Director’s Corner: Time to Cancel Conferences?

Are annual meetings still viable in a post-pandemic world?

Dear Director,

I got back from the ACEP conference and wondered what’s up with the attendance? Do you think these large conferences will ever return to pre-covid attendance?

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For more than 15 years, I was a regular attendee at ACEP.  I loved so much of it—seeing old friends and networking with new colleagues, exploring new cities, getting (a little) CME, and for a handful of years, being able to lecture to my colleagues.

At one point, one of my mentors told me that if you’re going to be a leader in emergency medicine at your hospital, you need to be at the conference where all the leaders go. Attending a large national conference was the best way to see all the new technology in one place and bring back the latest in best practices.  It was also a great recruiting venue. For me, that run of consecutive ACEP’s came to a halt in 2020.

Attendance at both ACEP and ACOEP meetings this fall was down about 40% compared to pre-pandemic.  In an article published earlier this summer, across all industries, meeting attendance is down about 35% compared to 2019.

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COVID-19 certainly has challenged everyone when planning to attend conferences.  My own hospital’s Medical Executive Committee planned to attend a conference on medical staff leadership last January.

When the omicron surge hit last December, we decided to cancel the reservations and skip the conference. Certainly, the optics wouldn’t look good if a large contingent of the medical staff leadership caught COVID at a conference, let alone if we did have an outbreak that led to additional time off due to illness.  Likely, this was an easier personal decision since the hospital was paying and the individual physicians were not at risk of losing their own money paying for cancellation fees.  Yet, it highlights the challenges that go into planning to attend a conference.

There are many reasons why attendance hasn’t fully recovered even though most of us are living a pretty normal life when it comes to work and travel.

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Why is conference attendance down?

Let’s start with CME budgets.  COVID has had significant consequences on healthcare finances.  First, we had to deal with declining volumes.  Now we have surging volumes and we’re paying extra to have docs work more.

Many ERs are experiencing staffing crises and paying top dollar for locums.  Groups have had to prioritize spending and at least sometimes, CME budgets were cut.  I was shocked recently when I talked to some friends in academia who told me their entire CME budgets were cut.  And let’s be honest, attending a national conference is not a low-cost event.  Between flights, a hotel, the actual conference and a few meals, it’s a very pricey decision to go whether you’re using your CME or your personal dollars.

Air travel certainly factors into this as well.  There’s been a lot of chaos in air travel and prices are still really high.  Flights cost more than in previous years and take up more of your budget.  But you also must factor in a much bigger risk of having your travel disrupted with delays and cancellations than before the pandemic. 2022 has seen the highest rate of flight cancellations since 2014 (excluding 2020 when the pandemic hit and we all stayed home) and the highest rate of flight delays since 2014 as well.

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Airfare increased about by 17% between the first quarter of 2021 and the first quarter of 2022. There’s even a higher number of passengers reporting damage to their bags in 2022 than in 2021.  Although I’ve flown a bunch this year, it’s been harder for me to get motivated for work travel than for personal travel with a higher fun factor.

I think conference organizers may also be a victim of their own success.  Organizers pivoted so well in 2020 with a variety of virtual options, many people have found there is no need to return to in-person conferences.  Digital solutions are so commonplace now, even this formerly paper publication EP Monthly has gone completely digital.

Looking at the ACEP conference there’s the “unconventional” option with a mix of live and recorded lectures. And if you’re going primarily for the CME, purchasing the online CME option, VirtualACEP, is a lot cheaper than traveling and you can get 10 times the amount of CME versus in-person attendance.  At my state-level CME conference, travel and hotels aren’t the rate-limiting step, but we’ve continued to offer an online virtual option, and about a third of our attendees preferred this option and participated virtually at our local conference earlier this year.

Why go in person?

There are still reasons to attend in-person conferences.  These are personal decisions but the biggest for me is the people. This is both seeing old friends and making new friends.  I had a great discussion at ACEP in San Francisco this year with a former Baltimore colleague who is now in Florida.

There are also a couple of vendor products I’ve used for years and while I may talk to the vendor representative on the phone throughout the year, I like the opportunity to see them in person at ACEP.  Many of these vendors have become friends after a decade. Some meetings like ACEP remain critical for recruitment as well.  As a chair, I don’t want to miss an opportunity to meet out-of-state candidates in a neutral site and avoid the cost of bringing them in for a preliminary interview or having a second meeting with someone I’ve already interviewed so they continue to consider my site.

Many docs will continue to go to network.  Networking might be for a job search, it might be to talk to others in your company if you’re part of a large staffing company, and it also might be to see others with similar professional interests as you.

There are certainly educational benefits to going to a conference in person.  I pay more attention when I’m live and in person than when I’m on zoom and often multi-tasking.  I had a few friends create their own hands own ultrasound course and they all went together as a small group to improve their sono skills.  Cadaver or procedure labs generally need to be in person as well.

Although some of the burnout we’ve experienced the last few years makes it hard to get motivated to spend our free time at a conference, certainly attending a conference may help reduce your burnout.  There is typically a lot of energy at a conference and although you may return from the conference sleep deprived, you’ll usually have a list of things to work on that you’re excited about.

It might be from a lecture that will change your approach to a disease, but it also might be from a conversation with a colleague or vendor. I don’t think I’ve ever returned from any type of conference anywhere without a to-do list that I was excited about. I have no doubt that something at the conference will get you enthusiastic about emergency medicine.

If you’re selling something or buying something, large national conferences may be beneficial to attend in person.  Some of the exhibit halls have lots of vendors where you can shop for ideas, meet other entrepreneurs, and shop for your products.  From a buying perspective, a large exhibit hall puts you with numerous vendors from everything from ultrasound machines to billing companies, to data analytics companies.

Visiting a great city remains a consideration when deciding to attend a conference.  I’ve found great restaurants and bars in all the cities that I’ve gone to for conferences, but I’ve enjoyed some locations more than others.

And on a personal note, because I often travel during the fall, I’ve even enjoyed watching all the local political ads that always seem to be on TV during the fall.  There are some cities that I’m happy to go back to and there are a few that I’m glad I’ve been to, but don’t feel the need to go to again for another conference.

Conclusions

I love traveling and I have great memories from conventions through the years.  I have also loved seeing the new gadgets on the exhibit floor. But the conference landscape is changing.  Great CME can be obtained virtually.  And learning in person versus virtual really depends on how motivated the learner is.  After all, with virtual CME, you can stop, rewind, listen and ponder which seems far better than scribbling notes in a large auditorium.

Even within EP Monthly, going digital/virtual means more content, pictures and video plus podcasts at a lower production cost. Budgets and prioritization of how to spend those precious CME dollars have changed and the opportunity to obtain CME without travel is better now than ever. For some people, the recruiting and committee work done outside of the main CME event will remain a draw.

But many people will likely find other ways to network and capture some of the energy of a large conference in other ways and I think it may be a while before the large conventions find a way to entice everyone back.

References

https://meetings.skift.com/event-attendance-post-pandemic/

https://www.valuepenguin.com/travel/delays-cancellations-bags-study