollar donated to the REF goes directly to support awards programs.
As the REF continues to evolve and mature, it is important to emphasize that it exists for the sole purpose of supporting the mission and goals of the ACR. Because of this, leaders from each organization serve on the boards and executive committees of the other. ACR members and leadership are involved in all major REF initiatives, such as the recent REF blue-ribbon panel review of core award programs. In addition, the two organizations are currently engaged in joint strategic planning efforts to ensure that both organizations will continue to be strongly aligned in the future.
The relationship between the ACR and the REF will continue to evolve over time. However, the strong bond between our two organizations, with their complementary and mutually reinforcing missions, will ensure the future of the rheumatology specialty.
Dr. Gabriel is president of the ACR. Contact her at [email protected]. Dr. Crofford is president of the REF. Contact her at [email protected].