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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 con- tinuing 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.
That whole environment seems to change on a dime. Just when you think things are done and over, they come back up.
‘The overarching issue that we’ve got is uncertainty. We know that there are compliance issues, funding issues, demographic shifts. But we never know when they’re really going to bite in.’
Lisa Astorga 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 govern- ment 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 We’re going to Amsterdam as well this year, and actually what they’re saying is that they don’t even con- sider 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 govern- mental 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.
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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 struc-
ture 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 deci- sion 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?