I AM GRATEFUL TO HAVE HAD the opportunity to serve as president of the American Congress of Rehabilitation Medicine (ACRM) during the past year. As 2005 ends, I would like to reflect on our association’s history and mission, and consider the benefits derived from our joint ownership of Archives of Physical Medicine and Rehabilitation with the American Academy of Physical Medicine and Rehabilitation (AAPM&R). Accordingly, this address highlights events in the Congress’s history, reviews member benefits, summarizes the status of Archives, highlights the priorities of Archives’s co-owners, reflects on the relationship between the Congress and Archives, and considers opportunities for rehabilitation research leadership.
ACRM’s predecessor organization, the American College of Radiology and Physiotherapy, was founded in 1923. The association’s name has changed several times, reflecting evolving needs: the Society of Physical Therapy Physicians, the American Congress of Physical Medicine, and the American Congress of Physical Medicine and Rehabilitation. Membership evolved from an exclusively physician association to a multidisciplinary association that allowed membership to professionals with master’s degrees in 1970 and to those with bachelor’s degrees in 1986. The 1972 publication Development of the American Congress of Rehabilitation Medicine into a Multidisciplinary Professional Society1 helped establish priorities that are still relevant today: a focus on research, multidisciplinary membership, and the centrality of Archives and a scientific program.
Much of our history has been distinguished by collaboration with AAPM&R on essential concerns. Shifting organizational priorities and financial constraints led to the separation of the Congress’s operations from the offices and management of the Academy in 1990. The last consecutive overlapping Academy and Congress meeting was scheduled in Chicago in 1996. These were challenging years during which the Congress’s board struggled with issues of organizational identity, focus, and declining membership. Out of lengthy board discussions emerged a vision statement: “ACRM will support and help to develop multidisciplinary leadership and innovation for provision of efficient and efficacious rehabilitation management of chronic disease and disability across the life span. ACRM will serve as the forum for creation and discussion of new treatment paradigms that define the composition of the ‘team’ and the duration and venues required to achieve optimal functional outcomes
….”2
Two years later, the board published a focus statement. “The American Congress of Rehabilitation Medicine serves people with disabling conditions by promoting rehabilitation research and facilitating information dissemination and the transfer of technology. We value rehabilitation research that promotes health, independence, productivity, and quality of life for people with disabling conditions. We are committed to research that is relevant to consumers, educates providers to deliver best practices, and supports advocacy efforts that ensure adequate public funding for our research endeavors.”3
Clarification of our vision and mission has helped the board and association staff to assure members receive value for membership. Major benefits today include Archives of Physical Medicine and Rehabilitation, our newsletter Rehabilitation Outlook, and the brain injury interdisciplinary special interest group (BI-ISIG) newsletter Moving Ahead. A “members’ only” section of the Congress’s website has been developed. A key benefit is the annual scientific conference, held for the fourth consecutive year (2005) with the American Society of Neurorehabilitation. An interactive website provides information about advocacy activities, networking groups and the BI-ISIG, career resources, research funding and fellowship information, information about evidence-based practice, research news, and various links. The BI-ISIG and 3 networking groups, focused on methodology and measurement, neuroscience, and spinal cord injury, provide members an opportunity to develop special interests.
Of these benefits, Archives is arguably the most valuable. Its predecessor, the Journal of Radiology, was founded by Albert Tyler, MD, in 1920. Management and ownership of Archives has evolved in important ways in the past 86 years. Dr. Tyler conveyed the journal to the Congress as a debt-free and unencumbered gift in 1930. An editorial board was formed in 1941, succeeding the single editor. In 1961, the Congress invited AAPM&R to adopt Archives as its official publication. The first nonphysician joined the editorial board in 1970. A joint agreement established the category of associate editor and designated issues in 1973. The Academy proposed a “joint and equal ownership” in 1979, and each organization began sponsoring an equal number of issues. A pivotal change occurred in 1986 when the Congress assigned an undivided half interest in Archives to the Academy, in part to assure continued commitment by the Academy to Archives.
Archives’s mission statement, as listed in the journal’s masthead, “is to disseminate information, with the ultimate goal of furthering the art and science of the practice of physical medicine and rehabilitation [PM&R] and interdisciplinary rehabilitation, and improving the health and welfare of persons with disabilities.”
The nonfinancial activities of Archives are controlled by an editorial board. One editor-in-chief is elected by members of the editorial board for a 1-year term renewal for no more than 6 years. The Academy and Congress have an equal number of editorial board members. Congress board members include professionals with training in physiatry, psychology, physical and occupational therapy, and law. The Congress and Academy editorial board members are selected from the ranks of their respective associate boards who, in turn, are selected from the pool of active reviewers by Archives’s executive committee (comprised of Congress and Academy members).
The quality of Archives has improved substantially in the past decade. Journal quality can be evaluated in various ways. One often-used method is the impact factor ranking, which is provided by ISI Web of Knowledge. The impact factor is defined as the average number of times articles from a journal published in the past 2 years have been cited in the past calendar year. For 2004, Archives’s impact factor was 1.656. This value compares favorably with other rehabilitation journals’ impact factors and has increased over the past 5 years. Archives also publishes more articles than any other rehabilitation-related journal (345 in 2004), accounting for 19% of the rehabilitation articles published in 25 journals tracked by ISI under the category “rehabilitation” during 2004.
One way of evaluating the similarity of journals is with ISI’s relatedness index. This index takes into account (1) the number of citations from Archives appearing in content published in the related journal, (2) the total number of articles in the related journal, and (3) the total number of citations from Archives. The higher the first factor is in relation to the other 2, the stronger the relationship between the 2 journals. Two values are calculated: citations appearing in Archives from the related journal and citations from related journals to content published in Archives. Archives is most related to Physical Therapy, whereas the American Journal of Physical Medicine and Rehabilitation is most related to Archives. These citing relationships show that Archives has “good company,” although it occupies a unique niche.
The health of a journal is reflected in the number of manuscripts submitted for review. A consistent upward trend is evident over the past decade. More than 800 manuscripts were submitted in each of 2003 and 2004, with the pace of submissions at a record in 2005.
It is important to consider Archives’s co-owners’ mission statements and the relationship of Archives to each organization and the larger field. The Congress’s mission is to “Promote the art, science, and practice of rehabilitation care for people with disabilities. This mission challenges us to be responsive to the rapidly changing environment of health care and the increasing diversity of rehabilitation service delivered by healthcare professionals from all disciplines and venues within the continuum of rehabilitation care.”4 The Academy’s mission is to support “its member physicians by advancing the field of physical medicine and rehabilitation, promoting excellence in physiatric practice, and advocating on public policy issues related to disability.”5 The Academy describes itself “as the premier medical society for the specialty of physical medicine and rehabilitation, AAPM&R is the only organization exclusively serving the needs of practicing PM&R physicians. With more than 7,000 members, the Academy represents more than 87 percent of U.S. physiatrists and international colleagues from 37 countries.”6 These contrasting missions help determine the perceived value of Archives to their respective members. The Congress is a multidisciplinary association of approximately 750 members with a rehabilitation research focus. Although members have not been surveyed recently, they appear to be relatively satisfied with the high, peer-reviewed quality of Archives. The Academy has a large and growing musculoskeletal contingent, is increasingly outpatient oriented, and desires a practice-oriented, peer-reviewed journal over which they have editorial control.
Representatives from each association’s board have been meeting to redraft an agreement with Elsevier to publish Archives; the current contract expires at the end of 2005. Highlights of the draft agreement include a proposed 3-year contract with Elsevier from January 1, 2006, through December 31, 2008. In the interim, the Academy leadership will explore a variety of ways to reflect the interests of practicing physiatrists, represent the specialty of PM&R, and advance the goals of the specialty.
These developments require that we consider the relationship between the Congress and Archives and what kind of benefit we desire it to be for our members, to the larger PM&R community, and to the persons with disabilities we seek to serve. One obvious question is: How does Archives reflect the Congress’s focus? Archives appears well positioned to fulfill our focus on promoting rehabilitation research and facilitating information dissemination and technology transfer. An internationally respected journal is an excellent means to disseminate rehabilitation research that promotes health, independence, productivity, and quality of life for people with disabling conditions. We are charged to maintain relevance to consumers, to educate providers to deliver best practices, and to support advocacy efforts that ensures adequate public funding for our research endeavors.
One should also ask how Congress members can support Archives. First, we can submit our best work to Archives for peer review. Second, we can engage members as peer reviewers. A high-quality journal will attract professionals in related fields to participate in rehabilitation research as authors, reviewers, and editors.
This new chapter in the relationship between Archives and the Academy and Congress provides several opportunities for rehabilitation research leadership. We must clarify and strengthen Archives’s editorial mission. We must promote individual and institutional subscriptions. The journal must attract high-quality submissions. The editorial board must continue to promote rigor and integrity in the peer-review process. The journal can increase efforts to disseminate research findings that enhance quality of life of persons with disabilities.
In concluding my presidential term, I am inspired by the findings from a new research project, funded by the National Institute on Disability and Rehabilitation Research through a Rehabilitation Research and Training Center on Measuring Rehabilitation Outcomes and Effectiveness. My colleagues (see Acknowledgments) and I are developing a measure of community participation and have conducted focus groups with various rehabilitation stakeholders including consumers, caregivers, providers, payers, and policymakers. Although the themes from these stakeholders define community participation generally, they provide lessons for the Congress’s leadership as we consider ways to promote participation of members in ACRM. The stakeholders’ themes of opportunity and choice, active engagement, control, having an impact, supporting others, citizenship, and inclusion may define participation in our community of rehabilitation research, too. Like me, I suspect you seek from the Congress opportunities and choice in ways to participate, active engagement in a community of rehabilitation researchers, a positive effect through our work, opportunities to support each other, a sense of corporate citizenship, and inclusion in the organization’s activities. More than ever, Archives provides a premier mechanism to fulfill the Congress’s mission and to promote our sense of community. I encourage you to engage actively in this rehabilitation research community and to reap the benefits of doing so.
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