According to a press release from the Medical Industry Conference Calendar Newsletter, the number of medical meetings being held annually has increased 50 percent since last year. Instead of an average of 20 medical meetings per business day (6,000 medical conferences, seminars, courses, and trade shows per year), now there are more than 30 per day, or about 9,000/year.

The rub is, medical organizations meetings and travel budgets aren t growing accordingly and, in fact, are shrinking at many institutions, it adds. Says newsletter publisher Dave Anast:

“That means that 50 percent more medical meetings will probably be competing for the same sized budget pie during the next 12 months. Or, in other words, if you are a conference organizer, the odds of your capturing the same number of registrants for an upcoming event, have probably worsened by roughly 50 percent.



“So if the odds were 1 out of 20 for a registrant to attend your particular conference on a particular day last year, the odds are now 1 out of 30 that a registrant will attend your event next month, instead of somebody else s event on that same day.”

But this newsletter s data appears to be off a bit, according to the ACCME s Annual Data Report. While its numbers are for 2003, not this year, it shows a total of 66,000 total activities, not 9,000, and that s just what ACCME s accredited providers are doing, not the total scope of all CME activities, much less all medical meetings. Of course, this is for all CME activities, not just live meetings, but since conferences, the largest category of CME activities offered by providers, represented 59 percent of the directly sponsored activities, I think it’s safe to say that 9,000/year figure is still very low. So does this mean that the situation is even more dire than that press release says?

According to the data report, the number of directly sponsored courses increased by 19 percent from 2002; it’s hard to imagine it jumped so dramatically this year over last, but I guess it’s possible it could be 50 percent.

But the data report also found that the number of physicians participating in CME activities grew 12 percent between 2002 and 2003. Unless something really awful has happened that I haven t heard about, I imagine this growth trend is continuing this year as well, so the potential participant pie should growing larger, albeit not as quickly as the number of activities offered.

And, from the newsletter s account, one would surmise that commercial support also might become scarcer if the pool of money available from supporters remained static. But it s not: Commercial support for CME has been growing by leaps and bounds, according to ACCME s report. Look for the September/October issue of Medical Meetingsfor a complete analysis, but total commercial support grew at almost triple the rate of total income for ACCME-accredited providers. It jumped more than 30 percent between 2002 and 2003, to more than $971 million in 2003, compared to $746 million in 2002. This is just the latest in a series of giant leaps: a 31 percent increase from 2001 to 2002; and a 23 percent increase between 2000 and 2001.

But do these numbers really seem meaningful to your organization? How competitive isthe CME market these days from your perspective?

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According to Game Journalism, there s a conference starting tomorrow called Games for Health 2004 that will “examine how interactive games can improve how the medical profession treats patients and trains doctors.” Among the presentations will be one that “will look at ways to improve surgical outcomes through video game training.”

Conventional wisdom is that docs would find game-based education beneath them, but I m not so sure. For more, read this article from wired.com. One quote from the article:

It’s only natural, really, that games would help doctors with laparoscopies — that’s when surgeons use a tiny camera and joystick-controlled tools to cut and sew. It’s about as close to gaming as surgery gets.

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The recommendations of the expert panel will result in the development of innovative content for numerous educational activities, which will help educate ophthalmologists and ophthalmology residents throughout the nation. Additionally, several publications will advance the dissemination of this significant work for the identification and treatment of patients at risk for glaucoma. This educational initiative is supported by two unrestricted educational grants totaling nearly $3.3 million from Pharmacia, now Pfizer Ophthalmics, a division of Pfizer Inc.



Based on their analysis of long-term, population-based studies of patients with high IOP and glaucoma, the authors of the AJO Perspectives article estimated that treatment may reduce the risk of progressing from untreated high IOP to blindness by a range of 1.2 percent to 8.1 percent over 15 years. They then determined that between 12 and 83 patients with high IOP require treatment to prevent one patient from progressing to unilateral blindness over a 15-year period.

I hope they have some way of measuring the ongoing impact of this CME initiative, because it sounds like it could make a big difference in patient outcomes.

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I wouldn t normally think of an the International Atomic Energy Agency meeting as being of interest to medical meeting providers, but in this case, I think it s relevant.

A meeting of experts at the International Atomic Energy Agency (IAEA) recently [found] a growing incidence of denials or delays in international shipments of needed radioactive material, including short-lived isotopes used for medical diagnosis and treatment& Industry representatives have told the IAEA of increasing difficulties in delivering lifesaving isotopes that require urgent international transport. The precise number of denials occurring worldwide is not known, however.



“There is a risk that if more airlines do deny, particularly where few airlines serve key regions, then this does raise a serious issue. It potentially means that medical clinics and hospitals in specific areas are at risk from being denied essential medical supplies,” [Michael Wangler, head of the Safety of Transport of Radioactive Materials Unit of the IAEA] said.

While of course the largest risk is to direct patient care, this also could impact training sessions that include these materials.

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I read recently that the AMA got $1 million grant for online course from The U.S. Department of Homeland Security to put its disaster and terrorist attack preparedness course online.

The course has been offered in the classroom setting at various conferences and educational institutions since June 2003. The grant will provide funding to put the program online to increase the number of physicians and other health care professionals in rural and underserved areas who are able to receive the training without missing work or incurring travel expenses. It also will pay to evaluate the course’s effectiveness.



The grant is one of 14 awarded by the Dept. of Homeland Security’s Competitive Training Grants Program, which will dole out $34 million in the next month.

This might be worth looking into if your organization offers similar training, or anything that could fall under the security mantle.

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According to Medical News Today, the National Institutes of Health “on Friday proposed a  major policy change that would make available at no cost to the public the results of all NIH-funded research six months after the work is published in a scientific journal, the Washington Post reports.”

Scientific journals, some of which sell subscriptions for thousands of dollars, currently retain control over the published information. The proposal, which NIH has been considering for more than a year, would require federally funded researchers to submit their papers to the agency after they have been accepted for publication and edited by a journal, the Post reports.

What, if anything, will this mean for journal CME?

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It may just be one or two out of an entire staff, but physicians who are yellers, screamers, and surgical instrument-throwers can be disruptive to patients and colleagues alike, according to a recent survey by the American College of Physician Executives.

When they do berate other healthcare workers or get snitty with patients, they rarely are punished, and in the rare case that they do get their wrists slapped, the slap is much gentler for physicians than other types of workers, the survey found.

“We have a horrible track record in our own profession of even recognizing physicians with difficult personalities, much less dealing effectively with them,” wrote one of more than 300 physician executives who submitted comments with their completed surveys&



“This has been a chronic problem that is acutely getting much worse,” wrote another survey respondent. “The stress of our jobs (I am a surgeon) is increasing due to the decrease in reimbursement for professional activities, increasing regulatory requirements and severe financial constraints placed upon the hospitals.”

The answer, of course, may lie in teaching organizational leaders on how to identify and deal with attitudinally impaired physicians, which is something survey co-authors Timothy Keogh, PhD, of Tulane University and William Martin, MPH, PsyD, of DePaul University do in their ACPE-sponsored courses.

If your organization has a few of these types on staff, it might be worth your while to offer some education on how to coach physicians on appropriate behavior, mediate disputes between doctors, nurses, and other staff, refer problem physicians to counseling, and take firm disciplinary measures against the offenders.

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Bain Capital LLC, a private equity and venture capital group, earlier in August bought a controlling interest in the parent company of Pri-Med for a reported amount of $400 million.

Pri-Med, whose partnership with Harvard Medical School has resulted in high-level content for its meetings, has been growing like a weed lately. Its trade shows have made Tradeshow Week s Fastest Growing 50 list for the past two years; it s been pumping out Pri-Med Insight surveys on physician behavior and learning at a brisk pace; it started up a new Latin American division to bring its educational series south of the border last year; and it recently started a series of programs for pharmacists. In fact, its gone from 37 CME conferences just two years ago to producing 89 this year in 45 cities.

What this means for Pri-Med is unclear at this point, other than the fact that I m sure they were not thrilled to hear their business described in this article as “a company that arranges conferences to help members of the pharmaceutical industry meet with doctors.” See It s both what you say and how you say it, below, for more on this industry s perception problems.

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[Communication company s] services provide pharmaceutical companies cost effective access to physicians, augmenting their existing sales and marketing activities. Additionally, [Communications company] enables physicians to conveniently learn important and relevant information about product and treatment options from thought leaders and their peers in an interactive environment, which physicians prefer.

While pharma has been going to great lengths to emphasize the separation of church and state, it sounds like some companies who service them still are not. It almost sounds as if the actual education is tacked on, just an “additional” benefit to the sales and marketing aim of putting docs and pharma together.

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Move over pharma: Now that so many foods are making health claims, is it any surprise that organizations like the California Walnut Commission are getting into the healthcare education game? (Walnuts are supposed to contain Omega-3 fatty acids and other “good” fats.) CWC, for example, is supporting a curriculum at an Alabama hospital to teach nurse practitioners about healthy fats, according to this article.

In addition, physicians employed by food companies are presenting information at medical conferences. This month, at the American College of Obstetricians and Gynecologists annual meeting in Philadelphia, James Greenberg, an obstetrician gynecologist at Brigham and Women’s Hospital in Boston, made a presentation about the benefits of cranberry juice cocktail for preventing urinary-tract infections. Dr. Greenberg is a paid consultant for Ocean Spray Cranberries Inc. Ocean Spray says it has long conducted research and marketed health information to consumers, but that in the past couple of years it has refocused energies on physicians.”

With all the new regulation relating to what pharmaceutical companies can and can t do in relation to medical meetings (go to mm.meetingsnet.com and search for PhRMA Code, OIG Guidance, AdvaMed Code, and Standards for Commercial Support for articles on the regs), it seems it would just be a matter of time before food company sponsorships and speakers will come under fire as well.

Or maybe not. According to the article, “The new approach to food marketing comes at a time when regulators are making it easier for companies to advertise health claims about their products.” While they used to only be able to advertise their products health benefits if the FDA agreed there was conclusive evidence, as of last year FDA began to allow “qualified health claims” for products that just have limited and preliminary scientific evidence.

Consumer advocates say the marketing tactics are raising some of the same ethical concerns that have drawn widespread criticism in the pharmaceuticals industry. For years, drug-company sales representatives have lavished gifts upon doctors, including golf vacations, cash and expensive dinners in an effort to get doctors to prescribe specific brand-name drugs. While the food-industry marketing tactics aren’t at that level, gifts, grants and sponsorships from food companies given to doctors or medical organizations are triggering similar concerns.

And it gets even more convoluted, says the article, with food companies working with pharma to bundle coupons for their products in with drug samples given to docs. And they re exhibiting at medical conferences now, too.

Oy vey.

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