What is the biggest challenge facing medical meeting planners right now?
Felix Niespodziewanski, Director of Convention and Meetings, American College of Surgeons (ACS) With the changes that are taking place in health-care delivery and reimbursement, our biggest challenge is to maintain our exhibitor base. We’re starting to lose some of our largest exhibitors, because they’re feeling that we’re too broad of an organization. And some of them have switched their focus to be more visible and active with regional or even smaller chapter state meetings, and also to focus more vertically. While the college is an umbrella organization for all of surgery, the largest contingent of membership are general surgeons, and general surgeons are sort of the steak and not the sizzle, as I say it.
One of the reasons, I’ve been told, is [exhibitors] struggle now gaining access to the provider, because so few of them now are independent practices. They’re part of a large group, or if not a large group, they’re employees of some kind of an institution. And frequently the buying decision now has been moved from their hands to someone in finance procurement, to determine what’s going to be purchased for the entire institution. And access to the provider has become more and more difficult for pharmaceutical and device manufacturers.
Barbara Smith, Executive Director, American Thyroid Association (ATA) I think the rigors of CME have gone overboard. This is true on all fronts. Right now, I’m in the middle of actually submitting for CME. It used to be that we would take our entire program, which has 32 hours of CME credit. Which means we have 130 faculty, all of whom volunteer their time; no one is getting paid. They don’t get honoraria. They don’t get travel. And, in fact, they pay their registration to come to the ATA meeting. We only have speakers who are thyroid specialists. We don’t have any special $10,000 or $50,000 speakers. The CME requirements now — for every hour of presentation, for every 20 minutes of presentation, we have to prove that that has a learning objective, it has a pre and post test, it has a proof that that has an impact on patient health. Which makes sense in the big picture of continuing medical education, but when you’re explaining how this one 20-minute talk is going to have a lasting effect — as opposed to the whole meeting, where people are coming for an education that is so exemplary, so without conflict, and so academic — I understand that we do have to have high standards, but it does seem like CME is going overboard.
Lisa Astorga, Director of Meetings, International Society on Thrombosis and Haemostasis (ISTH) Because we’re a truly international society and we hold international meetings, one [challenge] is certainly the compliance issues. I’m not just talking about ACCME [Accreditation Council for Continuing Medical Education] issues; there’s the PhRMA [Pharmaceutical Research and Manufacturers of America] issues, the accreditation issues, the local state and government issues.
Just to give you an example, we’re going into Amsterdam, and at the very last minute we were told that the Netherlands has this law that non-prescribing attendees cannot go into the exhibit hall. So we’re like, “Wow. So, this is a Dutch law. This is an industry-imposed sort of thing, and now what do we do?” And who polices this, and what if somebody sneaks in? Do the police come and shut us down? And how does this work exactly?
Ben Hainsworth, Director, Congresses and Meetings Division, European Society of Cardiology (ESC) We’re going to Amsterdam as well this year, and actually what they’re saying is that they don’t even consider nurses — sometimes nurses prescribe, but they don’t even accept nurses as medical professionals.
LA Correct. So, we’re trying to be compliant. Our meeting starts in a few days, and basically at this point we’re putting a sign outside of the hall that says, “Any non-prescribing attendee is not permitted in the hall.” We’ve been told that no one ever polices it, there’s never been a fine or anything against it. But in addition to that, it’s my understanding that the EU is sort of implementing this not from a state governmental law, but as an industry law across Europe. So that’ll be interesting to see how this pans out.
The other [challenge] that we look at is the sponsorship/ exhibit climate — is it up, is it down, where are we going? — because the society’s funded a great deal by sponsorship. That whole environment seems to change on a dime. Just when you think things are done and over, they come back up.
BH The overarching issue that we’ve got is uncertainty, because we know that there are compliance issues, we know that there are funding issues, we know that there are demographic shifts. But what we never know is when they’re really going to bite in, so to adapt a business model appropriately — not to overreact, not to under-react or to react too late — is really tricky. If we knew that certain things were going to be applied and when, it would be so much easier to deal with. It’s just that we don’t have that visibility.
Another idea where we don’t have the visibility or the certainty is, if I knew the exhibition was going to go down by 50 percent next year — if I knew that for certain — I would be able to factor that into my overall cost structure and so on, but I don’t. So I don’t even know how big a venue to go and hire. And in terms of accountability towards our stakeholders, that’s pretty tricky. It could indeed go down 50 percent next year; who knows? On the other hand, it might stay the same. What size exhibition hall do I hire?
And another uncertainty we have is, traditionally the registration fees are being paid by industry — not necessarily only pharma, but the health-care industry. And as that slowly goes down, we hear some people saying that physicians, or at least let’s say half of them, would pay for their own congress attendance if they had to or would find alternative funding. But we also hear that they wouldn’t. So the uncertainty as to that gap or the hole that’s going to be left by the industry decision not to fund delegates doesn’t put us on a firm footing.
Does that sort of widespread uncertainty change the planning process?
BH Yes, it destabilizes the decision-making process. Because if you lack a certain visibility in what your overall metric is going to be, you don’t know whether you can invest in new technology. You’re not too sure if you’re going to try out that new venue. You’re not too sure if you’re going to be able to hire those six-month interns or the extra staff that you might need for something. Or you don’t know if you’re going to be able to adjust your pricing.
LA What it also does is, it makes you very hesitant to do anything. And then when the funding actually does come through, it’s trying to implement things in a much shorter timeline: Okay, so now we can do this. How do we pull it together and have it done right, have it done correctly, and make the attendee experience what it should be in the time that we have to get things done?
How do you build enough flexibility into your planning to allow you to roll with those punches?
BH For years we managed to get by without a procurement office, but we have a procurement officer now, and one of her main tasks isn’t necessarily on the pricing of what we buy, but it’s the terms and the conditions and the scalability and the flexibility of what we buy or rent. And I think [that’s] putting a lot more pressure on our suppliers.
LA I’m new with [ISTH]; I started there about a year ago. And my primary role over the past year is setting up a Strategic Meetings Management plan that will then put us in the direction that you’re speaking of. I’m almost starting from scratch, because the way that the organization typically held meetings in the past is that physicians bid it — pretty much an international setup — and they would then hire a PCO. When we hit 8,000 members or 8,000 attendees, I think that the board and the [ISTH] Council took a look at it and said, “Wait a minute, we need to have some centralized management here,” realizing that the main revenue for the organization is our meeting, and that’s critical.
What are some of the opportunities facing medical meeting planners?
BH I thought about this before we started, and as the main challenge I put uncertainty and as the main opportunity I put uncertainty. Because, in a sense, the fact that there’s quite a lot of uncertainty in the profession for which I work, within [ESC members’] own professional life they’re beginning to have fewer and fewer solid references and solid things that they can rely on, i.e., jobs and sources of funding and so on. The association is one of the few things that remains constant in their professional life, so I think that is actually an opportunity, because that means that we will have their content. They will contribute their content to us, and with the technologies that are evolving we can continue to [be] the platform where we put that content.
So the value proposition that we can offer the members and the leaders is still strong, because they need us, and new technologies are allowing us to do things that are not necessarily meeting-related, but we can meet their requirements for high-profile visibility and representation, advocacy, and so on.
BS I think that contrary to the popular press saying that people are never going to talk to each other, teenagers are never going to have a conversation, adults are never going to want to meet face-to-face — a la 25 years ago, when they said we would never go to the movies again because of video — people want to meet face-to-face. Incredible synergy and collaborations happen in the halls of hotels outside the meeting room, inside the meeting room. Our thyroidologists already have international collaborations on research, international collaborations on writing guidelines, and what a meeting like this provides is that opportunity for, as we’ve all experienced, that kind of light bulb going off. That always happens when human beings get together and sit down and talk to each other. I don’t think that will ever be replaced.
LA Our role as meeting planners has evolved tremendously over the past 10 years, and it is exciting. You look at a planner 10 years ago, before we had this influx of technology, and it was sort of managing the compliance issues, which were pretty straightforward from a logistical standpoint, and really just taking a second seat in the society. Where now, I see especially a medical meeting planner really being able to have a seat at the table — if you can grasp the whole technology and you’re on board for change. I think it’s exciting, and I’m really excited for the younger people in the profession. We’re not going to get rid of meetings, let’s be honest. But, as Ben said, I think there are other opportunities there, especially with our content and what we do with our content, which is the most valuable asset of any organization right now.
BH We don’t actually use the word “planner” so much. The people that I’ve got working for me, up and coming in event management, they’re beginning to go beyond the five-day event and they are themselves — the very people who are planning the congresses or the conventions or the shows — also involved in maintaining some kind of dialogue with the delegates and the association for the whole year.
None of the people I now employ on specific events concentrate just on that five-day occurrence. It’s becoming less of a logistical job and slightly more strategic.
FN In our case, we have not been proactive in strengthening our international base, whether it’s on a membership level or an attendance level to the meeting. Ten years or so ago, we went down that path of offering some of our sessions in Spanish, because we would find a significant attendance from South America to our meetings. So there were a few sessions that offered translation, and we stopped…. But that thought has been resurrected — to offer some sessions in foreign languages with simultaneous translation.
Are your attendees showing up at your meetings expecting a different type of experience?
LA Well, they’re certainly expecting different technologies. I struggle with this sometimes, because we’ll go to PCMA, we’ll go to certain sessions, and they talk about how a lot of it is about the environment and different room sets. [But attendees] really like that continuity in the learning — how the learning is delivered.
However, they are expecting other things when they come to the meeting, especially technology. They want the mobile app, they want interaction; more people are using their iPads and you’re getting audience response. But where I find my challenge in creativity sometimes is, yeah, I’d love to set up a room that has couches and different areas, but for the way that our content is delivered, it wouldn’t work. So for medical meetings especially, we need to be creative in other areas, and I’d love for somebody to hit me over the head with something that I didn’t think about.
BH It’s great to talk about new technology and new learning formats and stuff, but if you alienate half of your audience by doing so, it’s not so brilliant. Forcing social media into these big sessions — some people think it’s necessary, but I think half of the people would be alienated.
But in general, to change what we’ve got, they’re just becoming more demanding. Not necessarily knowing exactly what they want, but they’re becoming a bit more discerning.
We used to have 70 percent of people who came were paid for by industry. They basically got shipped in on a coach, they were fed collectively, looked after collectively, and acted like a herd. And now that’s shifted completely the other way around.
So it’s a lot more individual people who are really deciding on their own to come, and they’re obviously, for that reason, much more demanding and harder to satisfy — but without saying what they might be expecting, what they might be demanding, what they’re going to be looking for. They simply are more demanding as a group of people. More of them have made the personal decision on their own to sacrifice their time or their holidays and money to go there.
With so much CME content now available online, what do you think your attendees are looking to get out of the live experience of your meetings — education, the show floor, networking?
FN All of the above. The question is, how much importance is being placed on each one of those categories, and has there been a shift in the importance that we aren’t catching? You know, people still will gather. I don’t believe in the medical industry that we’ll ever get to the point — “ever” is a long time, but I think we’re a long way away from getting to the point where everything will be done online. I think the medical industry is such that there needs to be that interchange, that interaction between people to discuss solutions and possible solutions.
BH I think it’s because maybe I’m beginning to be the same age as these people, I now realize that they like going to congresses because it’s a break from work. I don’t know about in the States, but in Europe the life of an average cardiologist professionally has become a little bit less fun; they’re no longer viewed in the same way in the sense of privileges. They’re being bossed around by hospital managers and having to think about things about health economics that they really don’t want to think about, and getting away for five days to congress is literally that — it’s getting away from it all. Still talking about work, but in an environment which is a bit more conducive to what they consider to be their specialty. I don’t think we can underestimate that.
LA And I think the other biggest factor, just like with any other meeting, is the networking and connection. They like seeing colleagues. One thing about medical meetings, you can get a pair of these physicians or researchers that haven’t seen each other for a while, and they’ll sit down, they’ll talk for hours. It’s amazing. Just looking at each other’s research or looking at each other’s way of how they’re doing it at their institution or their facility. So the networking is extremely, extremely important for them.
The education, yes. But a lot of it is the networking, and that is probably more for the older base. For the younger attendees, it’s to get their message out there. So they’re extremely excited about giving these posters and talking about their abstracts. It’s a really big deal for them.
BS From evaluations and from my experience with them, it’s the high-quality science [that ATA attendees are interested in], where they’re learning cutting edge, they’re learning new data that’s not just a review of what they already have read in their journals. They’re not coming to find out what’s happened in the past year. Our attendees come to hear about the absolute current state of thyroid research and discovery.
What are the challenges of serving an audience of international attendees?
LA I would say the challenges are the normal challenges — visa issues, because we are international and we do funding for some of the young investigators. But we’re a U.S.-based society, so with funding, say, for some of those coming from Cuba or Iran, we have to deal with OFAC [the U.S. Office of Foreign Assets Control], so that’s an issue for us. But generally most of it is just getting folks there — again, the visa issues, and for some of them that have never traveled outside of their area, just being able to make sure that we are accommodating, helpful, and can give them some insight and knowledge to where they’re going.
BH It’s not a big issue. In fact, what is more of a problem [for ESC] is the national issue. We are going to Amsterdam this year, and if, for example, we start having ideas from the Dutch Society of Cardiology to have the queen of Holland or something like that coming, that is something that we would actually fight off. The danger would be more the national rather than the international.
This might not be as much for an issue for the international societies, but has the implementation of health-care reform in the United States — Obamacare — affected your meetings?
BH Well, the problem is our direct member countries — we’ve got 54 of them, and they’ve all got their own health-care reforms. It just leaves everything up in the air and it increases all the funding issues for people coming and so on. It just makes it that much more complex. We can’t get into any one issue, or any one area of legislation, because there’s just too many to handle.
LA More than just Obamacare is the whole Sunshine Act [provision of the Affordable Care Act] and how this is going to impact our corporate partners and how that trickledown effect will impact us as a society. People think about the new Sunshine Act here in the States, but there are many countries that have a Sunshine Act, and again, it’s understanding all of those different compliances and how they will impact your meeting. And that’s terribly burdensome.
We’re still trying to get questions answered here about the U.S. Sunshine Act that will be implemented as of Aug. 1. Even though we’re doing international meetings, we do have U.S. speakers. Does it apply when they’re abroad? How does that impact the society, or is that just a reporting [mandate] for industry?
What are some new developments around medical meetings that you’re excited about?
BS I’m part of a patient advocacy board that the Society of Nuclear Medicine [and Molecular Imaging (SNMMI)] started. Because [ATA has] this alliance of five [patient] organizations, I go on their behalf. I represent the patients. [SNMMI’s Annual] Meeting was fascinating. They have a full-day workshop where their patients hear from the scientists and the physicians about their particular issues. And then we partnered with the patients and took them through the exhibit hall. Their exhibit hall is overwhelming because of all the machinery, all of the MRI machines and that kind of thing.
Because of the Internet and all the patients that are learning so much online — not necessarily good information, but they’re taking into their physician reams of paper and information — I think that will be the new frontier, if you will, of patients participating in a much greater degree. Not only in receiving the education, but in informing their physicians about what’s important.
BH What I find exciting is the fact that the meetings that we do are beginning to be spread over the whole year. The whole question of going mobile, going digital, going remote, going paperless — all of that kind of thing — and the fact that our meetings are a way to engage people throughout the whole year, I think, takes it towards something which has more value and goes beyond just the venue. It’s going to add to the overall impact of what we do. A lot of us that work for associations, we do have the hope that we’re actually doing something that shows a higher cause than just share value and so on, and I think that the way that things are evolving means that our work will improve the impact that the professions that we represent have on society.