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The American congress of rehabilitation medicine: where do we go from here?1
1097
ACRM PRESIDENTIAL ADDRESS
The American Congress of Rehabilitation Medicine: Where Do We Go From Here? Martin Grabois, MD ABSTRACT. Grabois M. The American Congress of Rehabilitation Medicine: where do we go from here? Arch Phys Med Rehabil 2003;84:1097-9. This presidential address reflects on my last 2 years as president of American Congress of Rehabilitation Medicine (ACRM). It recognizes those individuals who have been of significant help and support. The address discusses choices I have made in my professional life including selecting physical medicine and rehabilitation as a subspecialty; committing to an academic career; and choosing to get involved in local, state, national, and international physical medicine and rehabilitation societies. I review my presidential speech of 2001 when I spoke about the path we choose—to succeed or not to succeed. ACRM has come a long way in trying to succeed but continued opportunities remain in obtaining financial security, increased membership, and cost-effective and efficient management. This address includes 11 suggestions designed not only to keep the organization viable but also to allow ACRM to succeed. These suggestions include a new commitment to our strategic plan and the implementation of prioritized goals, reorganization of ACRM’s national office, and adherence to a realistic budget. Finally, we must continue to move the agenda of research in rehabilitation forward much more aggressively. Key Words: Physical medicine; Rehabilitation. © 2003 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation IS HARD TO BELIEVE that my 2 terms as president of American Congress of Rehabilitation Medicine (ACRM) IaretheTover. Being the only president to serve 2 consecutive terms, time still has passed incredibly fast. Although it has been one of the most challenging undertakings of my career, it has been most rewarding. It has been a pleasure and a delight to serve ACRM’s membership, to have had the opportunity to influence the direction that rehabilitation medicine is taking, and to continue to influence the course that the ACRM is taking. When I reflect on the past 2 years, I think first of all of the people who have helped me, supported me, and mentored me. The faculty of Baylor College of Medicine/University of Texas Health Science Center at Houston, Departments of Physical Medicine and Rehabilitation Alliance has to be recognized for its support and help in ways that made it possible for me to serve as president of ACRM. My administrative assistant,
From the Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX. Presented at the American Congress of Rehabilitation Medicine’s 79th Annual Assembly, October 2002, Philadelphia, PA. No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated. Reprint requests to Martin Grabois, MD, Dept of Physical Medicine and Rehabilitation, Baylor College of Medicine, 1333 Moursund Ave, Ste A-221, Houston, TX 77030. 0003-9993/03/8408-8314$30.00/0 doi:10.1016/S0003-9993(03)00231-4
Donna Jones, is amazing. Not only does she keep me going, acts as a frequent confidant and a friend, but she has also stepped in to serve ACRM as coordinator for the past 2 annual assemblies. She has done a superb job in supporting not only me and ACRM. I also want to recognize ACRM’s national office staff, its board of governors, and the committee chairs and members for stepping up to the plate these past 2 years. A special thank you to my wife, Ellen, and children, Sarah, Meredith, and her husband, Brian, who allowed me to do what I do and have always supported me. CHOICES Having served as president of the Association of Academic Physiatrists (AAP), American Academy of Physical Medicine and Rehabilitation (AAPM&R), International Rehabilitation Medicine Association, and now of ACRM, I hope I can provide a vivid perspective on the field. We make choices and will continue to do so in regard to our own future to the field of physical medicine and rehabilitation (PM&R) and to ACRM. My first choice was to pick the field of PM&R as a career. I am a product of the Vietnam War, and I decided to enter PM&R because of my experience in that war. It was in Vietnam that I gave significant thought to my future and decided PM&R was the specialty for me. It met my goals as a physician, allowing me to be clinically involved and provide care for patients over the long term. I could also meet societal needs because there was a shortage of people in the discipline. Most of all, I chose PM&R because it enabled me to work with an interdisciplinary team and to improve the quality of the lives of people whom we treated. Now, 32 years later, I can confirm that is has been and continues to be everything I ever hoped it would be. The professional friends I have made and the mentors who have taught me have made a continuing contribution to my career and to my abilities as a physician. They have also created in me a commitment to administration, education, clinical activities, and research. That commitment led me to pursue academic medicine as a career. Academic medicine has enabled me to practice PM&R and also become involved in scholarly rehabilitation science activities such as education and research. I urge you to consider an academic career that will enable you to have a lasting impact on the field. It will allow you to have the opportunity for increased involvement in scholarly activities, to practice on the cutting edge of new techniques and concepts of practice, to become a recognized expert in a subspecialization area of rehabilitation medicine, to enjoy an extended professional life by varying practice between direct and nondirect patient care activities, to work in an intellectually stimulating environment, to enjoy adequate financial rewards, and to have a positive effect on the future of rehabilitation medicine in the national arena. The choice to become active in the field of rehabilitation medicine at local, state, national, and international levels has allowed me, and will allow you, to meet wonderful colleagues, to travel widely, to influence the course of the field, and to provide the opportunities to learn and improve one’s self and Arch Phys Med Rehabil Vol 84, August 2003
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WHERE DO WE GO FROM HERE?, Grabois
one’s academic programs, and, most important, to serve one’s patients and the membership of this organization. It has always been clear to me that to change the course of the specialty in the future will require the expenditure of one’s time and personal commitment. This is not the time to sit back and hope someone else will do it. TO SUCCEED OR NOT TO SUCCEED In my 2001 presidential address,1 I discussed the paths we choose—to succeed or not to succeed. I spoke on the challenges of moving forward to succeed and what ACRM had to do not only to be a viable organization but also to realize its goals and objectives. It is said that sometimes it may seem harder to forgive someone who has hurt you than it is to ask forgiveness of someone you have hurt. Letting go of old wounds can be hard, but holding grudges prevents us from moving forward. It is like writing on a blackboard that never gets erased; there is no room to write anything new. Forgiving past hurts is like erasing the board; it gives us the room to write new chapters of our lives without the past getting in the way. We have worked toward goals of reconciliation with other rehabilitation organizations, with the formation of the “Triple A,” an alliance among ACRM, AAPM&R, and AAP. The leadership of these organizations meets twice a year to discuss, coordinate, and support separate or joint initiatives. This alliance has met twice and will hold meetings semiannually in association with each organization’s annual convention. There is precedent for joining forces. When rehabilitation medicine organizations joined with the community of people with disabilities to support passage of the Americans with Disabilities Act, they were not only successful, but they also enjoyed one of their finest hours.2 There is no question in my mind that if we partner with our patients and advocate for what is right for them, we will ultimately benefit and prosper as a field and as professionals. In 2001 and 2002, our main challenges continue to be financial security, increased membership, and cost-effective and efficient management. I wish I could say the board of governors and I have solved these issues, but we have still not accomplished these 3 goals. I, the board of governors, and, I hope, the ACRM membership continue to be committed to a mission of clinically relevant interdisciplinary research in rehabilitation medicine. We have and continue to nurture that mission in our publications, meetings, committees, and task force actions. However, research in rehabilitation medicine is still inadequately addressed not only by ACRM, but by our partners AAP, AAPM&R, and other rehabilitation organizations. We still lack the commitment and funding to address adequately issues of people with physical disabilities requiring rehabilitation. Obviously, for us to succeed and move the organization and the field forward, we need to deal with our membership issues, increase our financial resources, improve the quality and quantity of rehabilitation science, the funding for it, and the distribution of these findings to health care professionals and consumers. We also need an improved administrative structure at the board level, in our committees and task forces, and in the national office to succeed. To date, we still do not have these basic essentials in place and the last 10 years has not moved us closer to that goal. In my 2001 presidential address,1 I outlined a plan for the board of governors to move us forward. Sadly, I must say we have only been partially successful. Our success has been hindered by a number of issues including the financial cost of AAP’s decision not to continue to manage ACRM and our need Arch Phys Med Rehabil Vol 84, August 2003
to establish a separate administrative office. Our national office continues to maintain our activities but lacks the resources to move us forward. Many of our committees and task forces have accomplished only a few of the goals given to them. This has resulted in a stagnated strategic operating plan. However, all is not doom and gloom. We have established an e-mail newsletter (Enews), and now we need to make it a regular one. Once again, we organized a successful annual meeting in Philadelphia. We continue to contribute to a very successful journal, the Archives of Physical Medicine and Rehabilitation. We published a regular newsletter, Rehab Outlook. We are working to establish a Foundation for Rehabilitation Medicine. We have ended fiscal year 2002 with a small surplus. We revised our bylaws to strengthen the leadership of the organization, and we continued to move the interdisciplinary special interest group process forward. As I noted earlier, we have reconciled with other rehabilitation organizations, AAPM&R and AAP, with the formation of an alliance to address issues of mutual interest. Now, however, the time has come to take a serious accounting, once again, of who we are and where we are going. I had a dream of the organization I wanted the ACRM to be and how we would help accomplish it. In 2001, I reviewed that dream and vision with you. This year, 2002, we were forced to face reality. The reality is that unless significant changes are made in our organizational structure, membership base, and financial resources, we cannot move forward. In 2001, I noted that there was a commitment from many levels of the organization, but 1 significant component is still missing, a commitment from you the membership. I continue to urge you to commit, not silently but loudly. I urge you to commit not only by words, but also by actions. Have you renewed your membership, obtained at least 1 new member, participated in 1 or more activities of the ACRM, and attended our annual meeting? If you cannot answer yes to each of these questions, it is not enough. We need you; we want you to be involved. Do not let the opportunity to make a difference pass without your involvement, help, and support. Specifically, I make the following recommendations not only to keep the organization viable but also allow us to succeed. 1. We must face the reality that we are no longer a 2000- or even a 1000-member organization but a 500-member organization and have adjusted our national office, finances, and annual meeting to that reality. 2. We must obtain a new commitment from the board of governors, chairs of committees, task forces, and you the membership to our strategic plan and to implement prioritized goals. 3. We must continue to expand our liaison with AAPM&R, AAP, and other professional rehabilitation organizations, as we have done joining with the American Society of Neurorehabilitation for a successful joint congress in 2002. 4. We must establish a foundation to help us fund longrange projects of ACRM. 5. We must reinvent the national office not only to maintain the organization but also to have the ability to move forward. 6. We must live within a realistic budget and a surplus that is always based on current realities. 7. We must reinvent our annual meeting to face the realities of our limited resources and our membership base. 8. We must establish a marketing plan to let our members and the PM&R field know what we do and how we do it.
WHERE DO WE GO FROM HERE?, Grabois
9. We must renew the clinical components currently lacking in our mission and our meetings. 10. We must establish increased consumer interaction and affiliation with consumer organizations. 11. We must move the agenda of research in rehabilitation medicine forward much more aggressively. Some see the cup as half empty; some see the cup half full. Optimism and pessimism, confidence or insecurity, which shall it be? Since 1990, we have switched between these paradigms. In the past year, I have realized we still do not have a clear direction. It is up to all of us, with leadership from the board, to decide which direction ACRM moves.
1099
We can turn from uncertainty to success, put the past aside and move forward. It all rests on continuing to reinvent ourselves with our leadership and you the membership. I hope I have given you the key, once again, to open the door to the future of ACRM. Now you must use it, open the door, walk through, and succeed. References 1. Grabois M. The paths we chose: to succeed or not to succeed. Arch Phys Med Rehabil 2002;82:147-9. 2. Grabois M. Rehabilitation medicine: coming together in partnership. Arch Phys Med Rehabil 2001;82:295-9.
Arch Phys Med Rehabil Vol 84, August 2003
ACRM PRESIDENTIAL ADDRESS
The American Congress of Rehabilitation Medicine: Where Do We Go From Here? Martin Grabois, MD ABSTRACT. Grabois M. The American Congress of Rehabilitation Medicine: where do we go from here? Arch Phys Med Rehabil 2003;84:1097-9. This presidential address reflects on my last 2 years as president of American Congress of Rehabilitation Medicine (ACRM). It recognizes those individuals who have been of significant help and support. The address discusses choices I have made in my professional life including selecting physical medicine and rehabilitation as a subspecialty; committing to an academic career; and choosing to get involved in local, state, national, and international physical medicine and rehabilitation societies. I review my presidential speech of 2001 when I spoke about the path we choose—to succeed or not to succeed. ACRM has come a long way in trying to succeed but continued opportunities remain in obtaining financial security, increased membership, and cost-effective and efficient management. This address includes 11 suggestions designed not only to keep the organization viable but also to allow ACRM to succeed. These suggestions include a new commitment to our strategic plan and the implementation of prioritized goals, reorganization of ACRM’s national office, and adherence to a realistic budget. Finally, we must continue to move the agenda of research in rehabilitation forward much more aggressively. Key Words: Physical medicine; Rehabilitation. © 2003 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation IS HARD TO BELIEVE that my 2 terms as president of American Congress of Rehabilitation Medicine (ACRM) IaretheTover. Being the only president to serve 2 consecutive terms, time still has passed incredibly fast. Although it has been one of the most challenging undertakings of my career, it has been most rewarding. It has been a pleasure and a delight to serve ACRM’s membership, to have had the opportunity to influence the direction that rehabilitation medicine is taking, and to continue to influence the course that the ACRM is taking. When I reflect on the past 2 years, I think first of all of the people who have helped me, supported me, and mentored me. The faculty of Baylor College of Medicine/University of Texas Health Science Center at Houston, Departments of Physical Medicine and Rehabilitation Alliance has to be recognized for its support and help in ways that made it possible for me to serve as president of ACRM. My administrative assistant,
From the Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX. Presented at the American Congress of Rehabilitation Medicine’s 79th Annual Assembly, October 2002, Philadelphia, PA. No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated. Reprint requests to Martin Grabois, MD, Dept of Physical Medicine and Rehabilitation, Baylor College of Medicine, 1333 Moursund Ave, Ste A-221, Houston, TX 77030. 0003-9993/03/8408-8314$30.00/0 doi:10.1016/S0003-9993(03)00231-4
Donna Jones, is amazing. Not only does she keep me going, acts as a frequent confidant and a friend, but she has also stepped in to serve ACRM as coordinator for the past 2 annual assemblies. She has done a superb job in supporting not only me and ACRM. I also want to recognize ACRM’s national office staff, its board of governors, and the committee chairs and members for stepping up to the plate these past 2 years. A special thank you to my wife, Ellen, and children, Sarah, Meredith, and her husband, Brian, who allowed me to do what I do and have always supported me. CHOICES Having served as president of the Association of Academic Physiatrists (AAP), American Academy of Physical Medicine and Rehabilitation (AAPM&R), International Rehabilitation Medicine Association, and now of ACRM, I hope I can provide a vivid perspective on the field. We make choices and will continue to do so in regard to our own future to the field of physical medicine and rehabilitation (PM&R) and to ACRM. My first choice was to pick the field of PM&R as a career. I am a product of the Vietnam War, and I decided to enter PM&R because of my experience in that war. It was in Vietnam that I gave significant thought to my future and decided PM&R was the specialty for me. It met my goals as a physician, allowing me to be clinically involved and provide care for patients over the long term. I could also meet societal needs because there was a shortage of people in the discipline. Most of all, I chose PM&R because it enabled me to work with an interdisciplinary team and to improve the quality of the lives of people whom we treated. Now, 32 years later, I can confirm that is has been and continues to be everything I ever hoped it would be. The professional friends I have made and the mentors who have taught me have made a continuing contribution to my career and to my abilities as a physician. They have also created in me a commitment to administration, education, clinical activities, and research. That commitment led me to pursue academic medicine as a career. Academic medicine has enabled me to practice PM&R and also become involved in scholarly rehabilitation science activities such as education and research. I urge you to consider an academic career that will enable you to have a lasting impact on the field. It will allow you to have the opportunity for increased involvement in scholarly activities, to practice on the cutting edge of new techniques and concepts of practice, to become a recognized expert in a subspecialization area of rehabilitation medicine, to enjoy an extended professional life by varying practice between direct and nondirect patient care activities, to work in an intellectually stimulating environment, to enjoy adequate financial rewards, and to have a positive effect on the future of rehabilitation medicine in the national arena. The choice to become active in the field of rehabilitation medicine at local, state, national, and international levels has allowed me, and will allow you, to meet wonderful colleagues, to travel widely, to influence the course of the field, and to provide the opportunities to learn and improve one’s self and Arch Phys Med Rehabil Vol 84, August 2003
1098
WHERE DO WE GO FROM HERE?, Grabois
one’s academic programs, and, most important, to serve one’s patients and the membership of this organization. It has always been clear to me that to change the course of the specialty in the future will require the expenditure of one’s time and personal commitment. This is not the time to sit back and hope someone else will do it. TO SUCCEED OR NOT TO SUCCEED In my 2001 presidential address,1 I discussed the paths we choose—to succeed or not to succeed. I spoke on the challenges of moving forward to succeed and what ACRM had to do not only to be a viable organization but also to realize its goals and objectives. It is said that sometimes it may seem harder to forgive someone who has hurt you than it is to ask forgiveness of someone you have hurt. Letting go of old wounds can be hard, but holding grudges prevents us from moving forward. It is like writing on a blackboard that never gets erased; there is no room to write anything new. Forgiving past hurts is like erasing the board; it gives us the room to write new chapters of our lives without the past getting in the way. We have worked toward goals of reconciliation with other rehabilitation organizations, with the formation of the “Triple A,” an alliance among ACRM, AAPM&R, and AAP. The leadership of these organizations meets twice a year to discuss, coordinate, and support separate or joint initiatives. This alliance has met twice and will hold meetings semiannually in association with each organization’s annual convention. There is precedent for joining forces. When rehabilitation medicine organizations joined with the community of people with disabilities to support passage of the Americans with Disabilities Act, they were not only successful, but they also enjoyed one of their finest hours.2 There is no question in my mind that if we partner with our patients and advocate for what is right for them, we will ultimately benefit and prosper as a field and as professionals. In 2001 and 2002, our main challenges continue to be financial security, increased membership, and cost-effective and efficient management. I wish I could say the board of governors and I have solved these issues, but we have still not accomplished these 3 goals. I, the board of governors, and, I hope, the ACRM membership continue to be committed to a mission of clinically relevant interdisciplinary research in rehabilitation medicine. We have and continue to nurture that mission in our publications, meetings, committees, and task force actions. However, research in rehabilitation medicine is still inadequately addressed not only by ACRM, but by our partners AAP, AAPM&R, and other rehabilitation organizations. We still lack the commitment and funding to address adequately issues of people with physical disabilities requiring rehabilitation. Obviously, for us to succeed and move the organization and the field forward, we need to deal with our membership issues, increase our financial resources, improve the quality and quantity of rehabilitation science, the funding for it, and the distribution of these findings to health care professionals and consumers. We also need an improved administrative structure at the board level, in our committees and task forces, and in the national office to succeed. To date, we still do not have these basic essentials in place and the last 10 years has not moved us closer to that goal. In my 2001 presidential address,1 I outlined a plan for the board of governors to move us forward. Sadly, I must say we have only been partially successful. Our success has been hindered by a number of issues including the financial cost of AAP’s decision not to continue to manage ACRM and our need Arch Phys Med Rehabil Vol 84, August 2003
to establish a separate administrative office. Our national office continues to maintain our activities but lacks the resources to move us forward. Many of our committees and task forces have accomplished only a few of the goals given to them. This has resulted in a stagnated strategic operating plan. However, all is not doom and gloom. We have established an e-mail newsletter (Enews), and now we need to make it a regular one. Once again, we organized a successful annual meeting in Philadelphia. We continue to contribute to a very successful journal, the Archives of Physical Medicine and Rehabilitation. We published a regular newsletter, Rehab Outlook. We are working to establish a Foundation for Rehabilitation Medicine. We have ended fiscal year 2002 with a small surplus. We revised our bylaws to strengthen the leadership of the organization, and we continued to move the interdisciplinary special interest group process forward. As I noted earlier, we have reconciled with other rehabilitation organizations, AAPM&R and AAP, with the formation of an alliance to address issues of mutual interest. Now, however, the time has come to take a serious accounting, once again, of who we are and where we are going. I had a dream of the organization I wanted the ACRM to be and how we would help accomplish it. In 2001, I reviewed that dream and vision with you. This year, 2002, we were forced to face reality. The reality is that unless significant changes are made in our organizational structure, membership base, and financial resources, we cannot move forward. In 2001, I noted that there was a commitment from many levels of the organization, but 1 significant component is still missing, a commitment from you the membership. I continue to urge you to commit, not silently but loudly. I urge you to commit not only by words, but also by actions. Have you renewed your membership, obtained at least 1 new member, participated in 1 or more activities of the ACRM, and attended our annual meeting? If you cannot answer yes to each of these questions, it is not enough. We need you; we want you to be involved. Do not let the opportunity to make a difference pass without your involvement, help, and support. Specifically, I make the following recommendations not only to keep the organization viable but also allow us to succeed. 1. We must face the reality that we are no longer a 2000- or even a 1000-member organization but a 500-member organization and have adjusted our national office, finances, and annual meeting to that reality. 2. We must obtain a new commitment from the board of governors, chairs of committees, task forces, and you the membership to our strategic plan and to implement prioritized goals. 3. We must continue to expand our liaison with AAPM&R, AAP, and other professional rehabilitation organizations, as we have done joining with the American Society of Neurorehabilitation for a successful joint congress in 2002. 4. We must establish a foundation to help us fund longrange projects of ACRM. 5. We must reinvent the national office not only to maintain the organization but also to have the ability to move forward. 6. We must live within a realistic budget and a surplus that is always based on current realities. 7. We must reinvent our annual meeting to face the realities of our limited resources and our membership base. 8. We must establish a marketing plan to let our members and the PM&R field know what we do and how we do it.
WHERE DO WE GO FROM HERE?, Grabois
9. We must renew the clinical components currently lacking in our mission and our meetings. 10. We must establish increased consumer interaction and affiliation with consumer organizations. 11. We must move the agenda of research in rehabilitation medicine forward much more aggressively. Some see the cup as half empty; some see the cup half full. Optimism and pessimism, confidence or insecurity, which shall it be? Since 1990, we have switched between these paradigms. In the past year, I have realized we still do not have a clear direction. It is up to all of us, with leadership from the board, to decide which direction ACRM moves.
1099
We can turn from uncertainty to success, put the past aside and move forward. It all rests on continuing to reinvent ourselves with our leadership and you the membership. I hope I have given you the key, once again, to open the door to the future of ACRM. Now you must use it, open the door, walk through, and succeed. References 1. Grabois M. The paths we chose: to succeed or not to succeed. Arch Phys Med Rehabil 2002;82:147-9. 2. Grabois M. Rehabilitation medicine: coming together in partnership. Arch Phys Med Rehabil 2001;82:295-9.
Arch Phys Med Rehabil Vol 84, August 2003