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History of ACLPS

 

The Second Decade of The Academy of Clinical Laboratory Physicians and Scientists 1977-1986

Ellis S. Benson and Edward R. Ashwood

By January 1977, the Academy of Clinical Laboratory Physicians and Scientists (ACLPS) had a decade of growth and maturation behind it, was well established as the society "home" of academics in Laboratory Medicine, and stood optimistically on the threshold of a new decade. The new decade had its promises and problems, but, overall, this fledgling society under strong leadership was ready for its teen years.

George Z. Williams has provided an excellent summary of the first decade of the Society. This account was first published in the January 1989 ACLPS Newsletter and can be found in the Membership Directory. Our account of the second decade builds on, and adds to, this earlier report.

Founding the Academy

The fifty-one individuals who came together in Bethesda, Maryland, on November 12, 1966, to found the Society were led by David Seligson, Jon Straumfjord, George Z. Williams, Ernest Cotlove, and Ellis Benson. Other key attendees included Gerald Evans and Paul Strandjord. Evans, already a Professor Emeritus at the University of Minnesota, took a keen, fatherly interest in the proceedings, although he never became a member because of his emeritus status. Strandjord, then a junior faculty member at Minnesota, would have an immense impact on the Academy during its second decade. The founding members made certain key decisions which set the Society on a course which has continued to this day.

The first of these decisions was that it be a strictly academic society representing the academic realm of Laboratory Medicine/Clinical Pathology in the United States and Canada. Laboratory Medicine was comparatively weak in relation to anatomic and experimental pathology in most medical schools in the United States, and by comparison with Clinical Pathology in the community hospitals. The founding members perceived the need to strengthen academic Laboratory Medicine, and give recognition and encouragement to those colleagues in remote and isolated academic medical centers.

The second fundamental decision, a most important one, was that the Society should be inclusive rather than exclusive. It would include all faculty members in academic departments whether they were pathologists, non-pathologist physicians, or non-physician clinical and basic scientists. The struggle over this idea took place while naming the new society. The name Academic (later changed to Academy of) Clinical Laboratory Physicians and Scientists won out over the alternative "University Clinical Pathologists." The founding members saw the new society as an integrating one, bringing together the various disciplines (clinical chemistry, microbiology, hematology, blood banking, and immunology) in one organization for the advancement of academic Laboratory Medicine.

Three additional less fundamental but important decisions were also made: (1) that the Society should have a lean bureaucracy; (2) accordingly, that the membership dues should be modest; and (3) that the Society should meet yearly at the institution site of one of its members.

Originally five officers formed the Executive Council. These were Ellis Benson, President, Jon Straumfjord, Secretary-Treasurer, and Ernest Cotlove, David Seligson, and Tyra Hutchins, Committee on Membership and Nominations. The numbers of Council members have increased intermittently to its present form: president, president-elect, immediate past-president, past-president, secretary/treasurer, and six members-at-large.

The original annual dues were $10 per year. These gradually increased to $17.50 in 1977, $20 in 1979, and $25 in 1983. The increases were needed because as the Academy took on more responsibilities, its costs rose and subsidies from member institutions declined.

As the founding members decided, the annual meeting has been held at a member's institution, with one or two members serving as the local host(s). ACLPS still maintains this practice, which has helped give character and a sense of community to the Academy members who attend the annual meeting.

Academy Institutions

Certain institutions arose within ACLPS. These include the Cotlove and Evans Awards, the Newsletter, and the Young Investigator Award (YIA) program.

The Cotlove Award, initiated in 1973, is presented each year to an outstanding individual contributing to the science of Laboratory Medicine. The recipient presents the keynote lecture at the annual meeting. This award is given in honor and memory of Ernest Cotlove, whose early death in 1970 shocked and saddened the members. Twice the award has been made to a Nobel Laureate: first to Roslyn Yalow in 1973 at Edmonton (she later received the Nobel prize for her co- invention of the technique of radioimmunoassay), and second to Baruch

Blumberg in 1979 at Rochester, New York (he was recognized for his seminal work on hepatitis B virus).

The Evans Award, initiated in 1972, is made each year to a member of the Academy who has made notable contributions to teaching and research in Laboratory Medicine and in leadership and service to the Academy. The award recognizes Gerald T. Evans, considered by many the "Father of Academic Laboratory Medicine," a true pioneering leader of our field.

Richard Iammarino (then at the University of Pittsburgh) initiated the Academy Newsletter in January 1968. Published two to four times per year, the Newsletter keeps the Academy's members updated on ACLPS events. In fact, it has been a major archival source for these historical vignettes. It is mailed to all active and associate members and is also published online at www.pds.med.umich.edu/users/aclps.

The Young Investigator Award program was initiated following the recommendation of a long-range planning committee chaired by Paul Strandjord in 1978. The first awards were made in 1979 at the annual meeting at Dartmouth. This key program has become a centerpiece of the Academy's annual meetings. The awards are presented to residents, postdoctoral fellows, and medical students. Winners receive a travel grant to the annual meeting. The YIA program director invites all submitters of acceptable abstracts to make a ten minute scientific presentation at the meeting. The awards have helped to bring many young individuals into the field of Laboratory Medicine and into the Academy.

ACLPS and Laboratory Medicine in the Decade 1977–1986

In January 1977, ACLPS had grown from an initial charter membership of 78 members (including all those who joined during the first year) representing 43 institutions to 585 members representing 86 institutions in the United States and Canada. In January 1986, 489 members represented 117 institutions. Attendance at the annual meetings varied between 110 and 160 in the second decade. The Academy had become well established in its first decade but by 1977 was neither well known nor highly regarded by many in academic pathology. This circumstance changed in the second decade, largely through able leadership of the Society. A sign of this new recognition occurred in 1981 when David Brown, ACLPS representative on the Council of Academic Societies (CAS) of the Association of American Medical Colleges (AAMC), was elected chairman of the CAS and a member of the AAMC Executive Council. By 1986 pathology department heads and leaders of other pathology societies recognized ACLPS as representing academic Laboratory Medicine's interests.

Training programs for physicians in Laboratory Medicine had grown in number and strength by 1977 and five of them were described in the Academy's newsletter of Winter 1977. These five represented the leading institutions in Laboratory Medicine at that time: UCSF, Minnesota, University of Washington (Seattle), Washington University (St. Louis), and Yale. Described were three- to four-year programs designed to prepare physicians for academic Laboratory Medicine careers in the subspecialties of blood banking, clinical chemistry, hematology, and microbiology. By the end of the second decade, several other strong Laboratory Medicine/Clinical Pathology residencies had been added to these five including those at Pennsylvania, Mayo Medical School, University of Rochester, State University of New York at Syracuse, State University of New York at Stony Brook, and Utah. Most academic clinical pathologists were coming from these programs. Immunology, coagulation, and genetics were added as subspecialty areas by 1986.

Postdoctoral training programs for non-physicians in clinical chemistry and microbiology had been established by 1977 at several institutions, including University of Washington, Mayo Medical School, State University of New York at Buffalo, and Washington University. By 1986, other programs had been established at the University of Minnesota, University of Pennsylvania and other leading institutions represented in ACLPS.

Medical school education in Laboratory Medicine has always been a major concern of ACLPS. Members have generally believed that the subject has not received sufficient emphasis and time in most medical school curricula. Alfred Zettner and Peter Jatlow described successful medical student education programs at UCSD and Yale, respectively, in 1977. Pat Ward (University of Minnesota, Mt. Sinai Hospital) described the highly successful fourth year elective program that he and his colleagues, Desmond Burke and Charles Horwitz, established in the early 1970s. This elective, a model for similar programs at other schools, concentrates on cost-effective use of the clinical laboratory in patient care. Teaching of Laboratory Medicine to medical students continues to be a major concern of ACLPS members.

By the mid-1980s TEFRA and other federal legislative efforts created acute financial concerns in Laboratory Medicine. Funding of the clinical activities in Laboratory Medicine became uncertain. Many pathologists were confidently predicting the demise of Clinical Pathology. Academic Laboratory Medicine did not die, due in large to sound leadership and foresight of key individuals who developed strong Laboratory Medicine departments and divisions in many medical schools. ACLPS played a significant role in these developments.

By the end of the decade in 1986, many strong independent departments of Laboratory Medicine existed, patterned after the one established by Gerry Evans at Minnesota in 1959. These included Yale (David Seligson and Peter Jatlow), University of Washington (Paul Strandjord), UCSF (George Brecherand Laurence Marton), Mayo (Mike O'Sullivan) and Connecticut (F. William Sunderman, Jr.).

These were joined by several combined departments of Laboratory Medicine and Pathology headed by clinical laboratorians including Pennsylvania (Leonard Jarett), Minnesota (Ellis Benson), Dartmouth (Howard Rawnsley), Utah (John Matsen), Syracuse (Fred Davey), and Duluth (Pat Ward). Later, UCSD (David Bailey), Vermont (Edwin Bovill), and Georgetown (Jeff Cossman) joined these.

Furthermore, strong divisions of Laboratory Medicine/Clinical Pathology arose at several medical schools, including, but not limited to, Washington University, St. Louis (Jay McDonald), Rochester (Dean Arvan), Johns Hopkins (William Rock), Emory (Rex Conn), North Carolina (Bill McLendon), Southwestern, Dallas (Robert McKenna), University of Chicago (Tom Shaw), Case Western Reserve (Brooks Jackson), Stony Brook (Des Burke), Einstein (Arthur Karman) and USC (Ed Wong). This flourishing of academic Laboratory Medicine contrasted with the situation in 1966 when only a few bright spots could be found. ACLPS was a significant factor in this growth and development.

Many individuals were responsible for ACLPS's continued success during this decade but one person's name is especially noteworthy when one reviews the records. That person is Paul Strandjord. He chaired the task force that created the Young Investigators Award program. He strongly encouraged residents and fellows at the University of Washington to apply, and many did. Strandjord helped obtain financial support for the YIA program over the decade. In 1977, Paul put together the first Membership Directory of ACLPS which he updated and reissued periodically since that date with the able assistance of Jim Fine.

Strandjord also led the efforts to expand the membership in ACLPS. He personally wrote to individuals in Laboratory Medicine at all United States and Canadian schools that had no ACLPS members. He informed them of the Academy and invited them to join. This effort bore fruit, especially in the third decade of ACLPS. More than any other person, Paul held the Academy together and helped it move forward during a critical decade.

Major ACLPS Events During the Decade 1977–86

1977. After a highly successful annual meeting in Seattle in June 1976, in which 51 new members were added, the membership stood at 585. The Newsletter, now edited by Mary Bradley, reviewed five leading residency programs in straight Clinical Pathology (see above). In the Spring Newsletter, programs of postdoctoral training in clinical microbiology were described by John Washington (Mayo), Fritz Schoenknecht (University of Washington, Seattle), and

Konrad Wicher (SUNY, Buffalo) and in clinical chemistry by Jack Ladenson and Jay McDonald (Washington University, St. Louis), Alex Kaplan (University of Washington, Seattle), and Max Chilcott (SUNY, Buffalo).

The Academy gathered in Minneapolis at its annual meeting in June, with Ellis Benson and David Brown serving as local hosts. President Paul Strandjord, in his welcoming address, restated the aims of ACLPS as: (1) to encourage and advance the highest standard of education in the teaching of Laboratory Medicine; (2) to encourage and promote the highest standards of residency and postdoctoral training; (3) to promote the highest standards of service and research; and (4) to foster a sense of community with the various academic disciplines of Laboratory Medicine. With David Brown and Howard Rawnsley as program chairs, a symposium on diabetes mellitus was presented with David Brown, Ray Gambino, Leonard Jarett, Jose Barbosa, Henry Balfour, John Matsen, and Michael Steffes as speakers. The Cotlove Award lecture was given by Paul Lacy, Washington University, St. Louis, on the topic of "Mechanisms of Insulin Secretion." The Evans Award was bestowed on George Brecher of the University of California, San Francisco, a founder and early leader of ACLPS, and the first chair of the Department of Laboratory Medicine at UCSF.

ACLPS co-sponsored a highly successful two-week course on "Clinical Applications of Laboratory Medicine" directed by Pat Ward at Aspen, Colorado, in August 1977. There were 120 attendees.

1978. The annual meeting in San Diego on May 31-June 2, hosted by Alfred Zettner, was attended by 151 members whom President Howard Rawnsley welcomed. Myrton Beeler chaired a symposium on teaching Laboratory Medicine to medical students. Daniel Steinberg gave the Cotlove Award lecture on "Molecular Concepts of Lipoprotein Metabolism." The Evans Award was presented to Rex B. Conn, Emory, for his pioneering efforts in developing strong academic Laboratory Medicine organizations at West Virginia, Johns Hopkins, and Emory.

At the business meeting in San Diego, a Long-Range Planning Committee was established consisting of Paul Strandjord (chair), Ellis Benson, and Bill McLendon. Its notable contribution was the establishment of the Young Investigator Award (YIA) program.

1979. The annual meeting took place at Dartmouth, Hanover, New Hampshire, May 30-June 1, with 140 attending. Howard Rawnsley hosted the meeting and President John Matsen presided. At this meeting, the Young Investigator Award (YIA) program was initiated. Twenty-six awards were conferred. Award abstracts appeared in the program and awardees presented short papers. Ed Wong, now a prominent member and former president of ACLPS, was a YI awardee that year. He presented a paper on "Urinary 17-alpha- hydroxyprogesterone in Congenital Adrenal Hyperplasia." Dean Arvan agreed to serve as the first director of the YIA program. Nobel Laureate Baruch Blumberg gave the Cotlove Award lecture on "Hepatitis B Virus and Human Behavior." The Evans Award went to Fred Zettner (UCSD).

1980. With Mike O'Sullivan and Don Young serving as local hosts, the annual meeting took place at the Mayo Clinic and Medical School, Rochester, MN, in June. Presiding President Dean Arvan pointed out that the meeting was taking place at the site of what was once a remote village which, through the vision of the Brothers Mayo, now had become the home of a world renowned health center. He suggested that this progression might be symbolic of academic Laboratory Medicine. A tornado warning interrupted the annual banquet on the evening of June 4 and all had to go to the basement for twenty minutes. Claude Arnaud received the Cotlove Award and spoke on the topic, "Parathyroid Hormone, Heterogeneity and Clinical Utility." The Evans Award was presented to Esther Freier in recognition of her many contributions to clinical chemistry, Laboratory Medicine, medical technology, and ACLPS. Esther had helped train many in Laboratory Medicine including Ellis Benson, Rex Conn, Paul Strandjord, Des Burke, Ed Wong, and John Eckfeldt. The YIA program received expanded support in 1980 from individuals, departments, divisions, and industry largely through the efforts of Paul Strandjord and Dean Arvan.

1981. Chapel Hill, NC, was the site of the annual meeting in May with 120 attending. Bill McLendon ably hosted the meeting, while President David M. Brown presided. Twenty YI awards and presentations were made. The centerpiece of the meeting was a symposium on "Clinical Toxicology and Environmental Pathology" at the nearby, beautiful Research Triangle. Pedro Cuatrocasas presented the Cotlove Award lecture on "Receptor Micro- aggregation and Processing in Hormone Action." The Evans Award went to Donald Young in recognition of his national and international leadership accomplishments in clinical chemistry and his participation at annual ACLPS meetings. At this meeting, President Dave Brown warned members about impending federal legislation which would cast a dark cloud over funding of Laboratory Medicine in coming years.

1982. Seattle and the University of Washington were again the site of the annual meeting in June, with Paul Strandjord again serving as local host. President Bill McLendon noted the record number of YI awardees, 44 in all, representing 20 institutions. Ed Ashwood, past president of ACLPS, was himself a YI awardee this year from the University of Washington. George Z. Williams was appointed Historian and Archivist of the Society. Stanley Falkow gave the Cotlove Award lecture on "Molecular and Genetic Studies of Microbial Determinants: Application to Laboratory Medicine." The Evans Award was presented to Joseph Bove, Yale, for his outstanding leadership in blood banking and service on the ACLPS Executive Council.

1983. Gerald Taylor Evans died suddenly on April 29, 1983, at the home of his son, Ray Evans, in Litchfield, Minnesota. In a eulogy, Ellis Benson said in part, "Evans always remained true to his vision of a close clinical and laboratory partnership applying the fruits of science to the patient. He was our leader, a true pioneer." The annual meeting took place at Rochester, NY, in June with Dean Arvan hosting. President Armand Glassman, in his message to the assembled members, said in part, "The primary role of any department of Laboratory Medicine is excellence in patient care." Featured on the program were symposia on "Implications of New Biotechnology in Laboratory Medicine" and "Education in Laboratory Medicine." Des Burke, Ed Wong, and Ray Mayewski were speakers on the latter symposium which stressed cost-effective use of the laboratory in patient care. Roscoe Brady of NIH presented the Cotlove Award lecture on "Applications of New Technology to the Diagnosis of Lipid Storage Diseases." There were 33 YIA presentations from 18 institutions.

1984. The Academy met in an annual conclave at Salt Lake City, Utah, in June. President Peter Jatlow presided. John Matsen was local host of this outstanding meeting which featured a symposium on "The Broad Role of Immunology in Laboratory Medicine." The Cotlove Award lecture was presented by Willem J. Kolff, pioneer in the development of artificial organs. The Evans Award went to Bill McLendon, University of North Carolina. Those members attending ratified a change in the YIA program. The presenters of the best abstracts would receive a $100 cash award and their papers would be presented at the plenary session. Jay McDonald was selected to succeed Dean Arvan as director of the program. A survey of the 1983 YI awardees revealed that of 16 responding, 11 now held academic positions and 10 were actively engaged in research. Six had extra- mural funding.

1985. The annual meeting took place at Charleston, SC, with Armand Glassman, host, and President Michael O'Sullivan presiding. A symposium on "Molecular Biology and Immunogenetics: New Horizons for Laboratory Medicine" was the centerpiece of the scientific program. The Cotlove Award was awarded to ACLPS member Leonard Jarett, University of Pennsylvania, an outstanding scientist and a leader in Laboratory Medicine. Leonard's lecture was on the "Mechanisms of Insulin Secretion and Action." The Evans Award was presented to Dean Arvan for his outstanding effort in developing a division of Laboratory Medicine at the University of Rochester and his many important contributions to ACLPS (including his directorship of the YIA program in its early formative years).

1986. The new president of ACLPS, Michael Steffes, called in the Spring Newsletter for a better balance in membership and activity among the sub- disciplines of chemistry, microbiology, hematology, blood banking, immunology, and genetics. He asked members to do all possible to achieve better balance. He also appointed a committee to consider constitutional and bylaw revisions. The annual meeting took place at the University of Chicago. Tom Shaw and Josephine Morello served as local hosts. The program included a symposium on "Academic Laboratory Medicine in the Prospective Payment Era," organized and led by Shaw. The Cotlove Award went to a member of ACLPS, our respected senior founder, David Seligson of Yale. Howard Rawnsley was named the Evans Award recipient for his many outstanding contributions to Laboratory Medicine at Pennsylvania and Dartmouth and for his service to ACLPS. Neil Blumberg accepted the position of newsletter editor. Issues engaging the Society's concern in 1986 including impending congressional legislation on reimbursement including "M.D.-DRGs for RAPs," an issue addressed by Tom Shaw in a letter to Congress, reprinted in the Newsletter.

Implementation of S.I. units was also an issue which was addressed by Jocelyn Hicks in the Newsletter. Among the YI awardees in 1986 was David Sacks, then a resident at Washington University, now on the faculty of Harvard, and currently the director of the Young Investigator program.

Officers and Council Members during the Second Decade

Presidents: Paul Strandjord (1976-77), Howard Rawnsley (1977-78), John Matsen (1978-79), Dean Arvan (1979-80), David Brown (1980-81), William McLendon (1981-82), Armand Glassman (1982-83), Peter Jatlow (1983-84), Michael O'Sullivan (1984-84), and Michael Steffes (1985-86). An outstanding honor roll! Secretary-Treasurers: Esther Freier (1976-80), Marie Coyle (1980-83), Owen Ash (1983-85), Ron Elin (1985-87).

Newsletter Editors: Mary Bradley (1976-79), K. Owen Ash and John Matsen (1979-84), M. Desmond Burke (1984-86).

Executive Council Members: John Foft and John Matsen (1974-77), Morton Schwartz and Dean Arvan (1975-78), William McLendon and Donald Young (1976-79), Joseph Bove and John Washington (1977-80), Armand Glassman and James Detter (1978-81), Laurence McCarthy and Peter Jatlow (1979-82), Owen Ash and Michael O'Sullivan (1980-83), Michael Steffes and Jay McDonald (1981- 84), Colin Macpherson and Josephine Morello (1982-85), Desmond Burke and Michael Wills (1983-86), Jack Ladenson and David Bailey (1984-87), Ed Wong and Tom Shaw (1985-88), Marie Coyle and Neil Blumberg (1986-89).

Acknowledgments

The authors acknowledge invaluable assistance in preparing this history from George Z. Williams, Esther Freier, James Fine, Paul Strandjord, and Anne Lawler.