Another Outstanding Meeting…and More
By Gary M. Kammer, M. D.
In September OAR held its fifth annual meeting at the Cherry Valley Lodge in Newark, OH. And what a meeting it was! Like 2009’s meeting, we had a record attendance. The rustic ambiance of the lodge with its flaming hearth warmed our spirits and prompted fireside chats. And—no hyperbole here—the meeting was truly outstanding.
Here are some details that tell the story. Of the 34 folks in attendance, 30 (88%) were physicians. Twenty-nine were rheumatologists, one was a P.A., and four included a Ph.D. and J.D. Of those physicians responding to our questionnaire, all reported that the course description listed in our brochure was accurate and felt that the material was presented in a balanced, unbiased manner without any commercial tilt. Several offered the following comments: “Well balanced discussion of advocacy….Very good broad based program.”
We asked our attendees to grade speakers from 0 to 4.0 based on the several criteria. These included (1) meeting learning objectives; (2) relevance to clinical practice of rheumatology; (3) quality, clarity and organization of presentation; and, (4) audience participation. Of the three morning talks on advocacy, the ratings ranged from 3.5 to 3.9. Attendees commented on the speakers’ overall knowledge, insights and understanding of the broad array of health care reform issues discussed. Specific comments included: “Wonderful talk…I learned more detailed information about the ACA (Affordable Care Act of 2010)…the option to ‘opt out’ [of Medicare] is novel to me…what’s going on with changes and legislation [affecting the practice of medicine in Ohio].”
Our line-up of clinical speakers in the afternoon fared as well. All speakers were rated 3.5 to 4.0. It doesn’t get better than that! Attendees were particularly fascinated to hear how translational research has yielded such major therapeutic advancements in the rheumatic diseases, especially in biologic therapies, as well as understanding the pathophysiologic mechanisms of inflammatory myopathies and osteoarthritis. Of particular interest were the following comments: “New intracellular signal transduction inhibitors and their potential for use in RA [are exciting]….MTX monotherapy is still an impressive option….Inflammatory aspect of osteoarthritis [and the importance of] cytokines in the pathophysiology of OA…Incredibly complex subject [OA] made relatively understandable….[The review on inflammatory myopathies] was a very timely [one] for me [since] I have had a ‘run’ on these rare diseases….Reinforced the need for a DAM [Disease Activity Measurements]…Well done.”
Our informal Friday evening dinner and Saturday noon luncheon provided quality time for attendees to renew acquaintances, meet new members, and, importantly, to talk with speakers. I just happened to walk up as Dave Racer, our keynote speaker on health care reform, was waxing elegantly on what really is ailing our health care system. It was a fascinating tour de force, essentially a mini-lecture. (By the way, I recommend Dave’s booklet entitled “What really ails the U.S. health care system” for a forceful, no-holds-barred discussion of the facts and myths of our health care system.)
If you didn’t have an opportunity to join us for this exhilarating meeting, please consider attending our sixth annual meeting next Fall. More about that in the near future from Stephanie Ott, M. D. (Lancaster, OH) and Wael Jarjour, M. D. (Columbus, OH), who will be co-chairing the meeting.
Gary M. Kammer, M. D. is the current president of OAR, editor of The OAR Advocate, and a practicing rheumatologist in suburban Cleveland.
ACA · annual meeting · ffordable Care Act of 2010 · Gary Kammer · inflammatory myopathies · Medicare · MTX monotherapy · OAR · osteoarthritis · pathophysiologic mechanisms · rheumatic diseases
By Gary M. Kammer, M. D.
OAR was founded primarily as an advocacy society. Its founders, a cadre of northeast Ohio practicing rheumatologists, recognized a troubling trend of over-regulation of physicians by for-profit commercial health insurance companies and governmental agencies. Despite the pro-physician activism of the Ohio State Medical Association, no unified voice spoke for the specific needs and particular concerns of the Ohio rheumatology community. This perceived gap prompted the creation of a mission statement that formed the foundation of OAR, a 501(c) organization.
In the years since its founding, the OAR Board has hewed to its mission of advocating and protecting patient access to all appropriate treatments for rheumatic diseases as well as enhancing the quality of rheumatology services to patients. Our mission statement is now posted on the public section of our website at www.ohiorheumatology.org.
A case in point is the imbroglio over coverage of Cimzia administration in the office by Palmetto/Medicare. The Board’s view is that subq administration of Cimzia is sufficiently complicated that many patients with rheumatoid arthritis will not be able to self-administer the agent at home. Moreover, as a TNF inhibitor with a black box alert due to the potential complication of infections, we strongly recommend that patients be evaluated in the office prior to each treatment to reduce potential adverse effects. This past summer I wrote to Dr. Kamps, medical director of Ohio’s Palmetto office, on behalf of OAR to strongly urge Palmetto to exclude Cimzia from the self-administered list of subq agents. As it turned out, a recent survey of rheumatologists in states serviced by Palmetto found that Cimzia “is not usually self-administered 60% of the time, and under the 50% rule, the drug would be eligible for coverage under Medicare Part B.” According to Roy P. Hall, a member of the Site of Care Team at UCB Pharma, a “critical conference call” between UCB Pharma and Palmetto will take place next week that will determine the outcome of this contentious issue. I believe that OAR’s prompt input and leadership in support of in-office administration of Cimzia, along with other rheumatologists and rheumatology organizations (such as Coalition of State Rheumatology Organizations) across the country, prompted the survey and has contributed meaningfully to the discourse with Palmetto. Of course, we hope the outcome will fulfill our mission of “advocating and protecting patient access to all appropriate treatments” by making Cimzia readily available as an in-office therapy. We will certainly keep our members updated as information is made available to us.
So, why have I ominously entitled this blog “Can OAR Survive?” There are two reasons. First, OAR has been unable to achieve its goal of membership. In many personal discussions with our colleagues, at previous statewide meetings, and, most recently, through a membership drive, we have not been able to attract membership. Consider this: even the low cost of $50 per year and putting in place the infrastructure of a user-friendly website and semi-annual newsletter have not stimulated membership. Indeed, based on membership, OAR represents fewer than 15% of Ohio’s almost 200 rheumatologists. Without membership, OAR serves no purpose.
Second, OAR cannot attract volunteer leadership. Since its founding, OAR’s leadership has largely been its founders and remained in suburban Cleveland. Believing that the leadership should be rotated throughout the state, I have approached a number of Ohio colleagues with demonstrated interest in OAR and leadership capability. Unfortunately, none of our many capable and talented colleagues have stepped up to the plate.
To survive, to grow and, ultimately, to mature into an effective advocacy organization for Ohio rheumatologists, OAR must succeed in building a broad membership base and attracting innovative leadership. This is our immediate challenge! Without these two fundamental components, OAR will cease to survive. And, over time, that will certainly be an inestimable loss to our patients. Can OAR survive? Yes, but only with your participation.
Gary M. Kammer, M. D. is the current president of OAR, editor of The OAR Advocate, and a practicing rheumatologist in suburban Cleveland.
future · leadership · membership · OAR
Written by Gary M. Kammer, M. D.
In my March President’s blog, I addressed a question that has been frequently posed to me: “Why should I become a member of OAR?” I first approached this question in the May 2009 OAR Advocate by detailing OAR’s mission statement, reviewing how OAR works, and introducing the current OAR Board. Because I was drawn to OAR for several reasons, the March President’s blog delved into my personal response to this question. I hope that sharing my experiences with OAR gave you pause to consider what OAR can do for you personally and professionally
What more is OAR doing to enhance its value to members? While our mission statement emphasizes patient advocacy, nurturing interest of medical students and internal medicine trainees in rheumatology, and interactions with other professional organizations with an emphasis on musculoskeletal and rheumatic disorders, there is no specific mission directed to Ohio rheumatologists. One goal I have had since assuming the presidency of OAR is to plug that hole. To that end, our Board has provided me one of the tools to do just that: expanding our annual meetings to include the trilogy of physician advocacy, cutting edge lectures on clinical rheumatology, and Ohio-oriented legislative updates on health care. Our meetings now span the breadth of interests of Ohio rheumatologists who want to be in the know.
In my inaugural February President’s blog entitled “Looking Back…Looking Forward”, I reviewed our initial experience with this expanded one-day format at our 4th Annual OAR Meeting last August. Without any intended hyperbole, I reported to you that the meeting was a “smashing success”. The data I cited supported that conclusion. No where can you as a practicing Ohio rheumatologist get this CME package in a single meeting! Thus, our sixth, but as yet unwritten, mission is to bring our Ohio colleagues the most compelling, informative and entertaining perspectives on the economic, ethical, legal and political issues in today’s practice of medicine, hot topics in clinical rheumatology, and the legislative frontiers of health care in Ohio by leaders and critics in their fields.
Still, there is an occasional pundit among us who questions OAR’s raison d’être. In an e-mail from one colleague, he opined: “I think the biggest challenge to OAR is showing Ohio rheumatologists that you have something to offer them that they want. To date, I don’t think OAR has been compelling in this regard…. Many folks I talk with in Ohio don’t see the value of OAR…” Pondering this comment, two immediate reasons for this colleague’s opinion became apparent.
First, he has not become involved in OAR. Despite being repeatedly invited him to do so, he has unfortunately declined. If he had become involved, it would have become apparent that our focus is on Ohio rheumatology: what the daily concerns of our practicing colleagues are; what the obstacles are that hinder the efficiency of their practices and frustrate them; what gaps and deficiencies exist that limit our colleagues’ efficient practice and provision of high quality care to their patients. These are among the many issues we strive to work on for our colleagues. We discuss these issues in depth at our annual meeting and in our newsletter, OAR Advocate.
Second, he believes that the ACR’s Affiliate Society Council (ASC) is sufficient to serve the role of OAR. In his e-mail, our colleague states: “I think ASC can help provide that…”, meaning that ASC can do what OAR does. Really? If that were so, there wouldn’t already be 25 state rheumatology societies who have banded together as the Coalition of State Rheumatology Societies (CSRO; www.csro.info/).
What his missive does not point out is that, in fact, there is overlap in the missions of CSRO and ASC. To wit, the ACR website states that the ASC, “a subcommittee of the ACR Committee on Rheumatologic Care, exists to strengthen state and local societies and communication between the ACR and local rheumatologists…. ASC will discuss policy issues affecting rheumatologists in local areas. The ASC will have an opportunity to present issues and ideas to the Committee on Rheumatologic Care for further discussion and action by the CORC and Health Policy staff…Affiliates will have an opportunity to influence national policy by submitting resolutions to the CORC. Once national policy has been established, the ACR expects that affiliate societies will support the national priorities and policies. “
Considering this, I still do not understand our colleague’s hesitation to become involved even if he already supports ASC. Indeed, OAR is a member of both the CSRO and ASC, because we believe that all means must be in play to deal with any new issue that comes down the pike, the most recent being the new health care legislation that will surely change the face of rheumatology practice in Ohio and nationally. Nevertheless, there are issues that only concern the practice of rheumatology in Ohio that cannot be addressed by CSRO or ASC. Those problems must be addressed and solved by OAR.
I hope you will agree that OAR is stepping up to the plate to represent your views. The Board again invites you to become involved by attending our annual meeting and by participating by teleconference in our Board’s monthly meetings. These meetings are open to all OAR members; teleconferencing is free. To learn more about how to become involved, please peruse our website, www.ohiorheumatology.org, and click on the “Get Involved” button on the left under Main Menu. Or, give me a call directly at 216-218-0330; I would be delighted to talk with you and meet you.
Gary M. Kammer, M. D. is the current president of OAR, editor of OAR Advocate, and a practicing rheumatologist in suburban Cleveland, OH.
ASC · CSRO · medicine · musculoskeletal · OAR · ohio · rheumatic · rheumatology
Written by Gary M. Kammer, M. D.
“Why should I become a member of OAR?” “Doesn’t my membership in ACR mean my interests are already represented?” “I already belong to other professional organizations; how many do I need?” So go the questions I hear when I call some of our rheumatology colleagues around the state.
Certainly these are good, if not probing questions. Pondering them, I thought back to why I became a member. Obviously, it wasn’t that I needed another organization to add to my yearly dues list. And, who needs another newsletter on top of all the others that get piled on the corner of my desk for weeks until I get to them? What caught my attention was the potential of OAR.
OAR is a nascent grassroots organization of rheumatologists dedicated to finding solutions to problematic issues that affect Ohio rheumatologists and our patients. First, I was drawn to the idea that OAR is all about Ohio. I considered meeting and working with fellow Ohio rheumatologists to build an organization all about local rheumatology and our patients both appealing and challenging. And, I thought, we as rheumatologists are certainly faced with practical and obdurate obstacles to practice every day that hinder our patients’ access to our treatments. Second, here is an upstart group of colleagues who want to do something about the many fundamental, thorny and frustrating disputations that directly affect how we treat our patients and make our livings. These require the kind of advocacy and expertise only we rheumatologists can bring to bear! So, if OAR can grow through membership to represent Ohio rheumatology we just might be able to fix some of these vexing conflicts. Here then, I recognized, is how OAR can represent my interests.
Still, was the idea of solving problems enough of an impetus to join OAR? I didn’t think so. Then I was invited to attend some “working dinner meetings” here in Cleveland with founding president, David Mandel, M. D., secretary-treasurer, Terry Foley, M. D., and others. At that time they were addressing reimbursements for biologics with big Pharma and the pernicious CAT tax with a local Ohio House representative. Although we lost the fight to have rheumatologists who administer biologics in their offices exempted from the tax, we did make meaningful headway with Pharma on reimbursements on behalf of our colleagues.
Quite unexpectedly, I picked up on the camaraderie among our colleagues in these meetings. And, this feeling was sealed when I attended my first annual OAR meeting at the Ritz Carlton Hotel in 2005. I found meeting and talking with that small group of rheumatologists from around Ohio to be most enjoyable and fulfilling. As docs are wont to do, we traded fascinomas, debated the utility of EMRs (still a much debated question some five years later), and commiserated about insurance and government intrusion in practice and lack of meaningful tort reform (still hot issues!). Making new friends of colleagues around the state whom I now communicate with periodically and see annually at our meetings was, in and of itself, enough of a reason for me to continue my membership in OAR. Over time I’ve met other colleagues, including Ed Herzig, M. D. of Fairfield, OH, Ed Goldberger, M. D. of Toledo, and Rob Haladay, M. D. of Sandusky, OH, all of whom have gone on to leadership in our organization. And, importantly, I greatly enjoyed the opportunity to renew old acquaintances. Now, one of those acquaintances—Bill Treuhaft, M. D. of Toledo—is an OAR board member.
So, here are my responses to the questions above: OAR membership provides you the opportunity to make and expand friendships with your colleagues here in Ohio at our annual meetings. And, if you are so moved (and we hope you will be), we welcome you to join our monthly meetings held by teleconference to contribute to the ongoing issues OAR is working on. And, now I hope you can see that OAR and ACR have complementary missions; while there is some unavoidable overlap, OAR focuses on what’s going on in Ohio that affects you and your practice.
Please consider OAR membership. A great place and time to start your membership and involvement in OAR is our upcoming 5th annual meeting on September 24th and 25th at the Cherry Valley Lodge and Resort in rural Newark, OH. Please see our website www.ohiorheumatology.org for details on the Home page. We’ve planned a terrific meeting with national speakers that will be equally divided between advocacy and clinical medicine. Moreover, we’re planning a new event this year after dinner on Friday evening that you definitely won’t want to miss: presentations of brain-teasing cases by rheum fellows. You are invited to join us!
Gary M. Kammer, M. D. is the current president of OAR, editor of OAR Advocate, and a practicing rheumatologist in suburban Cleveland, OH.
annual meeting · cherry valley · membership · OAR · ohio · rheumatologists
Written by Gary M. Kammer, M. D.
Looking back to last August, our fourth OAR Annual Meeting was a smashing success! Our all-star lineup of speakers each hit a homer out of Blackwell park. And our 26 attendees were all winners.
We held our fourth annual OAR meeting at the Blackwell Hotel and Conference Center in Columbus on August 29th. Our program was roughly divided into three parts: advocacy, clinical rheumatology and legislative update. The morning session included talks by reputed experts in their fields. Devon Herrick, Ph. D., a senior fellow at the National Center for Policy Analysis, presented a highly informative and thoughtful talk on “Health Care Reform: What It’s All About and What Will It Look Like”. Roy Ramthun, president and CEO of HSA Consulting Services in Silver Spring, MD, gave a fascinating overview entitled “Update from Washington: Reform, Regulations, and Reality?”. Michael Schweitz, M. D., a practicing rheumatologist, vice president of the Coalition of State Rheumatology Associations and past president of the Florida Society of Rheumatology, next presented a sobering message entitled “Medicare: What You Need To Know About Recovery Audit Contractors (RACs)”. A follow-up panel discussion quickly ignited a flurry of probing questions and provocative discussion that highlighted the issues, controversies and uncertainties of our times.
Our afternoon session focused on clinical rheumatology and legislative updates. Extending our goal of presenting timely, highly-focused and relevant clinical topics in rheumatology, Michael Lewicki, M. D., a practicing endocrinologist and director of the New Mexico Clinical Research and Osteoporosis Center in Albuquerque presented a pithy overview entitled “Osteoporosis: Pathogenesis Meets Clinical Practice”. This was followed by another outstanding talk by Carol Langford, M. D., a practicing rheumatologist and director of the Center for Vasculitis Care and Research at the Cleveland Clinic, entitled “Vasculitis: Update on Pathogenesis and Treatment Concepts”. OAR members Joseph Flood, M. D. of Columbus and David Mandel, M. D. of suburban Cleveland reviewed pending Congressional legislation, including the Arthritis Prevention, Control and Cure Act and Medicare Fracture Prevention & Osteoporosis Testing Act.
Why was our annual meeting a resounding success? The numbers speak for themselves. Of the 26 persons attending the meeting, 23 (88%) were physicians; post-meeting evaluations were completed by 15 (65%) physicians. All physicians reported that the meeting was “balanced, unbiased” and did not promote commercial interests. Most importantly, all speakers were rated 3.9 to 4.0 (on a scale of 0 to 4.0). To me, that is an astounding outcome that I have never witnessed in my experience with CME programs. General comments by physicians about the program included some of the following: “excellent conference”, “well balanced; well thought [out]”; “very informative”; “overall well organized and informative meeting”; and, “excellent mix with clinical and advocacy topics”. One respondent was very direct: “I appreciate all the hard work to pull this off”. I heartily agree with all of these assessments. And, we, the Board, very much appreciate your support and attendance at this program and the kind comments we heard after the meeting.
Looking forward, the Board is ensconced in preparations for our fifth OAR Annual Meeting. Here’s a peek: change of venue; cutting edge talks on health care reform and Medicare; legislative updates; and, clinical case presentations by clinical rheumatology fellows.
Our new venue will be Cherry Valley Lodge in Newark, OH. We selected Cherry Valley Lodge because it is a family-oriented resort situated in rustic Ohio just 30 mi or so east of Columbus. Yet, it offers state-of-the-art facilities for meetings like ours. Wael Jarjour, M. D., director of rheumatology at OSU Medical Center and Annual Meeting committee member, recently visited Cherry Valley over a weekend and gave the facility a thumbs-up. The Board thanks Wael for his effort on our behalf. As our Save the Date notice that you recently received by e-mail emphasized, please consider attending and bringing your spouse or significant other and family for the entire weekend. My wife, Ilene, and I have already booked our room for Friday, 9/24, through Sunday, 9/26. Come join us for a mix of fun and education. What a great venue to get to know our Ohio rheumatology colleagues. Finally, please log-on to www.ohiorheumatology.org at your convenience to keep updated about the meeting agenda. We will, of course, remind you periodically with e-mail notices as well.
Gary M. Kammer, M. D. is current president of OAR, editor of OAR Advocate, and a practicing rheumatologist in suburban Cleveland.
annual meeting · blog · health care reform · kammer · OAR
