The Rheumatologist

As an ACR volunteer who comes from the world of academic medicine and research, I knew I would have a lot to learn when I joined the ACR Board of Directors in 2000. But I could not have anticipated the pace, scope, or complexity of the changes rheumatology has experienced in the past six years. All ACR members can recognize the impressive advances in understanding rheumatic diseases and the significant improvements in therapeutic options for our patients. Rheumatology can take a great deal of credit for bringing biologic therapies to medicine, but along with those advances have come important challenges for all ACR members.

While participating in board and ACR Executive Committee discussions, my colleagues and I have responded to opportunities for continued strengthening of the specialty but have also been faced with crafting appropriate and productive responses to conditions in the changing healthcare environment. The growth in the cost of healthcare cannot be sustained and yet our patients need access to increasingly sophisticated therapies. Healthcare is moving in the direction of requiring documentation of both quality of care and efficiency, yet practicing physicians have neither the experience nor resources to respond to new requirements coming from the government and insurance companies. We have concerns regarding the strength of academic rheumatology divisions and the capacity of those divisions to adequately train the next generation of rheumatologists.

A Comprehensive Resource

There is much that is exciting and promising in our field, and there are also many changes and challenges. Whatever rheumatology may face, our primary responsibility is to ensure that our members are aware, educated, and prepared for the future. A constant theme in our Executive Committee meetings has been the need to communicate more effectively to our members. We could not be more excited to present the first issue of The Rheumatologist, a publication that we hope will be your most comprehensive resource for information important to your interests and work. We want the ACR to be the first place you turn to know more about an issue affecting your practice, your professional life, or the changing world of healthcare. The Rheumatologist will be one of your most important resources for keeping informed about the work of ACR and a spectrum of broader topics important to rheumatologists, rheumatology health professionals, and researchers.

The Rheumatologist is the latest in an array of new communications efforts the College has implemented over the past two years. It is the result of an evolutionary effort to develop content that will enhance your care of patients and your practice of medicine, while also providing a concise way to report on the latest work of the College, the ARHP, and the ACR Research and Education Foundation. I think you’ll find this premiere full of issues and information at the forefront of our profession today.

A Host of Information Outlets

While the launch of this new publication is our latest effort to keep you informed regarding the many issues affecting our profession, it is by no means the only way we’ll keep you up to date. Our communications efforts are varied and fluid; given the topic and its timeliness, we may reach out to you in any number of ways. Although I could simply point out to you our key communications vehicles—The Rheumatologist, the Web site, our e-mail and fax communications, the journals, our clinical symposia and annual meeting, Hotline, and Practice View—I’d rather illustrate how we primarily talk about several perennial issues. By no means is the following list of issues all-inclusive (I’d need all the pages of this publication to begin to do justice to every issue); rather, these are the issues I and other College leaders hear most frequently from our members:

• Practice management issues through the Committee on Rheumatologic Care (CORC), the Regional Advisory Council, and virtually everyone at every level of the College. CORC is the key standing committee that addresses the myriad socioeconomic issues faced by members in private practice and other clinicians. CORC’s volunteers tackle issues ranging from physician payment reform to documentation and coding issues, limiting liability risks to disaster preparedness, position statements to patient care, and Part B to Part D. Because its scope of work is so far-reaching, CORC has established liaisons to nearly every internal ACR committee and developed relationships with external groups like the American Medical Association, the Centers for Disease Control and Prevention, and the Centers for Medicare and Medicaid Services (CMS). Their work is reported widely throughout many of the College’s vehicles and will be covered extensively in the pages of The Rheumatologist as well as on the ACR Web site and via broadcast e-mail updates.
• Developments in Washington through The Rheumatologist, the Web site, and broadcast e-mails. We work hard to keep members apprised of the work of Congress, CMS, the Food and Drug Administration, and other regulatory agencies, and what the ACR is doing to advocate on the important issues that affect rheumatologists. Dozens of ACR and ARHP volunteers (including myself), as well as hundreds of members and their patients, visit or write to Congress about important issues affecting our profession. Volunteers also meet with key regulatory agencies on a regular basis, and the ACR reports the outcomes of these meetings to the membership. We will continue to explore grassroots advocacy efforts and report on our progress.
• Quality movement through multi-platform efforts directed by the Quality Leadership Council (QLC). Among the many efforts undertaken by the QLC this year are focus groups at the ACR State-of-the-Art meeting; a Quality Movement membership survey; the ACR’s Rheumatology Quality Stakeholders Summit of key organizations, insurance groups, and regulatory agencies; the latest Practice View; an editorial by incoming ACR President Neil S. Birnbaum, MD, of Pacific Rheumatology Associates Medical Group in San Francisco, Calif., and an overview of our current work in this area in this issue (see page 8); and a Quality Movement Town Hall session at this month’s annual meeting. They will continue to define the overall strategy of ACR’s quality initiatives and connect the quality-related work of ACR Committees on Quality Measures, Rheumatologic Affairs, Education, Training and Workforce, and Government Affairs.
• The work of the ACR Board of Directors through e-mail summaries. Last year I began sending out summaries of the ACR Board of Directors meetings to all members after each meeting. It is a way for you to know almost immediately what issues were discussed and what actions were taken. As a result of these summaries, dozens of you have contacted me personally to ask questions, offer suggestions, and provide feedback on a variety of issues the board is—or should be—looking at.
• Local issues through the Regional Advisory Council and six ACR list serves. Formed two years ago, this sub-committee of CORC was established to effectively link local practitioners via regional member advisors to the ACR. Regional advisors (as well as the professional coders on staff at the ACR) not only attend meetings of local societies and contribute content to local society newsletters, but serve as a local-level resource for members who have practice-related issues. Through this council we have a two-way communication street: Members can report issues, ask for help, and hear about what others are doing, and the ACR better understands and can proactively respond to key local trends. The regional and coding/practice management list serves, which were established this summer, have attracted hundreds of rheumatologists, health professionals, and practice management staff who communicate with each other across the region (or the country) as well as with the ACR.
• Research and training through the Committees on Workforce and Training and Research. Gaining new insights into rheumatic diseases and building the workforce of tomorrow are essential for maintaining the strength of rheumatology. Many of you participated in surveys commissioned by our Workforce and Training Committee and the Committee on Research to assess current and future manpower needs and define the strengths and weaknesses of our academic rheumatology programs. The data derived from these studies will be used to develop strategies to strengthen our research and training resources.

Tell Us What You Want to Know

Because we know we need to constantly improve our communications efforts, our newly re-formed Communications and Marketing Committee will be working with all standing committees to develop an effective, targeted communication plan. Our goal is that you, the individual member, can find all the information you could want or need on any particular topic. The ACR, through its hundreds of volunteers, individual member champions, and staff, is working on dozens of issues that affect you each and every day. And yet, we all know it’s not possible to be all things to all people, and there may be a particular issue you don’t see covered in our various efforts. Bring it to our attention—tell us what you think.

The next time you have a question about an issue affecting your practice or the profession, or you want to know what the ACR is doing about something, don’t hesitate to call or e-mail the ACR office at (404) 633-3777 or [email protected], get in touch with any member of the ACR Board of Directors (including incoming president Dr. Birnbaum at [email protected]), or contact your U.S. regional advisor.

It’s been an honor and pleasure serving as your president this past year. The learning curve has been steep but stimulating, and I have full confidence that we all will continue to experience the rewards of working in the medical specialty with the most fascinating and challenging patients and with the most significant therapeutic advances.

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