Charles “Chad” Helmick, MD
Medical Epidemiologist, Arthritis Program, Centers for Disease Control and Prevention (CDC), Atlanta
Background: Dr. Helmick and former U.S. Rep. Barney Frank (D-MA) now share a link beyond the fact that Frank formerly represented Dr. Helmick’s brother in Congress. Now they are sharing this year’s ACR award for public leadership. The honor for Dr. Helmick is a nod to a career spent at the CDC, which he joined in 1979 to enroll in the Epidemic Intelligence Service training program. He then completed his preventative medicine residency there and never left. His work has focused on creating public awareness for arthritis and is credited by ACR as having led to a better understanding of why arthritis merits a higher profile in policy circles.
Q: What does an award like this mean to you?
A: Recognizing the public health aspects of rheumatology is so important—in particular, understanding how big the problem is and how the public health system can work with healthcare providers to improve the health of people with arthritis.
Q: You note that, despite the positive impacts of exercise, there’s not been mass adoption by patients. Why not?
A: There are the usual barriers for everyone—finding the time, doing something enjoyable, making it easy to do. There are special arthritis barriers as well. Some people worry about increasing their pain and harming their joints because they may not be sure how to be physically active safely. Other people are not aware of the benefits in terms of reduced joint pain. And their doctors (mostly primary care providers) may not recommend it because they are unaware of the benefits or don’t know what to recommend.
Q: What is the big hurdle to getting attention or credit to the public health system?
A: Attention is needed, not credit. A big hurdle is that the routine nature of dealing with important public health issues doesn’t get a lot of attention. Another is that the “easy” public health interventions like vaccinations have been largely done. What remains requires behavior change (e.g., be physically active, lose weight, don’t smoke, drink in moderation), and not an occasional vaccination. Behavior change is difficult.
Distinguished Clinician Scholar
Theodore Pincus, MD
Clinical Professor of Medicine, NYU School of Medicine, New York
Background: Dr. Pincus makes no bones about it: he loves data. He’s been collecting and analyzing rheumatology data for more than 50 years, and he says he’ll “never get tired of it.” Born into a medical family in New York City, Dr. Pincus earned his medical degree at Harvard and trained at Massachusetts General Hospital in Boston before embarking on a cross-country career in research. He spent a number of years in basic research before turning his focus to rheumatology. He has served on faculties at Cornell, Stanford, the University of Pennsylvania, and Vanderbilt before settling at NYU. Although he doesn’t see patients anymore, Dr. Pincus hopes this award brings attention to his life’s work: the importance of patient questionnaires for every patient at every visit. Those checklists, he says, “have pragmatic advantages” like improving patient–doctor communication and saving practitioners’ time, but also provide “scientific advantages, because, in a way, they’re the most important information for clinical decisions.”
Q: What is the key takeaway from your years of research?
A: Every rheumatologist should use a patient questionnaire at every visit, which about 20% now do. Rheumatologists—including me—have been trying for 50 years to find magic-bullet lab tests like cholesterol, glucose, or hemoglobin A1-C that are going to tell them what to do exactly with a patient, but it doesn’t work that way in rheumatology. The patient questionnaire, in a way, is a scientific patient history. It doesn’t eliminate talking to the patient; in fact, it makes talking to the patient much more informative.
Q: What advice do you have for the next generation of researchers?
A: They should open their minds to what I would call “bio-psycho-social medicine.” … I think rheumatology has to start paying attention to these things, or we’re just going to keep spinning wheels spending fortunes on patients.
Q: What does this award mean to you?
A: It’s always nice to be recognized, but I would be much happier if some of the things that I’ve been advocating for many years were implemented more by the rheumatology community.
ACR Distinguished Service
Eileen Moynihan, MD
Solo practitioner, Woodbury, N.J.
Background: The only potential pitfall Dr. Moynihan sees in winning the ACR award for outstanding and sustained service to the ACR is that she feels it’s more of a lifetime achievement award. “I kind of think it should come at the end of your career,” she says with a laugh. “I didn’t realize I was done yet.”
Hardly, if the past 30 years of her private practice are any indication. Dr. Moynihan graduated from Temple University School of Medicine in Philadelphia in 1977 and did her residency and fellowship at Philadelphia hospitals. She then launched her private practice in the city’s New Jersey suburbs. She has been an active ACR member since, serving on multiple committees and as the alternate American Medical Association (AMA) delegate for the College at AMA national meetings. In 1998, she was selected for the ACR Paulding Phelps Award. Four years ago, she received the Medical Executive Award from the Edward J. Ill Medical Foundation.
Q: What does an award like this mean to you in terms of your legacy?
A: I’m looking at it more or less as a thank you. I’m not looking at it as any kind of legacy. The people who do all the academic work in the College probably are the ones who leave legacies. I’m just a clinician in the trenches. This, to me, is just an organization saying thank you for all the hours.
Q: Are you proud to be a “just a clinician”?
A: It’s a very nice thing for the organization to recognize people who have devoted a lot of time without any remuneration. It’s nice to be recognized in a formal way.
Q: As a community physician, you see the need for more rheumatologists. Is it daunting to you to know there are not enough physicians doing the job?
A: It’s going to be a huge issue as we step forward. Rheumatology is probably on the bottom of anybody’s list as a specialty to save unless you are a rheumatologist. People don’t always understand the need for them…it makes me concerned about when I could possibly even retire, because I wouldn’t know where to send the [patients] I have now.
ACR Distinguished Fellowship Program Director
Ronald Anderson, MD
Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Boston; Associate Professor of Medicine, Harvard Medical School, Boston
Background: When Dr. Anderson joined Harvard Medical School’s faculty in 1971 to create a teaching program in rheumatology at Robert Breck Brigham and Peter Bent Brigham Hospitals, there were neither training guidelines nor a specialty board for the nascent field. Now he is the inaugural recipient of the Distinguished Fellowship Program Director’s Award. Between 1971 and 2004, as director of clinical training, he crafted and led programs that have trained more than 150 rheumatologists. Those physicians have served on the faculty of more than 20 medical schools, 26 have become full professors of medicine, and 13 have gone on to serve as training program directors themselves. Since relinquishing his administrative responsibilities, he has continued to practice and teach at the same level. He has received multiple teaching awards, the Marian Ropes Award given by the Arthritis Foundation, and has been recognized as a Master by the ACR.
Q: What is it like to be the first winner of this award?
A: There are many qualified individuals. I feel honored and particularly appreciative of the recognition that the ACR has given to this career pathway. I certainly have enjoyed the experience.
Q: You’ve said that training future rheumatologists is your greatest professional accomplishment. Why?
A: I take great pride and satisfaction in their accomplishments. They have had a positive impact on the entire field in the areas of patient care, research, and teaching. The graduates of our program have expanded and enriched rheumatology by recruiting and training new physicians in this challenging and rewarding area of medicine.
Q: What is it about rheumatology that drew you to such a young specialty?
A: First of all, I liked the challenge of the patients and the dependency upon history and physical exam as the major diagnostic tool. But, moreover, as a medical resident, I came to the realization that patients who had a condition that could not be cured probably needed a physician more than patients with a condition that is easily corrected. I was also convinced at that time that there would be significant improvements in the care of these patients over my career. Fortunately, this has occurred.
ACR Presidential Gold Medal
Herbert Kaplan, MD
Retired private practice rheumatologist, Denver
Background: Dr. Kaplan is among the first rheumatologists. He passed the first board examination in the specialty in 1972, after having first worked under Charley Smyth, MD, one of the field’s founders. Dr. Kaplan graduated from Albany Medical College in Albany, N.Y., in 1955 and later served as assistant chief of the medical service at the U.S. Army Hospital in Munich, Germany, from 1959–1962 before opening his private practice in Denver.
He has worked on 48 published papers, is one of the founders of the Denver Arthritis Clinic and the Rocky Mountain Rheumatism Society, served as ACR president from 1993–1994, and has won the ACR’s Paulding Phelps Award. He is the first community-based practitioner to receive this award.
Q: As the ACR’s representative to the American Society of Internal Medicine (ASIM) in the early 1980s, you persuaded them to include rheumatology as a subspecialty. Why is that important?
A: For me, 1972 is not that long ago and, up until then, rheumatology did not have board exams.
People didn’t realize rheumatology was a specialty to itself … it may sound difficult to understand in the modern day, when we have thousands of people attending the [annual] meeting.
Q: You were first author of many of your 48 peer-reviewed papers.
How difficult do you think it is today for private practice doctors to publish that prolifically?
A: Most of them now don’t have the time to do it because of the stresses and pressures of private practice. I was fortunate that—and I probably sound like an old codger—[I practiced] in the golden age of medicine. It’s a different world now.
Q: What did working with ACR and the Arthritis Foundation mean to you professionally and personally?
A: I enjoyed doing things outside of my office that also educated patients as to what was available with specialty care to treat the more than 100 different types of arthritis and rheumatism.
It helped me spread the word about treating patients with arthritis and other things. Volunteering for these organizations—if you want to take the time to do it—is another way of helping to treat patients.
ACR Paulding Phelps
Fredrica Smith, MD
Private practice rheumatologist, Los Alamos, N.M.
Background: Dr. Smith graduated from Duke University School of Medicine in Durham, N.C., in June 1971, and since then, she’s spent just 17 months of her career—her rheumatology fellowship at University of Virginia in Charlottesville—outside of New Mexico. She has been a two-time chief of staff at Los Alamos Medical Center and has served as a preceptor for medical students from the University of New Mexico (where she did research under rheumatologist and former ACR Presidential Gold Medal winner Ralph Williams, Jr., MD) and other medical schools. Her community involvement includes helping to build a year-round aquatic center and being a 37-year member of the Los Alamos Symphony Orchestra. Her retirement will be official by year end.
Q: This award is for community and patient service. Is that what drew you to rheumatology?
A: One of the pleasures of rheumatology is you get to know the patients with whom you’re working. You work with them for so many years on their problems that you really get to know them as people, which is always very nice, as opposed to a person you can’t remember. I have some patients I’ve taken care of for all 37 years I’ve been in practice. That’s a nice thing to be able to do. It’s also intellectually challenging because these people have very complicated problems … rheumatology is the best of the internal medicine world because of the complexity and the patient interactions that occur over so many years.
Q: What impact does your community involvement have on your practice?
A: It’s a very important part of my life. One of the things you learn very quickly in a small community is how to maintain a friendship without getting into anything medical away from the office. That’s true, I’m sure, in every small town.
Q: Is that an easy lesson to learn?
A: I don’t know whether it’s easy or not. It’s a very nice thing to know people in another context. Play in the orchestra with them, swim with them, or serve on [community] committees with them. You just learn how to balance that. You don’t deal with the medical issues outside the office, but you’re not isolated from the community because of your medical work.
ACR Excellence In Ivestigative Mentoring
Virginia Steen, MD
Professor of Medicine, Rheumatology Fellowship Program Director, Georgetown University Hospital, Georgetown University Medical Center, Washington, D.C.
Background: Dr. Steen’s path to rheumatology started on the first day of medical school at the University of Pittsburgh, when she met her future husband standing in line for pictures. Both she and Joseph Verbalis, MD, now chief of the endocrinology division at Georgetown, wanted to be in internal medicine fields that dealt with patients who had long-term and complex conditions. Rheumatology fit perfectly, but her career-long work with scleroderma was less planned. After completing an internal medicine residency at the University of Pennsylvania, she returned to Pitt for a rheumatology fellowship and worked under Drs. Gerald Rodnan and Thomas Medsger. Alongside Dr. Medsger, she helped establish the largest single-site, prospective cohort study of systemic sclerosis. She moved to Georgetown in 1995 and has since won the ACR Clinical Science Award and the 2010 Doctor of the Year honor from the Scleroderma Foundation. She is also the coordinating investigator of the multicenter Pulmonary Hypertension Assessment and Recognition of Outcomes in Scleroderma (PHAROS) trial, an eight-year ongoing study that has lead to five published papers.
Q: Having worked under Dr. Medsger, you saw the value of a mentor. What did that experience teach you?
A: I certainly saw that it was very hard to do things alone. Having a mentor, having someone who can help guide you in directions and open doors that might not have been open because you didn’t have a mentor—I saw how important that was.
Q: How important is mentoring for a field such as rheumatology, where there are many long-term concerns about staffing?
A: That’s really been my concern. It is clear to me that if we didn’t really focus on trying to get this young generation of people who had a special interest in scleroderma … this whole area of research and focus would be much diminished. That has really been one of my goals over the last 15 years.
Q: You’ve won many awards over your career. Where does this one rank?
A: It is especially meaningful to me because I was nominated by my young colleagues and then chosen by peer colleagues. Frequently, this is an award given to a basic scientist who mentors a lot of people getting a lot of grants. My approach has been much broader, dealing with a specific disease and mentoring young scleroderma investigators. It was especially satisfying to me.
Henry Kunkel Young Investigator
Jeffrey R. Curtis, MD, MS, MPH
Associate Professor of Medicine, Director, Arthritis Clinical Intervention Program, Codirector, Center for Education and Research on Therapeutics of Musculoskeletal Disorders (CERTS), Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham (UAB)
Background: Dr. Curtis spent most of his undergraduate years focused on computer science before marrying his technical background with his interest in population-based health. He earned his medical degree and a master’s degree in public health from Oregon Health and Sciences University (OHSU) in Portland. After completing his residency at OHSU and a rheumatology fellowship at UAB, he received a Master of Science degree in epidemiology at the Harvard School of Public Health. His research team, which focuses on patient safety and comparative effectiveness of medications for rheumatic diseases, includes rheumatologists, epidemiologists, health economists, statisticians, and analysts. “We work collaboratively together on a number of different projects,” he says. “We have both content and analytic expertise.”
Q: What is the long-term goal of your research?
A: The long-term goal is to achieve personalized medicine. That means different things to different people. Personalized medicine could be in the form of using a blood test to figure out which drug is best for somebody. It may also mean better understanding risks and benefits at the level of an individual patient, not just for groups of patients. Another facet might be to figure out quickly after patients start a new medication whether they’re likely to do well or not on it using clinical or biomarker data. The possibilities are myriad, but all reflect a need to better align patients with their own optimal treatment regimens that take into account safety, effectiveness, and patients’ personal preferences and goals.
Q: What’s the most important thing you learned from your mentors?
A: Attention to detail is critical. Comparative effectiveness and drug safety needs to be done with the same methodologic and scientific rigor that any lab-based researcher needs in doing experiments with animals or with cells. And sometimes, frankly, that requirement is a bit underappreciated in this line of work.
Q: What does this award mean to you?
A: It means that I am incredibly privileged and blessed to be working with such talented and supportive colleagues here. I’m both thankful and humbled by this award, and I recognize that my own research efforts are very much part of a team effort.
Henry Kunkel Young Investigator
Sampath Prahalad, MD, MS
Marcus Professor of Pediatric Rheumatology, Chief, Division of Pediatric Rheumatology, Associate Professor of Pediatrics and Human Genetics, Emory University, Atlanta
Background: Dr. Prahalad immigrated to the U.S. in 1994 and found his calling fast. He completed his pediatric residency, chose a career in pediatric rheumatology, and pursued a fellowship at Cincinnati Children’s Hospital, where he began studying the genetics of juvenile idiopathic arthritis (JIA). He spent eight years at the University of Utah and then joined Emory as associate professor of pediatrics and human genetics. He is the inaugural recipient of the Marcus Professorship in Pediatric Rheumatology at Emory University. Dr. Prahalad’s research has identified associations between JIA and variants in HLA, LMP7, CCR5, STAT4, c12orf30, and TNFAIP3 loci. A member of the ACR’s Special Committee on Pediatric Rheumatology, he is investigating distant relatives of JIA patients for shared genomic regions harboring causal variants. He currently is investigating children with JIA who have a form of adult rheumatoid arthritis.
Q: What is the most important thing about being a mentor?
A: A good mentor is someone who doesn’t expect you to be like them. They encourage you to be the best you can be, and they understand your style and let you forge your own path.
Q: Where do you see the future of rheumatology research?
A: Clinically, it’s an exciting time. There are so many new drugs to choose from, which I believe are the fruits of prior research. From the research point of view, I think understanding more about the genome is clearly a huge new area. I think it will allow us to personalize the treatment going forward. I think we’ll be able to look at the genes and predict which drugs are going to work better for someone, and who’s going to be at risk for a bad outcome.
Q: As a young researcher, what is your biggest challenge today?
A: There is a huge need for collaborative research. For some of these studies, we need patients from a lot of centers and this can be very challenging. Another major challenge is the tight funding climate for research. Projects that likely would have been funded in the past are now not getting funded.
Distinguished Basic Investigator
Shu Man Fu, MD, PhD
Margaret M. Trolinger Professor of Rheumatology, Professor of Medicine and Microbiology, Division of Clinical Rheumatology, University of Virginia School of Medicine
Background: Dr. Fu investigates the genetic and environmental factors of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) and is being recognized contributions in the field of basic and clinical immunology. He earned his medical degree at Stanford University and his doctorate at Rockefeller University in New York City, where he trained under two of the field’s research pioneers—Halsted Holman and the late Henry Kunkel. He was chief of the Clinical Immunology and Rheumatology Division at the University of Virginia for nine years and director of the Specialized Center of Research on SLE for 10 years.
Q: What does this award mean to you?
A: It indicates my contributions and years of hard work have been recognized. It’s also a tribute to my mentors, Halsted Holman and the late Henry Kunkel, both of whom taught me to be critical and to look at clinical problems from an investigative view.
Q: What are the keys to being a good mentor?
A: You have to be frank with your mentees and analyze data with them. Frequent discussions of data and current literature will lead to new ideas and experiments. You also have to leave them alone to allow them to explore their ideas and to experience the joy of being independent. You can’t force your will on their growth.
Q: What would you tell the next generation of researchers?
A: I think the next generation will be different. The key will still be to immerse yourself in your research for a period of time, maybe three or four years, with no distractions. You have to think about your research problem all the time; this is not a 9–5 job, Monday through Friday. You have to be able to look at the developments in multiple areas and try to bring them to your own research projects. Most importantly, you have to think big so that you will work on important questions.
Distinguished Clinical Investigator
Marc Hochberg, MD, MPH
Professor of Medicine and Epidemiology and Public Health, and Head, Division of Rheumatology and Clinical Immunology, University of Maryland School of Medicine, Baltimore
Background: Dr. Hochberg has spent the past 43 years of his professional career in Baltimore, first at Johns Hopkins University and, since 1991, at the University of Maryland School of Medicine. Spurred by his work on an ACR subcommittee under the leadership of Roy Altman, Dr. Hochberg has focused his research on osteoarthritis (OA) for the past 30 years. He has developed and validated grading scales for radiographic features of OA of the hand, hip, and knee for use in epidemiologic studies, and studied risk factors for development and progression of hand, hip, and knee OA. He’s principal investigator of the Baltimore Clinical Center of the Osteoarthritis Initiative (OAI), and co-principal investigator of the Genetic Contributions to Knee Osteoarthritis, a genome-wide association study utilizing DNA specimens from subjects enrolled in the OAI.
Q: How did mentors help guide your research career?
A: Dr. Mary Betty Stevens was a superb clinician and an excellent clinical teacher, especially at the patient’s bedside and in the examination room. She made the practice of medicine exciting. Dr. Lawrence Shulman instilled the desire for learning and research, and led me on the path of an area that was understudied. … This is key for younger people. To be successful in a research career, they have to have the appropriate mentorship and an appropriate amount of protected time to develop their research portfolio and demonstrate success.
Q: What has been the most gratifying part of your research?
A: The translation of research findings into the practice arena, both for primary and secondary prevention.
Q: You’ve been an ACR board member and active committee member. What has the College meant to you professionally and personally?
A: It’s given me an opportunity to participate. I have had the chance to meet a lot of people I never would have come across in my daily activities. And, it’s given me a perspective, not only on the various aspects of rheumatology in the U.S., but also international exposure through the ACR–EULAR exchange and international meetings. When you are an investigator, that exposure provides new insights into your own work. It’s been a tremendous experience, and I would encourage younger academic and practicing rheumatologists to seize the opportunity.
Richard Quinn is a freelance writer based in New Jersey.
