THE OFFICIAL NEWS SOURCE OF ACR CONVERGENCE 2022 • NOVEMBER 10-14



Q&A: Incoming ACR President Ellen Gravallese, MD

Ellen M. Gravallese, MD
Ellen M. Gravallese, MD

Ellen M. Gravallese, MD, Chief of the Division of Rheumatology, Inflammation, and Immunity at the Brigham and Women’s Hospital, Harvard Medical School, will become the 83rd president of the American College of Rheumatology during the annual ACR Business Meeting, which will be held from 1:30 – 2:00 pm Tuesday in Room A311, Building A in the Georgia World Congress Center. 


The business meeting gives members the opportunity to learn more about the College’s many activities and to interact with College leadership. This year, there will be reports from the Rheumatology Research Foundation, the Association of Rheumatology Professionals, and the ACR secretary.


Before this year’s ACR/ARP Annual Meeting, Dr. Gravallese spoke with ACR Daily News about the Annual Meeting and rheumatology overall.


What makes the Annual Meeting so great? 


There is so much going on at the Annual Meeting. The sheer breadth of the topics covered at the meeting is remarkable, from cutting-edge science in many different specialty areas, to the latest clinical research, to sessions on practice and the interprofessional team. There are also sessions that provide an overview of a specific disease or pathway, allowing you to listen to what’s happened in an area over time and to better appreciate a topic that you are not specifically working on or involved with. The ACR is always looking for new and better ways to present educational content, which keeps the meeting exciting. The Annual Meeting is also a great opportunity to network and interact with colleagues — these social aspects of the meeting are very important.


What advice do you have for newcomers to the Annual Meeting?


It’s critical to think ahead about what it is you hope to get out of the meeting. The Annual Meeting can be overwhelming because there’s so much content presented, so planning is really important. For those new to the meeting, I suggest reading through the abstracts ahead of time and prioritizing the sessions you want to attend. It seems obvious, but it is also important to think through the geography of overlapping sessions. Often, people plan to attend the first half of one session and the second half of another, only to find that the sessions turn out to be located on opposite ends of the conference center. For newcomers, I believe the plenary sessions are important to attend, as those abstracts are carefully selected for high visibility. I also would encourage newcomers to attend sessions in areas they don’t know much about. Sometimes, you learn the most in an overview session in an area completely new to you. Most of all, enjoy it.


Why did you decide to become active in ACR leadership?


Rheumatology has been such a fabulous career choice for me, as I have always found our field to be fascinating and challenging, both on the clinical and on the research side. I want to see the field continue to grow and remain relevant. I want to see new blood brought into the field in order to create a robust workforce for the future. And finally, I want to see all the new discoveries and technical advances in immunology become translated into new therapies for our patients. (Leadership) feels like one way to help all of that happen. Also, my career has bridged a number of different areas, from basic science to clinical and administrative work, and I hope to be able to apply all the knowledge I’ve gained to help the field of rheumatology move forward, grow and thrive. 


How have you prepared for your term as ACR president?


In truth, I’ve been unknowingly preparing over the past 15 years because I’ve been an active volunteer for the ACR for that long. I think working in many different capacities for the ACR has been very important. One of my early roles was as chair of the Committee on Journal Publications, and I then became a member of the ACR Board of Directors and the Rheumatology Research Foundation Board of Directors, as well as serving on a number of task forces. So I really have learned about the organization from top to bottom. I’ve also served on the Executive Committee, for two years as secretary and during the past year as president-elect. All of these experiences have given me a great overview, not only of the ACR as an organization, but also of the challenges and issues facing us in our field. I feel eager and ready to step into this position.


Future workforce issues will be one of the topics during this year’s meeting. How can ACR members help address these concerns?


Honestly, I don’t know very many rheumatologists who are unhappy in their career choice. I would suggest that our members demonstrate their enthusiasm for the field and reach out to young students and trainees — the younger they are when we reach out to them, the better. Medical school would be a great time. There’s nothing more important than an enthusiastic mentor, someone who can wax eloquent about the field that they’re in and explain why they love their field so much. Everyone in the ACR membership could do this and I believe that would go a long way to bringing talented young people into the field. 


The ACR itself is doing a number of things to address the workforce shortage, expanding the number of training slots in rheumatology and looking for creative ways to fill gaps in underserved areas. The Rheumatology Research Foundation is raising funds for all of this. We really need to be thinking even further about expanding the attention that we’re giving to the workforce shortage. It’s part of the problem for access to care for patients. However, the “access to care” issue goes beyond the workforce shortage. It goes to access to medications for our patients and the existing barriers. Many of our medications are of course very expensive, and there are a number of challenges, from PBMs, to limitations from insurers and “step therapy,” to limited approval of biosimilars, all things that are working against us and limiting access. We need to advocate at every level of government to mitigate all of these challenges to access. And any rheumatologists can get involved in advocacy.


Why did you choose rheumatology?


I am a basic scientist, and I was fascinated by immunology. When I was in training in medicine, there were so many new discoveries in immunology and I could see that these discoveries were going to become clinically relevant in the field of rheumatology and that this would be a field that would just explode with new therapeutic opportunities. And that’s exactly what has happened. I think we’re currently in another phase just like that, where there is new genetic and epigenetic information about autoimmune diseases, new insights into phenotypes and into the preclinical phases of these diseases. All of these scientific advances are going to become directly relevant to patient care. We’re in one of the most exciting areas in medicine.


What’s the most common question you get from trainees and medical students, and how do you answer it?


Interestingly, the most common questions I get revolve around work-life balance. How do you manage clinical work, a career in investigation, a family — how does one fit all of this in? I always say that I’m someone who just absolutely loves the work, and, of course, hard work has its own wonderful rewards. But the advice that I give about work-life balance is to really focus your energies. When you’re at work, devote all of your thoughts, all of your actions and energies, to the work at hand. And when you’re at home, try to focus that same intensity on your family and whatever it is at home that’s important to you. I view this as compartmentalizing, trying to just be present in the moment at all times.