The Korean College of Rheumatology (KCR) recently celebrated its 40th anniversary. Over the past 40 years, the KCR has achieved remarkable growth. Despite the impact of the COVID-19 pandemic in our lives and the lives of the whole nation, the KCR has an important history and continues to impact daily life and normal academic activities.
Rheumatology in Korea began as an independent field in October 1979, when senior professors of orthopedics, internal medicine, and pediatrics held a preparatory meeting at the Scandinavian Club in the National Medical Center . In November 1980, 21 promoters held a general meeting of the Korean Rheumatism Association, and in January 1981, the inaugural general meeting and a commemorative symposium were held in Seoul National University Hospital. Professor Moon-Sik Han served as the president of the KCR for 10 years from the launching of the society. Since then, the Association has held two academic conferences every year. In November 1990, the first Asian Pacific League Against Rheumatism (APLAR) Seoul Symposium was held in Seoul, and 400 people from more than 20 countries attended.
The Korean Rheumatism Association joined the Korean Medical Association Branch Science Council (currently the Korean Medical Association) as an associate member in 1983 and was approved as a full member in 2000. It was renamed the Korean College of Rheumatology in 2010 and adopted a new logo, which remains in use.
In 1992, rheumatology in Korea reached an important turning point associated with establishment of a subspeciality board system by the Korean Association of Internal Medicine. Rheumatology was recognized as a subdivision of internal medicine and included in the regular curriculum of the medical school. Since then, the number of certified rheumatologists has continued to increase, with more than 400 rheumatologists currently working at institutes including universities and private clinics.
The Journal of the Korean Rheumatism Association, founded in 1994, initially served as a journal in which domestic researchers could publish Korean data in the field of rheumatology . In 2006, an online journal submission system was established, and in 2007, the journal was selected as a registered journal by the National Research Foundation. In 2011, the
In May 1997, the 17th Spring Conference and The First Korea-Japan Combined Meeting of Rheumatology were held in Gyeongju. This meeting has been held every two years after being held in Kyoto, Japan in 1998 and Jeju in 1999. In 2005, China joined the group, and the combined meeting was developed into what is now known as the East Asia Group of Rheumatology (EAGOR) meeting. The meeting has continued to be held every two years, with the eighth session held in Korea in 2019.
By the turn of the 21st century, widespread use of biologic agents had achieved great influence in rheumatology. This brought about changes in the classification criteria for diseases, and the paradigm of treatment was modified significantly.
There have been many changes in the medical society, the biggest of which is that the society changed leadership from mainly internal medicine doctors to those who specialize in rheumatology. More than 1,400 delegates, including more than 100 speakers from outside of the APLAR region, attended the 11th APLAR meeting held in Jeju in 2004, further solidifying the status of rheumatologists in the society. Professor Ho-Youn Kim, who served as the 13th president, became the first chairman of the board in 2006 and established the chairperson system of the Korean Rheumatism Association. In 2008, the Rheumatology Research Foundation was founded as a nonprofit organization, and Professor Ho-Youn Kim served as the president of APLAR. The International Symposium started in 2006 and has been held every year since then; the 11th International Symposium in 2017 attracted more than 1,000 attendees and established the society internationally.
In 2008, the Ministry of Health and Welfare established rheumatoid and degenerative arthritis disease centers in five regions of Korea (Chonnam National University, Daegu Catholic University, Chungnam National University, Gyeongsang National University, and Jeju National University) to spread medical care outside of metropolitan areas and to help patients with rheumatic diseases receive the best treatment in their own regions . These centers were established to treat patients with rheumatic diseases in each region, establish a medical delivery system including primary and secondary medical centers, and contribute to an educational system for local health workers to learn to manage patients with rheumatic diseases.
The public rheumatism campaign has been held on the second week of October, during World Arthritis Week, each year since 2003 to educate the public. Since 2008, the Yeoryusarang (a portmanteau consisting of the first letters of Korean words for “women” and “rheumatism”) campaign has been held around March 8, International Women’s Day, and includes a public awareness campaign for rheumatoid arthritis, photo exhibitions, and Olle Trail hikes with patients . The 1, 2, 3, Campaign (representing the 1% of the population with rheumatoid arthritis, treatment results are good if patients are treated within 2 years, and good results are obtained when patients, family, and medical personnel work together) increased public awareness about rheumatism. This campaign is now known as the Gold Ring campaign.
In 2006, 40 authors participated in the publication of rheumatology textbook written in Korean language, named as Clinic Rheumatology, guided by the Clinic Rheumatology Compilation Committee. KCR launched a special committee to prepare publication of Textbook of Rheumatology, and recruited more than 100 contributors in 2012. After the first edition in 2014 and the second edition in 2018, publication of the third edition is scheduled for 2022 and is in its final stages.
The National Health Insurance Service has implemented special estimate case since 2000. Many rheumatic diseases, including seropositive rheumatoid arthritis, were included in the special estimate case in 2010, which greatly reduced associated burden on patients. This not only helped patients with rheumatic diseases, but also doctors who treat rheumatic diseases. In addition, these diseases were placed in group A as severe, and this change contributed to the status of doctors treating rheumatic diseases at tertiary general hospitals.
The Study Group for Collagen Disease was started in 1989, anchored by young physicians interested in rheumatology. After 1989, a rheumatology subspecialist system was established in Korea, and the name of the group was changed to the Rheumatology Research Society. Clinicians involved in the group currently exchange information about research and clinical practice in the field of rheumatology at meetings 3~4 times a year . Since the Lupus Research Group formed in 2006, several other study groups have been established, and a total of 14 study groups is active currently.
The future of the KCR is dependent on many factors, including research, insurance/policy, and information/promotion.
Rheumatologists in Korea are focusing on pathogenesis, treatment, and economic cost for rheumatoid arthritis, systemic lupus erythematosus, osteoarthritis, osteoporosis, gout, and spondylitis, although some are interested in the rarer rheumatic diseases. There are 14 special interest research groups under the KCR, and each discusses pathogenesis, treatment, guidelines, and recommendations for a disease. In the future, such specialized research groups are expected to become more active. Currently, the KCR is interacting with the ACR, EULAR, APLAR, JCR, and ARA-NZRA through symposiums and invitational lectures. In particular, the APLAR participates in the most frequent academic exchanges in Asia. Engagement of many Korean rheumatologists in the expert groups under the APLAR will form a research core in Asia. This core is expected to motivate more active academic exchanges, including hosting the APLAR in Korea.
The medical environment is currently facing several difficult healthcare-related issues such as a one-sided cut in drug costs, application of diagnosis-related groups (DRGs), and issues concerning health care system reform. The KCR focuses as much on insurance/policy as on treatment. As medical insurance cover expands, the government’s financial burden increases, and the Health Insurance Review and Assessment Service screening becomes stricter, which can discourage both medical staff and patients. In particular, drugs commonly used for rheumatic diseases are expensive and few, which can cause insurance problems. Therefore, it is necessary to cooperate with the government and obtain additional research data. The KCR has accumulated knowledge and experience with biological agents through the Korean College of Rheumatology Biologics and Targeted therapy Registry (KOBIO). As a result, it was adopted as a national project sponsored by the National Evidence based healthcare Collaborating Agency (NECA) and is conducting research. Interest in government policy decisions and discussions will increase participation in insurance/policy through accumulation of research data.
An abundance of information can provide many answers but also cause problems. During the COVID-19 pandemic, online communication has become a more important means of communication between rheumatologists and patients. Therefore, access to accurate information must be assured, which suggests the need for two-way communication between rheumatologists and patients. Information sharing among patients/guardians, medical staff, and pharmaceutical companies is imperative. To aid in this communication, the KCR will share information among its members and use it for effective patient treatment.
No potential conflict of interest relevant to this article was reported.
Designing: J.C., T.K. Writing manuscript: J.C., T.K.