ACR President David I. Daikh, MD, PhD, is Professor of Medicine and the Kenneth H. Fye Chair in Rheumatology at the University of California, San Francisco. He also directs the Rheumatology Fellowship Training Program and serves as division chief and directs the rheumatology clinic at the San Francisco VA Medical Center.
Dr. Daikh recently answered questions about the upcoming Annual Meeting and the rheumatology field. Answers were edited for length and clarity.
What makes the Annual Meeting special or different from other rheumatology meetings?
Certainly, the size of the meeting, and that it includes up-to-date clinical and research information that spans the gamut from basic research and the fundamental causes of rheumatic disease to the newest in clinical care, clinical trials, and other clinical research information. There are also sessions about legislative issues, government affairs, and issues that affect practice, plus state-of-the art presentations leading to modern approaches to medical education.
One neat thing about the meeting is that we invite medical students. We try to identify students from underrepresented groups and then invite them to the meeting so they have the opportunity to learn about the field of rheumatology.
And even though it’s a meeting of the American College of Rheumatology, the meeting has a real international aspect to it as well. Not only do we have many attendees from around the world, but also the content also relates to international issues. In fact, many of the various international rheumatology leagues have organized special sessions at the meeting. So our meeting is unparalleled in terms of its scope.
What are some of the things that excite you most about this year’s meeting?
There are so many new therapies that are coming out, so the up-to-date abstracts and presentations about the newest therapies are always exciting. I think it is a particularly important time as many new treatment targets are being identified and there are now studies showing the impact of these targets on a range of diseases.
And it’s exciting that we’re going to be meeting in Chicago this year, which is a wonderful venue. Great food, great architecture and the Miracle Mile architecture. The last time the meeting was in Chicago, people seemed to really enjoy the city—so this year’s meeting has a great setting.
What advice would you give somebody so they get the most out of the Annual Meeting?
First, certainly, is make sure to download the official meeting app so you have the schedule at your fingertips and you can put together a meeting plan for the day. That’s really helpful to make the most of your time.
I recommend mixing it up in terms of getting practical information for your clinical practice, but also checking out some new developments, maybe cutting-edge research or new treatment targets in an area that’s new to you. That helps keep everything fresh.
I also enjoy the poster sessions and talking directly with the people that are doing the work. It’s a great way to learn clinical pearls or share your clinical experiences with others. So many people are working in innovative and groundbreaking ways.
Also take advantage of ACR Beyond, which is so valuable when it comes to getting the most out of the meeting because it’s impossible to get to every session, and sometimes it’s even hard to absorb everything at a session while you’re hearing it.
How important are the networking events to the Annual Meeting?
It’s one thing that can’t be duplicated by going to a virtual meeting or utilizing online content for education. There really is no substitute for being face to face with colleagues, friends, and former associates. Others may become collaborators in research projects or new clinical care initiatives. You can find and talk to people dealing with similar challenges that you are facing in your work. The opportunity to compare notes and share best practices cannot be duplicated. Networking events can be valuable for identifying career pathways or job opportunities, as well.
What excites you about rheumatology right now and into the future?
Society’s health care needs are increasing in so many ways, and rheumatology is right in the center, certainly in terms of developing innovative and more effective treatments for complex diseases. Rheumatology has been in the lead in so many areas.
Being able to help patients manage chronic complex illness or illness that affects many different aspects of life over many years is an increasing challenge for our aging population, and in rheumatology, it’s part and parcel of what we do as rheumatologists—collaborating with allied health professionals to deliver that care over extended periods of time and knowing all the aspects of the patients and working with a health care team. It’s really not a surprise that rheumatology has started to become a more popular specialty as people realize that they can really have an impact on people’s lives, and it’s very satisfying to practice in the way that we do.
Another area of innovation and form of leadership happening in rheumatology is quality improvement and leveraging the experience of practitioners around the country through their participation in the RISE patient registry, which is the largest registry of patient information for rheumatic diseases in the world.
On the flip side, what are the challenges ahead?
We take care of patients who have a large burden of illness across the country, but there are too few of us. This is a huge challenge, and it’s an increasing challenge. It’s good news that our specialty is popular and that more people are thinking about rheumatology, but we still need more than we have coming into the field.
Patient care that requires invasive procedures or surgery tends to have a lot more economic stability than the so-called cognitive specialties such as rheumatology. We’ve seen in the last year where rates of reimbursement for care of patients with complex illness is being reduced and access to a rheumatologist and the care they provide is being limited by the health plans and payers, including the government. It’s an ongoing challenge to be able to practice in a way that is viable and to provide care to the whole range of patients regardless of their payer source, and develop a practice that is able to provide equal access to all those patients in an economically viable way.
It’s a focus for our organization, too. We’re trying to find ways to address that. That’s been a huge focus for us in the advocacy realm, the legislative realm, and working with the payers to try and preserve access for patients. We’ve made progress, but it’s health care, so it’s been slow. But we’ve made a lot of people more aware about the issues and we need to continue to stress the many ways that rheumatology provides truly high-value care.
What would be your “dream day” at the Annual Meeting look like, if you didn’t have any leadership or presidential duties?
I really enjoy picking one day that I’m going to focus on clinical care, for example, and then another day decide I’m going to focus on new research. It’s hard to do that day by day because you’ll have sessions any given day that you really want to get to in one realm or the other, but I like to have a mix of experiences to be able to learn about things that are happening across the spectrum, not only my own area but in new areas. I always really enjoy going to the presentations about the innovative research that’s being funded by the Rheumatology Research Foundation. And I really like being able to wander around the posters, talking to people directly about the work they are doing.
Why did you choose rheumatology for a career?
I always wanted to combine research with patient care in an academic setting. I naturally gravitated towards specialties like neurology, rheumatology, endocrinology, and infectious disease. I was doing research in neuroscience as a graduate student, but when I got onto the hospital wards and really saw the breadth of conditions that comprise rheumatologic care, it fit all of my interests.
One of the last frontiers of biology is the immune system and how it’s regulated. Understanding these details is the key to so many diseases. And I also enjoy using my ears and eyes to understand the patient along with my hands through the physical examination and an understanding of anatomy to make a diagnosis.
Rheumatologists have to be really good detectives, and that’s something I’ve always found very attractive and stimulating about the specialty. In addition, the opportunity to work with a patient over an extended period of time, sometimes for many years, is really a privilege and a source of much satisfaction.