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EDITORIAL
THE AMERICAN RHEUMATISM ASSOCIATION AND THE ARTHRITIS FOUNDATION: Commentary on 14 Years of a Happy Union DANIEL J. McCARTY The Editor-in-Chief of our Journal solicited my thoughts on the status of our “marriage” with the Arthritis Foundation (AF). I am delighted to take up my pen to record success. The American Rheumatism Association (ARA) was incorporated in the State of Delaware in 1938 as the successor to the American Committee for the Control of Rheumatic Diseases (ACCR) which first met in 1934. (The numbering of the ARA annual meetings derives from this date.) This organization developed in turn from a group called the American Committee for the Control of Rheumatism which first met in 1928. The name “American Rheumatism Association’’ was chosen in 1937 over the “American Rheumatism Society” which was rejected because of the somewhat risque connotation of its abbreviation (ARS)! The early history of our organization is well described in the lead article in the very first volume of Arthritis and Rheumatism (1). The first meeting of the ACCR was held at the Racquet Club in Philadelphia and was chaired by Ralph Pemberton on March 17, 1928. The need for fund raising in. support of its programs was discussed. An informal approach to the Rockefeller Foundation and the Mayo Foundation was suggested. When the committee met on October 10, 1929, it was recorded that “various members approach certain public-spirited individuals who have shown or might show interest in the work of the committee.” Such persons would constitute an auxiliary (lay) committee whose purpose would be to raise funds. In 1938, it was recorded that 70 laypersons had contributed a total of $1,200 to the ARA! In 1946, ARA President Walter Bauer appointed Paul Holbrook as Chairman of the Committee on Research
and Education with instructions to solicit lay members himself. A Medical Advisory Committee was appointed consisting of influential persons in American Medicine. “Some at least accepted appointments in the hopes that research money would come to their departments” (1). As a direct result of the efforts of these committees, the Arthritis and Rheumatism Foundation was chartered in 1948 as a confederation of local societies with Paul Holbrook as its first President. This organization shortened its title to “The Arthritis Foundation” in 1965. Thus, the ARA is the natural mother of the AF. Some of the original ARA functions such as public and patient education gradually became AF responsibilities in addition to the more obvious functions of fund raising and liaison with the local chapters. After 17 years of cohabitation in what may seem an incestuous relationship, the ARA became amalgamated into the AF as one of two professional “sections.”* This marriage was consummated in Philadelphia in 1965. The medical and scientific aspects of AF committees were regularly reviewed by a Medical Advisory Committee (MAC) of AF, which was operationally identical to the Executive Committee of the ARA. The latter generally met twice a year in the morning and after luncheon and a change of hats, met in the afternoon as MAC. In 1976, the AF again underwent reorganization with the goals of increasing efficiency and development of better communication between staff and both professional and lay volunteers. Its committees were reconstituted with an admixture of lay and professional persons. MAC was abolished. Communication between lay and
Daniel J. McCarty, MD: President, American Rheumatism Association, 1979- 1980; Professor and Chairman, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
*The widespread acceptance of the “team” approach to the management of arthritis attracted many talented nurses, physical therapists, and other nonphysician professionals who were organized as the Allied Healrh Professionals section in 1965.
Arthritis and Rheumatism, Vol. 22, No. 12 (December 1979)
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EDITORIAL
professional volunteers improved greatly but decisions and problems dealt with by AF committees now often bypassed ARA Executive Committee review completely. Medical policy evolved and promulgated by AF often had only nominal ARA input. These policies were sometimes presented to groups such as the National Arthritis Advisory Board (NAAB), the National Institute of Arthritis, Metabolism and Digestive Diseases (NIAMDD), and even congressional committees at about the same time that the ARA leadership became aware of them. Some of the functions of the AF committees continued to overlap to a considerable degree with ARA committees (e.g., Professional Education). These problems have been largely remedied under our immediate Past President, Dr. Alan S. Cohen, who invited each Chairman of AF committees involved in medical or scientific affairs to report informally to the ARA Executive Committee as well as formally to the AF Board of Trustees. The recent appointment of Dr. Frederic C. McDuffie as Senior Vice President for Medical and Scientific Affairs will certainly assure improved communication between AF staff and the professional volunteers of ARA. Although, as in any marriage, there have been times of ineffective communication, misunderstanding, and moments of disappointment, there have also been times of great rapport, mutual understanding, and even ecstasy. The net result has been a stable union. The groundwork has been laid for the golden years. The ARA remains a healthy section of its offspring. Its members work diligently on its regional and annual scientific programs, on its continuing education progrz.ms comprising its scientific workshops, clinical seminars, and biennial rheumatology review course. Other members staff committees developing criteria for various rheumatic diseases, organizing conferences, collecting data relative to education of physicians at all levels. Its journal, Arthritis and Rheumatism, has achieved an excellence comparable to the best of subspecialty journals in other fields. Its Rheumatism Reviews continue to provide a biennial summary of the literature. Liaison with other professional organizations devoted to the study of the rheumatic diseases around the world is vigorously maintained. ARA members continue to be heavily involved in AF committees, such as the Research Committee and its subcommittees, the Government Liaison Committee, committees devoted to Chapter Operations, Professional, Public and Patient Education and many others. ARA professional volunteers are active in staffing the Board of Trustees and the various committees of the local chapters of the AF. ARA members edit and (of-
ten) write the Bulletin on the Rheumatic Diseases for professional distribution by AF as well as the various booklets designed to aid arthritic patients and to help them understand their disease and its treatment. They also write and edit the Primer on the Rheumatic Diseases which has served to introduce the fundamentals of rheumatology to generations of medical students and housestaff. The development of inhouse publication capability by the AF has greatly strengthened each of the ARA and AF literary efforts cited here. And, in keeping with modem marital concepts the ARA has kept its own name and pays its own way. For example, scrutiny of the AF fiscal report for 1978 reveals the following: Income Meetings, Registration ...................................................... Dues (estimated) ........................................................ Arthritis & Rheumatism Sales .................................................................. Arthritis & Rheumatism Advertising .......................................................
TOTAL:
$ 223,645
54,000 199,522 215,367 $692,534
Expenditures ARA Department ................................................ Arthritis & Rheumatism ........................................
$ 239,478
409,655
TOTAL:
$649,133
Net contributed to AF:
$ 43,401
In summary, I perceive a vigorous volunteer professional organization which has maintained its identity and its fiscal integrity while married to a larger organization with a broader mission, composed of dedicated volunteers, both professional and lay, working shoulder to shoulder toward common goals. The honeymoon and the early years of struggle are clearly over. Our golden years lie ahead. If only Pemberton, Bauer, Holbrook, Osgood, Hench and the other pioneers could see us now! REFERENCE 1. Stecher RM: The American Rheumatism Association: its origins, development and maturity. Arthritis Rheum 1 : 4 19, 1958
EDITORIAL
THE AMERICAN RHEUMATISM ASSOCIATION AND THE ARTHRITIS FOUNDATION: Commentary on 14 Years of a Happy Union DANIEL J. McCARTY The Editor-in-Chief of our Journal solicited my thoughts on the status of our “marriage” with the Arthritis Foundation (AF). I am delighted to take up my pen to record success. The American Rheumatism Association (ARA) was incorporated in the State of Delaware in 1938 as the successor to the American Committee for the Control of Rheumatic Diseases (ACCR) which first met in 1934. (The numbering of the ARA annual meetings derives from this date.) This organization developed in turn from a group called the American Committee for the Control of Rheumatism which first met in 1928. The name “American Rheumatism Association’’ was chosen in 1937 over the “American Rheumatism Society” which was rejected because of the somewhat risque connotation of its abbreviation (ARS)! The early history of our organization is well described in the lead article in the very first volume of Arthritis and Rheumatism (1). The first meeting of the ACCR was held at the Racquet Club in Philadelphia and was chaired by Ralph Pemberton on March 17, 1928. The need for fund raising in. support of its programs was discussed. An informal approach to the Rockefeller Foundation and the Mayo Foundation was suggested. When the committee met on October 10, 1929, it was recorded that “various members approach certain public-spirited individuals who have shown or might show interest in the work of the committee.” Such persons would constitute an auxiliary (lay) committee whose purpose would be to raise funds. In 1938, it was recorded that 70 laypersons had contributed a total of $1,200 to the ARA! In 1946, ARA President Walter Bauer appointed Paul Holbrook as Chairman of the Committee on Research
and Education with instructions to solicit lay members himself. A Medical Advisory Committee was appointed consisting of influential persons in American Medicine. “Some at least accepted appointments in the hopes that research money would come to their departments” (1). As a direct result of the efforts of these committees, the Arthritis and Rheumatism Foundation was chartered in 1948 as a confederation of local societies with Paul Holbrook as its first President. This organization shortened its title to “The Arthritis Foundation” in 1965. Thus, the ARA is the natural mother of the AF. Some of the original ARA functions such as public and patient education gradually became AF responsibilities in addition to the more obvious functions of fund raising and liaison with the local chapters. After 17 years of cohabitation in what may seem an incestuous relationship, the ARA became amalgamated into the AF as one of two professional “sections.”* This marriage was consummated in Philadelphia in 1965. The medical and scientific aspects of AF committees were regularly reviewed by a Medical Advisory Committee (MAC) of AF, which was operationally identical to the Executive Committee of the ARA. The latter generally met twice a year in the morning and after luncheon and a change of hats, met in the afternoon as MAC. In 1976, the AF again underwent reorganization with the goals of increasing efficiency and development of better communication between staff and both professional and lay volunteers. Its committees were reconstituted with an admixture of lay and professional persons. MAC was abolished. Communication between lay and
Daniel J. McCarty, MD: President, American Rheumatism Association, 1979- 1980; Professor and Chairman, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
*The widespread acceptance of the “team” approach to the management of arthritis attracted many talented nurses, physical therapists, and other nonphysician professionals who were organized as the Allied Healrh Professionals section in 1965.
Arthritis and Rheumatism, Vol. 22, No. 12 (December 1979)
1395
EDITORIAL
professional volunteers improved greatly but decisions and problems dealt with by AF committees now often bypassed ARA Executive Committee review completely. Medical policy evolved and promulgated by AF often had only nominal ARA input. These policies were sometimes presented to groups such as the National Arthritis Advisory Board (NAAB), the National Institute of Arthritis, Metabolism and Digestive Diseases (NIAMDD), and even congressional committees at about the same time that the ARA leadership became aware of them. Some of the functions of the AF committees continued to overlap to a considerable degree with ARA committees (e.g., Professional Education). These problems have been largely remedied under our immediate Past President, Dr. Alan S. Cohen, who invited each Chairman of AF committees involved in medical or scientific affairs to report informally to the ARA Executive Committee as well as formally to the AF Board of Trustees. The recent appointment of Dr. Frederic C. McDuffie as Senior Vice President for Medical and Scientific Affairs will certainly assure improved communication between AF staff and the professional volunteers of ARA. Although, as in any marriage, there have been times of ineffective communication, misunderstanding, and moments of disappointment, there have also been times of great rapport, mutual understanding, and even ecstasy. The net result has been a stable union. The groundwork has been laid for the golden years. The ARA remains a healthy section of its offspring. Its members work diligently on its regional and annual scientific programs, on its continuing education progrz.ms comprising its scientific workshops, clinical seminars, and biennial rheumatology review course. Other members staff committees developing criteria for various rheumatic diseases, organizing conferences, collecting data relative to education of physicians at all levels. Its journal, Arthritis and Rheumatism, has achieved an excellence comparable to the best of subspecialty journals in other fields. Its Rheumatism Reviews continue to provide a biennial summary of the literature. Liaison with other professional organizations devoted to the study of the rheumatic diseases around the world is vigorously maintained. ARA members continue to be heavily involved in AF committees, such as the Research Committee and its subcommittees, the Government Liaison Committee, committees devoted to Chapter Operations, Professional, Public and Patient Education and many others. ARA professional volunteers are active in staffing the Board of Trustees and the various committees of the local chapters of the AF. ARA members edit and (of-
ten) write the Bulletin on the Rheumatic Diseases for professional distribution by AF as well as the various booklets designed to aid arthritic patients and to help them understand their disease and its treatment. They also write and edit the Primer on the Rheumatic Diseases which has served to introduce the fundamentals of rheumatology to generations of medical students and housestaff. The development of inhouse publication capability by the AF has greatly strengthened each of the ARA and AF literary efforts cited here. And, in keeping with modem marital concepts the ARA has kept its own name and pays its own way. For example, scrutiny of the AF fiscal report for 1978 reveals the following: Income Meetings, Registration ...................................................... Dues (estimated) ........................................................ Arthritis & Rheumatism Sales .................................................................. Arthritis & Rheumatism Advertising .......................................................
TOTAL:
$ 223,645
54,000 199,522 215,367 $692,534
Expenditures ARA Department ................................................ Arthritis & Rheumatism ........................................
$ 239,478
409,655
TOTAL:
$649,133
Net contributed to AF:
$ 43,401
In summary, I perceive a vigorous volunteer professional organization which has maintained its identity and its fiscal integrity while married to a larger organization with a broader mission, composed of dedicated volunteers, both professional and lay, working shoulder to shoulder toward common goals. The honeymoon and the early years of struggle are clearly over. Our golden years lie ahead. If only Pemberton, Bauer, Holbrook, Osgood, Hench and the other pioneers could see us now! REFERENCE 1. Stecher RM: The American Rheumatism Association: its origins, development and maturity. Arthritis Rheum 1 : 4 19, 1958
