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.

“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