Unity in the field of rheumatology: The role of the ACR

Colleagues and guests: it is my pleasure to again welcome you to this opening session of the 2008 Annual Scientific Meeting of the American College of Rheumatology, and to have the opportunity to deliver the ACR Presidential address. My topic is “Unity in the field of rheumatology—the role of the ACR.” Rheumatology is unique amongst the subspecialties of internal medicine in the United States in that the entire spectrum of our profession is represented by a single cohesive organization—the ACR. Not only does the ACR include virtually all rheumatologists in this country, whether they are engaged in clinical practice, research, teaching, or positions in industry—but it also encompasses the many other health professionals whose clinical practice or research is also devoted to improving the health of patients with rheumatic diseases. The program of this meeting reflects the broad scope of our College, and the tireless work of a terrific team of ACR staff and volunteers. I’m especially pleased to announce that beginning in 2009 the abstract submission deadline for the ACR Annual Meeting will be moved from early May to late June. This significant change, which will involve even more concentrated efforts by the many individuals who assemble the program for the Annual Meeting, will ensure that the science presented is as up to date as possible. An organization like the ACR, whose membership is diverse, functions at its best when its multiple constituencies achieve a harmonious balance. A relevant analogy (relevant, at least, from the point of view of someone who does immunology research) can be found if one considers the cellular components of the immune system. These include several subsets of CD4 effector T lymphocytes, known as Th1, Th2, and Th17 populations, as well as regulatory T cells, CD8 cells, B lymphocytes, natural killer cells, and the myeloid antigen-presenting cells that include dendritic cells and monocytes. The collaboration of all of these cellular components is required to maintain effective host defenses, a task not achievable by any one cell type alone. Moreover, disproportionate activation of any one population or failures of regulatory mechanisms lead to autoimmunity. In a similar vein, the ACR works best when each of its constituencies, adult rheumatologists and pediatric rheumatologists, researchers and clinicians, educators and trainees, nurse practitioners and occupational therapists, physicians’ assistants and physical therapists— and all other members of the ACR—can assume roles that are dynamic and collaborative in the work of our College. Domination by any single constituency would be undesirable, analogous to breakdown of regulatory balance during an immune response. A sign of the health of our organization is the remarkable extent to which members of the ACR care about, work for, and advocate for components of the College outside of their own constituency. This is evident in the exponentially expanded activities of our Government Affairs Committee and staff. With the help Presented at the 72nd Annual Scientific Meeting of the American College of Rheumatology, October 25, 2008. David A. Fox, MD: University of Michigan, Ann Arbor; President, American College of Rheumatology, 2007–2008. Address correspondence and reprint requests to David A. Fox, MD, University of Michigan, Room 3918 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0358. E-mail: dfox@umich.edu. Submitted for publication November 21, 2008; accepted November 21, 2008. Arthritis & Rheumatism