The Carbon Footprint of Medical Conferences

There's been another kerfluffle in the British Medical Journal about whether medical conferences are worth their environmental cost.

In the June 28, 2008 issue of the BMJ, Dr. Malcolm Green, professor emeritus of respiratory medicine at Imperial College, London, argues that international medical conferences are a luxury the world can no longer afford. He quotes calculations indicating that the annual meeting of the American Thoracic Society, which attracts 15,000 attendees, is responsible for 100 million person-air-miles of travel and 10,800 tonnes of carbon emissions. And he says that the "American Cardiac Society" attracts 45,000 attendees, who travel 300 million person-air-miles.

(We'll be kind to Dr. Green and the BMJ's copy editors and pass over the fact that there is no American Cardiac Society. I'm guessing he meant the American Heart Association.)

"If there are, say, 20 medical conferences a year in the US," Dr. Green writes, "and we add in conferences in Europe, Asia, and Australasia, the impact from travel toconferences would be at least 6 billion person air miles a year or 600,000 tonnes of carbon."

Wow, are there really only 20 medical conferences a year in the US? I cover that many all by myself, and I go to only a tiny minority of them. He's off by at least an order of magnitude, and probably by a factor of 50 or more if you include medical conferences outside the US. His main argument--that medical conferences could more easily and more economically be conducted virtually, online, via teleconferences--would be more persuasive if he didn't make those simple errors of fact.

His opponent in the BMJ's "Head to Head" debate is hardly more persuasive. Dr. James Owen Drife, professor of obstetrics and gynaecology at Leeds General Infirmary, argues that nothing can substitute for face-to-face contact, and that anyway medical conferences only have a minuscule effect on global warming.

I'm surprised that the BMJ would publish such a poorly argued debate. Neither debater did more than wave his hands to support his argument that virtual conferences would (Dr. Green) or would not (Dr. Drife) be an adequate substitute for face-to-face meetings. I would have been happier if either one of them pointed to a single well-done study--hell, even a single lousy study--that demonstrated the value, or the lack of value, of face-to-face scientific meetings. Their arguments are even short of anecdotal evidence!

One thing is for certain. There would be dire consequences for medical journalists if virtual medical conferences became popular.

1. We'd no longer be able to wheedle subsidized travel to Detroit, Mich., Anaheim, Calif., Orlando, Fla., and other exotic vacation destinations.

2. We'd lose out on the romance of modern air travel, the luxurious amenities in airports, and the tender loving care of flight attendants.

3. We'd have to purchase our own pens and post-it pads.

4. No more free stale coffee, pasta salad, and rubber chicken in meeting press rooms.

5. We'd have even less reason ever to move away from our desks, and our profession would be afflicted with an ever worsening epidemic of writer's ass.

It's Not Just the ADA: EULAR, a Rant

In my previous post I took the American Diabetes Association to task for failing to allow reporters to photograph or record any sessions. Despite my invitation to do so, Collen Fogarty and Diane Tuncer of the ADA have declined to offer any explanation for these restrictive policies.

Unfortunately the ADA is not alone in these restrictions. Today I heard from a noted medical journalist (who prefers to remain anonymous) who had a similar experience at the recent EULAR (European League Against Rheumatism) meeting in Paris. The journalist wrote:

Roueche,

I read your rant RE: ADA prohibitions with much interest and similar feelings of frustration. I have just returned from EULAR where similar restrictions are imposed. They are also strictly enforced (one of my colleagues who was taking photographs was physically ejected from the conference when he refused to turn over his camera).

I use audio recordings and photographs of slides as a form of note taking for the exact reasons you expressed: I cannot efficiently collect the data I need any other way. The articles I write contain real clinical information including p values, CI, HR, etc. They are researched and referenced and I work with the presenters (during and post conference) to ensure that I "got it right". At EULAR I initially opted to ignore the rules until asked to stop. When this happened (and it didn't take long), I asked why photography and recording were prohibited. The security guard (a real, headset wearing, burly, somewhat intimidating security guard not a student hired just to watch the audience) responded "We have our orders." When I took my inquiry to the EULAR committee I was given several reasons including "copyright" (?). One of the more interesting responses was "this is sensitive information that some presenters do not want released." I won’t say more about either of these response – they just don’t deserve to be commented on. When I countered that as a credentialed (invited) member of the press I needed the information to accurately report what was presented and that this was a form of note taking, I was informed "If I let you do it then everyone will want to do it."

From what I could tell - 75-80% of this conference was being videotaped by an outside service. When I asked one of the employees of the service how the material they were capturing was going to be used, they said they didn't know. I did not see any place on-site where CDs/DVDs could be purchased and as of today there is nothing on the web site to indicate that this material is/will be available for purchase.

In addition to the general frustration of not being able to do my job, these restrictions reinforce my concern about the accuracy of some of the data I've seen in on-line reports that appear to be slightly altered regurgitations of Press Releases. For one of the EULAR presentations, I noted a discrepancy in what was contained in the slides the presenter sent to me post conference (at my request) and the data contained in several articles posted on major medical news web sites. I asked the presenter for clarification to be sure that I was interpreting the data correctly. He informed me that the data in the Press Release (the obvious source of the online articles) was not exactly correct as it was taken from two different reports. This is not the first time I've encountered this problem and I'm sure it will not be the last. Often Press Releases are written from the data contained in the abstract (which can be as much as 6 months old) vs what is actually presented during the conference session.

I agree that although it is an interesting approach, using the Americans With Disabilities Act, is not the way to go. Somehow we need to convince the societies that: (1) they should be concerned about the quality of the information that comes out of their conferences; (2) giving the press privileges that other attendees don't have is a perfectly acceptable practice; (3)as you noted - facilitating the free flow of information is the right thing to do.

Feel free to post this if you like.

I'd love to hear similar horror stories from other reporters at other medical meetings. Let's compile a list of medical societies that pretend to welcome reporters, but in fact have policies that make it extremely difficult to cover their conferences.

The American Diabetes Association: A Rant (Updated)

The American Diabetes Association (ADA) is a fine organization, providing important services to the diabetes community, funding critical research, and organizing several fine annual conferences, including their huge and recently concluded 68th Scientific Sessions in San Francisco.

And the ADA hosts a well-run newsroom at this meeting every year. They provided those of us covering the meeting with a comfortable place to work, wireless and wired broadband Internet access, and even tasty and free breakfasts and lunches every day. The red-shirted ADA staffers in the news room were unfailingly cheerful, polite, and very, very helpful.

It's too bad that some of the Association’s misguided policies virtually ensure that a great deal of the coverage of the many important studies presented at this meeting will be incomplete and inaccurate.

Take a look at their news room policies. Videotaping is prohibited. Photography is prohibited in oral and poster sessions. And in an addendum to these policies, handed personally to each news room registrant, they added audio recording --- audio recording! --- to the list of prohibitions.

In fairness, these restrictions apply to all attendees, not just the news media. They were widely ignored by reporters and other attendees. But in at least one large session a security guard bellowed a warning that if he caught anyone using a camera it would be confiscated.

I suppose we should feel grateful that they don't prohibit paper and pencil. If they took this one, small, additional step all of our stories would look something like this:

Diabetes Is Bad for You; a Drug May Help

San Francisco--Researchers at a university somewhere in North America have concluded that diabetes has certain negative consequences for the people who have it. Fortunately, a new drug may help. In a study of a bunch of patients with one of the forms of diabetes, this drug, having a name beginning with the letter R, appeared to help them in one way or another. The investigators said, however, that more research was needed.

-30-

Many of the reporters in the news room expressed annoyance at the irritating restrictions on photography and audio recording. These restrictions were especially galling given that for $200 or so anyone could purchase audio recordings of the entire conference, available on a DVD or online. Many of us would gladly have spent the $200 for these presumably high quality professional recordings. Problem is, they're not going to be available for two weeks. We’re in the news business. In two weeks it's not news, it's olds!

Oh, and guess who's selling those professional recordings. Well I’ll be a monkey's uncle, it's the ADA itself! Could it be that they prohibit audio recording to protect their monopoly? Say it ain't so, Joe.

If this isn't the motivation for these restrictions on reporters, I don't know what is. Are they afraid that results will be reported prematurely? Well then, they shouldn’t make recordings available at all and, for that matter, they shouldn’t publish their abstract volume and they should confiscate all writing material at the door. Hell, they should just cancel the meeting and stay home.

To be fair, the ADA is not the only society that imposes similar restrictions at its annual meeting. I've never understood these restrictions. Don't they want us to report the science accurately? Unless you have training as a court reporter and have learned how to use a stenotype machine, it simply is not possible to take notes fast enough while at the same time trying to understand the science and to evaluate its newsworthiness. (And if reporters started lugging stenotype machines around, some societies would probably prohibit those as well.)

It's especially hard if you’re working for a publication that isn’t afraid of printing actual numbers in its articles. You just can't get all of those numbers in your notes, and often the speaker doesn’t even recite them so they're not even in the audio recording; they're only on the PowerPoint slides. And the only sure way to get those numbers is to photograph the screen with a handy digital camera.

I would love to hear the ADA's rationale for these restrictions, and I'll be sending a link to this post to ADA media representative Colleen Fogarty (703-549-1500 ext. 2146 or cfogarty@diabetes.org) for a response. I'll let you know what she says.

Meanwhile, I think that an enterprising reporter could make an argument that such restrictions violate the Americans with Disabilities Act. Carpal tunnel syndrome and other wrist maladies are among the common occupational hazards of the journalism profession. (“Ink-stained wretches” is an anachronism. “Wrist-wrecked wretches” would be more apt these days.) It seems to me that audio recording and photography could be seen as “reasonable accommodations” (a term of art in the Disabilities Act) for someone whose disability prevents her from taking legible notes fast enough to do her job.

It seems to me that the American Diabetes Association, many of whose members are disabled, shouldn’t be discriminating against those of us with disabling wrist injuries.

But, you know, no one should have to make that argument. The ADA should permit reporters to use the tools of their trade not for fear of a lawsuit and bad publicity, but simply because facilitating the free flow of accurate scientific and medical news is the right thing to do.

UPDATE

I had the following brief email exchange with Colleen Fogarty of the ADA:

June 11, 2008

Colleen,

I'm a medical reporter and the anonymous author of the Medical Conference Blog (http://medmeeting.blogspot.com/). Recently I wrote a blog post that praises the ADA and its news room staff, but criticizes certain of the ADA's news room policies. You'll find that specific post at http://medmeeting.blogspot.com/2008/06/american-diabetes-association-rant.html

I hope you'll take a look at it and consider a response. I'll promise to post your response in full.

Best wishes,

Roueche

On June 12, 2008 she responded:

Hi Roueche,

If you would like to talk to Diane Tuncer, our managing director of Communications, please feel free to call her directly at 703-549-1500, ext. 5510.

However, respectfully, we would like you to share your identity so myself (or Diane) can know to whom we are speaking with.

Thank you,

Colleen

Colleen Fogarty
Specialist, Communications
American Diabetes Association
1701 North Beauregard Street
Alexandria, VA 22311
703-549-1500, ext. 2146
703-549-6294 - fax

And on 6/12/2008 I responded:

Colleen,

Respectfully, I decline to share my identity. Among the ADA's objectionable media policies are explicit threats to ban reporters who violate your policies -- and their organizations -- from covering future meetings. I'm not willing to take that risk.

I hope you and Ms. Tuncer will visit my blog and comment on my criticisms anyway. I believe these criticisms are valid regardless of who I am and what organization employed me to cover your meeting.

If you believe the ADA has a good reason for restricting photography and audio recording by reporters, I'd love to hear it. Such a reason is not articulated anywhere on the ADA web site, or in the press kit, as far as I can tell. Or maybe my arguments were so persuasive that you've decided to change the policy. I'd especially love to hear that.

By the way, my post on the ADA meeting has generated more visitors than any other post on my blog, with one exception (http://medmeeting.blogspot.com/2007/01/how-to-find-medical-conferences.html). Try googling "American Diabetes Association news room" (without the quotes). You'll find my ADA post among the first page of results.

Cheers,

Roueche

I've heard nothing since.

Breaking In to Conference Coverage

> Hello,
>
> I stumbled onto your blog today and appreciate the resource. I am a
> medical writer who currently writes lots of abstracts and posters and
> I'd like to break into conference coverage, particularly in the areas
> of [redacted].
> I've previously done some conference coverage at [redacted]. Do you have any
> suggestions for how to go about this? Which outlets are best for a
> newby, etc?
>
> I've heard starting out, companies don't usually pay travel--but will
> they pay conference registration fees?
>
> Thank you for your time,
> [redacted]

[Redacted],

I'm happy you're finding my blog useful. If I could get off my duff and
update it more than once a month it would be more useful still.

If I were trying to break into conference coverage, I would focus on
medical trade papers and other resources for physicians (such as
docguide.com) rather than general interest publications. Many of the
medical trades use freelancers, especially when the freelancer is local
to the conference and so wouldn't need to travel. I don't know how many
conferences are in [your city], but you may want to consider which other
cities are a doable commute for you. Then find out what the upcoming
conferences are and contact the trade papers you've decided to target.

You're right that most of these companies won't pay travel expenses for
someone just starting out, but as you become more of a known quantity,
it's legitimate to expect that they would pay for your travel. And
conference registration fees are rarely an issue. Reporters on
assignment routinely receive complementary registration, especially when
they have an assignment letter and have contacted the conference
sponsors in advance.

Please feel free to contact me with additional questions.

Roueche

That goes for the rest of you as well. I'm happy to answer questions from new and aspiring medical and science writers.

9 Tips for Covering an Unfamilar Specialty

Yesterday I had one of my recurring nightmares. I'm covering a medical conference in an unfamiliar specialty. I can't understand a word anyone is saying. My recorder isn't working. Neither is my camera. Oh, and I'm naked.

Except for that last one I've experienced all of those calamities in real life. And (again except for that last one) I've found ways to to salvage those bad situations.

Today I'll discuss what to do if you find yourself covering an unfamiliar specialty.

1. First rule: don't let yourself get into that situation. When you're assigned to cover a specialty that's new to you, begin preparing at least a week in advance. Visit the society's web site. Google previous coverage of that meeting. Skim through a textbook. Learn the lingo and try to determine the important unanswered questions and controversies in the field.

But for the sake of argument, let's say that that much preparation is impossible. Maybe you got a last minute assignment, and you're going to the conference tomorrow. Maybe you're just lazy, and you find yourself sitting in the conference room, reading the program, and not even understanding the titles of the talks. What do you do then?

2. Attend the keynote speech and the first plenary session. I usually skip keynote speeches because they're often just broad overviews with little news value. But that's just the type of presentation that's perfect for bringing you up to speed. The first plenary session is likely to be at least somewhat newsier and will give you big pointers to the important issues in the field.

3. Don't panic if the jargon is so thick that you can barely tell whether the speakers are using English. I find that if I just let that jargon wash over me I begin understanding it after the first morning of the conference.

4. For that reason, it's especially important to record those first few talks, even if you doubt that they'll be newsworthy. Once you've absorbed the jargon, you'll be able to listen to those first talks with new ears.

5. Make a point to walk through the industry exhibits early in the meeting. You'll quickly learn the names and uses of the drugs and devices important to specialists in that field.

6. Pick up a copy of the conference's daily newspaper if it has one.

7. Latch onto a friendly colleague. Reporters familiar with a specialty often know even better than the specialists themselves the important issues in the field. It's my experience that there's a decent level of camaraderie in most meeting press rooms, and few reporters guard their scoops jealously.

8. Pick the brains of the meeting press officers. They're usually medical writers too, and they're eager to point you to the hot topics and the good sessions.

9. At least glance at the press releases inside and outside the press room, even if you have no interest in covering the touted stories. Press releases are usually written by professional writers like us specifically for reporters, and they're likely to put the topic in context and define their terms.

Advice from a veteran to a newbie

Interesting Q&A on the nasw-freelance listserve. I thank Nancy Allison and Bob Roehr for allowing me to quote their posts in full.

First, Nancy's question:

Date: Sun, 27 Jan 2008 15:50:33 +0000 (GMT)
From: Nancy Allison 
Subject: [NASW-Freelance] First medical conference
To: NASW-Freelance discussion list 

Hi everybody,
I'm a new member of NASW and have written about health issues for consumer and university magazines, but have never attended a medical conference (or written about one).

This summer, I will be in Paris during the dates of the European League Against Rheumatism conference. My stepmother has scleroderma, so I am interested in going anyway to hear about new research.

But I'd also like to write about the conference and make some new contacts. Is it crazy to think that I can do this, never having done it before? I really don't know where to start.

Any pointers (I realize that they might be in the vein of: "stick to alumni magazines, honey!") would be greatly appreciated.

Thanks in advance,

Nancy Allison

Then Bob's response:

Date: Sun, 27 Jan 2008 11:43:31 EST
From: BobRoehr@aol.com
Subject: Re: [NASW-Freelance] First medical conference
To: nasw-freelance@nasw.org


I think a lot of it depends on what you mean by "conference coverage." My  experience is that generally it means writing about individual resentations or sessions for a clinician reader, with rapid turn around -- often that same night, or within 1-2 weeks of the conference.

Ideally one has experience covering conferences and knows the subject  matter inside out. The later is important to both understand the materials as they whip by, and to make editorial judgments on what is new/important in the context of what has been presented and published in the field in the last 6-12 months. If you don't have that background knowledge base, then trying to pick it up at a conference and simultaneously turn it around on short deadline is a nearly impossible task; it is not the situation for on the job training.

If you do have that type of background knowledge of rheumatism, and have  written about it with clips to show (ideally with the level of detail for a  clinical not a consumer audience), the next step is to get a sense of where that particular conference stands in the hierarchy of meetings on the subject. There  has been such a proliferation of meetings over the last few decades -- many operated largely to generate revenue for either a company or a professional association -- that editors and publishers have to be judicious in what they cover. Only then would I think about researching what publication and editor to  approach.

Keep in mind that coverage is planned and assigned 3-12 months in advance  with most organizations, and they tend to use the same people to cover the  same meetings year after year because they have the knowledge base to do so and are known quantities that can deliver a good product on deadline. But there are  always conflicts with other meetings and churn, sometimes at the last minute.

Bob Roehr

That's excellent advice from a true veteran. I'd only take issue with one minor point. Although I've covered many different areas of medicine, I'm occasionally assigned to a meeting in a specialty I'm not familiar with. I usually feel at sea during the first half-day or so of the meeting, but once I've absorbed the lingo and figured out the issues that are important to the docs in that field, I can write intelligently about the presentations. Understanding statistics and medical science in general can go a long way if you're a quick study.

This gives me an idea for a blog post that I hope to write in the next few days: Rules for Covering Conferences in an Unfamiliar Specialty.