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| EDITORIAL |
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| Year : 2023 | Volume
: 6
| Issue : 2 | Page : 121-123 |
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Medical conferences and medical practice
Ritesh Runu
Additional Professor, Department of Orthopaedics, IGIMS, Patna, Bihar, India
| Date of Submission | 25-Apr-2023 |
| Date of Acceptance | 25-Apr-2023 |
| Date of Web Publication | 3-May-2023 |
Correspondence Address:
Ritesh Runu
Department of Orthopaedics, IGIMS, Patna, Bihar
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/jodp.jodp_45_23
How to cite this article:
Runu R. Medical conferences and medical practice. J Orthop Dis Traumatol 2023;6:121-3 |
Now these days, the organization of conferences for medical professionals, especially orthopedic professionals, has increased a lot. We have an annual conference of the national body, i. e., the Indian Orthopaedic Association. Apart from that, we have an annual meeting of the Central Zone of Indian Orthopaedic Association and many national bodies of subspecialties such as – Paediatric Orthopaedic Society of India, The Association of Surgeons for the Application and Methodology of Ilizarov, Indian Foot and Ankle Society, Indian Society of Rheumatology, Association of Spinal Surgeons of India, Indian Arthroscopy Society, Indian Arthroplasty Society, The Association of Pelvis and Acetabular Surgeons of India, and many more. Furthermore, we have annual conferences of state bodies of orthopedic surgeons in various states. All these states have their annual meeting once a year. Almost one fourth of a year (90 days) is spent attending scientific meetings.
| Do we Really Benefit from these Meetings? | |  |
This question was relevant 20 years back and is relevant even today as we find in journals and articles.[1],[2],[3] Most of the members who attend the national body meetings are seen on the stalls or enjoying the hospitality of pharmaceuticals and organizers. Some go to nearby tourist places with their families and few stay in the meetings. In the halls, half of the presentations are repetitions of the same information and only few presentations really impact our minds and practice. As discussed by Mishra in his editorial, we need to regulate the number and quality of these meetings.[1] He suggested that the scientific meetings should be organized by national and international medical societies. It should impart clarity of knowledge and enable skill development. Guidelines should be made for organizing a Continuing Medical Education (CME) such as well-defined aim, methodology, participants, and faculty streamlined conduction of a conference. Each conference should have a specific goal, mission, and vision which are different from others so that a clear-cut objective is achieved at the end of a meeting. All conferences should offer CME credits. Care should be taken to ensure effective participation/interaction with delegates.[1]
These suggestions are very practical. Ioannidis opined that these meetings should aim to disseminate and advance research, training, and education, and set evidence-based policy. However, the evidence do not support the utility of most conferences. He also discussed the negative aspects of travel by the delegates, speakers, and pharma people in large scale. The alternatives suggested by him include video conference meetings and the development of educational tools for training utilizing huge savings.[4]
In 2008, BMJ (volume 336) published an article on medical conferences. Green had opinions against high-profile, luxurious meetings. He advocated the use of videoconferencing, virtual networks, virtual posters, or conference videos for such meetings. This will help in reducing the cost incurred on these meetings as well as it will save the environmental from the ill effects of traveling. The carbon burden of flying to far-off places is millions of tons. Like smoking, fuel burning in traveling needs to be reduced. Furthermore, the cost of huge hotels, conference venue management, and delegate activities had an impact on the environment.[5]
On the contrary, Prof. James Owen Drife, Professor of Obstetrics and Gynecology at Leeds General Infirmary, Leeds, UK favored the organization of medical conferences. Regarding carbon emissions, he quoted that 6.3% of emissions are from air travel which has very little impact on the environment. He also quoted an article of 1995 suggesting medical conferences gives us – education, inspiration, evaluation, presentation, and recreation. It has high impact on fellow colleagues to work hard and grow.[5]
Usually, the conferences are self-funded or supported by the government. The situation is not the same always. On several occasions, the meetings are organized and sponsored by the pharmaceuticals with the aim of promoting their products and to oblige the prescribing physicians.
Abakumova et al. surveyed the invitations to the physicians in the city of Kazan, Russia in 2012–2013. They concluded that pharmaceuticals invite physicians for scientific meetings on an average of 2.4 (2012) and 2.8 (2013) conferences/month. The highest number of invitations was in November. Most of the meetings were sponsored by pharmaceutical. Here, apart from the exchange of scientific knowledge, entertainment is also arranged. The overt and covert participation of pharmaceuticals may affect the clinical practice either directly or indirectly.[6] In another study, Rutledge et al. found that more than 50% of medical conferences are supported by pharmaceuticals.[2]
The over dependence of doctors on the pharmaceuticals for these meetings erodes their integrity and image. Doctors and drug companies may work together to advance knowledge and promote ethical health care. However, unwanted association harms all– patients, doctors, and pharmaceuticals. Considerable evidence exists that drug companies influence doctors, prescribing habits.[3] As Anand aptly puts it, “No one should have any doubt that the costs of industry-sponsored trips, meals, gifts, conferences, and symposia have simply added to the prices of drugs and devices. The drug industry treats doctors as prescribers and not caregivers. When we attend a sponsored banquet, we may be adding significantly to the drug prices in India.”[7]
The American College of Physicians[8] and The World Medical Association[9] reviewed the association of doctors and pharmaceuticals. Instead of breaking the relationship, these bodies suggest, ethical association between the two and to help the society and the medical field together. They suggested no individual doctors should receive direct payment from commercial companies to cover traveling expenses or compensation for their time. Pharmaceuticals should have no influence on the content, presentation, choice of speakers, or publication of results. The companies supporting the event should be publicly disclosed. Funding for a conference should be accepted as a contribution to the general costs of the meeting but not as payment for any specific lecturer or participant. Physicians should not accept gifts, hospitality, services, and subsidies from the industry if acceptance might diminish, or appear to others to diminish, the objectivity of professional judgment. All conference organizers and lecturers should disclose their financial affiliations to the conference participants. This activity makes the conference transparent.
A similar suggestion was given by Mishra. A healthy and transparent partnership between industry and the medical profession is essential for innovation and effective translation of basic science to clinical practice culminating in the optimal improvement of patient outcomes. Attempts must be made to curtail costs in conferences and remain focused on the educational component. At the same time, the meeting venue should be presentable and state-of-the-art because not only it helps in effective communication but also is a matter of prestige with our international faculty.[1]
Kalantri demonstrated that simple, quality educational conferences can be held without the industry's involvement, provided there is some institutional support, and delegates agree to pay for their own education. They organized two state-level conferences at MGIMS, Wardha. They showed that an educationally useful program in a medical college can be organized provided doctors in India pay the conference fees from their own wallets. By doing so, they can maintain the academic independence and integrity of medical science.[6] Professional bodies, medical colleges, and teaching hospitals should adopt policies to minimize the influence of drug companies on medical education.[3] The effect of conferences on publication was highlighted by Daruwalla et al.[10] The authors found that podium presentations were more than twice as likely to be published compared to poster presentations and international presenters were more likely to have their work published than local presenters. They found that trauma articles were less likely to be published compared to subspecialty articles. Subspecialty conferences have been found to quote publication rates ranging between 40% and 64%.[11],[12],[13],[14] The median time to publication after presentation was found to be 16.5 months and ranged between 0 and 76 months.[15]
They suggest that each national orthopedic association should determine the ratio of “presentations” to “publications” and use this as a measure of their annual conference's impact on the addition and advancement to the orthopedic literature. This tool may in turn assist clinicians in determining which meetings to attend.
Acknowledgments
We would like to thank Dr. Shweta Lall, Professor, Endodontics and Conservative Surgery, B R Ambedkar Dental College, Patna.
| References | | |
| 1. | Mishra S. Do medical conferences have a role to play? Sharpen the saw. Indian Heart J 2016;68:111-3.  |
| 2. | Rutledge P, Crookes D, McKinstry B, Maxwell SR. Do doctors rely on pharmaceutical industry funding to attend conferences and do they perceive that this creates a bias in their drug selection? Results from a questionnaire survey. Pharmacoepidemiol Drug Saf 2003;12:663-7. |
| 3. | Kalantri SP. Drug industry and medical conferences. Indian J Anaesth 2004;48:28-30. [Full text] |
| 4. | Ioannidis JP. Are medical conferences useful? And for whom? JAMA 2012;307:1257-8. |
| 5. | Green M. Are international medical conferences an outdated luxury the planet can't afford? Yes. BMJ 2008;336:1466. |
| 6. | Abakumova TR, Safina AF, Ziganshina LE. Clinical conferences for physicians: Who sets the agenda? Int J Risk Saf Med 2015;27 Suppl 1:S91-2. |
| 7. | Anand AC. The pharmaceutical industry: Our 'silent' partner in the practice of medicine. Natl Med J India 2000;13:319-21. |
| 8. | Coyle SL, Ethics and Human Rights Committee, American College of Physicians-American Society of Internal Medicine. Physician-industry relations. Part 1: Individual physicians. Ann Intern Med 2002;136:396-402. |
| 9. | Mayor S. World medical association reviews doctors' links with drug companies. BMJ 2003;326:1165. |
| 10. | Daruwalla ZJ, Huq SS, Wong KL, Nee PY, Murphy DP. “Publish or perish”-presentations at annual national orthopaedic meetings and their correlation with subsequent publication. J Orthop Surg Res 2015;10:58. |
| 11. | Wang JC, Yoo S, Delamarter RB. The publication rates of presentations at major spine specialty society meetings (NASS, SRS, ISSLS). Spine (Phila Pa 1976) 1999;24:425-7. |
| 12. | Jackson KR, Daluiski A, Kay RM. Publication of abstracts submitted to the annual meeting of the pediatric orthopaedic society of North America. J Pediatr Orthop 2000;20:2-6. |
| 13. | Preston CF, Bhandari M, Fulkerson E, Ginat D, Egol KA, Koval KJ. The consistency between scientific papers presented at the orthopaedic trauma association and their subsequent full-text publication. J Orthop Trauma 2006;20:129-33. |
| 14. | Nguyen V, Tornetta P 3 rd, Bkaric M. Publication rates for the scientific sessions of the OTA. Orthopaedic trauma association. J Orthop Trauma 1998;12:457-9. |
| 15. | Voleti PB, Donegan DJ, Kim TW, Lee GC. Level of evidence: Does it change the rate of publication and time to publication of American academy of orthopaedic Surgeons presentations? J Bone Joint Surg Am 2013;95:e2. |
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