Richard Lehman on conferences.

Medical conferences exist to affirm everything that hinders the progress of medicine as a compassionate and honest enterprise. They are a showcase for authority figures, pharma-funded research, half-completed work in the form of abstracts and late-breaking sessions; they use up prodigious amounts of money and carbon fuels; they reward high-tech flashiness and set no value on basic care and joined-up thinking: they reinforce a career structure and a social hierarchy in medicine which undermines the whole concept of patient-centredness.

Whole article here.

Makes a lot of good points doesn’t he. Yet I feel entirely complicit and tied into the whole structure that he critiques.

It’s actually with regard to a piece by Ioannidis who wrote a famour piece called “¬†Why Most Published Research Findings Are False”.

Worth the read.

About Andy Neill

EM Reg/Resident based near Dublin. Former anatomy lecturer, theology student and occasional musician @andyneill | + Andy Neill | Contact

Comments

  1. This is a great article, and the opening paragraph is very thought provoking. I have often pondered upon the multitude of reasons that people attend conferences (of which I believe there are many). Perhaps for me the greatest value of conferences is the opportunity they provide for the exchange of ideas that could lead to better patient care. Unfortunately I don’t think the way that the majority of medical conferences are conducted allow for this to happen in an efficient way, and it feels like many of the negative possibilities of conferences that Richard Lehman talks do become a predominant reality.

    It would be nice to see more open (and well facilitated) discussion in conferences, between ‘those with more expertise’ and those with ‘less expertise’. I am always left feeling a little frustrated when after many great talks there is never really ample discussion about how the topic at hand either ‘fits in to local practice’ or ‘doesn’t fit in to local practice’ in the eyes of the audience. Sometimes it’s because of poor facilitation of questions, other times a lack of time beings structured into the schedule, but in my opinion the most common reason for lack of discussion is the medical culture of not saying something because of humiliation for not knowing everything under the sun! -- Either way lack of discussion of topic can mean lack of integration of this rich information into both our memory banks, and also our regular practice.

    In this technological era (with simple tools like slideshare.com for example) we are now have the means for every single talk, at every conference to be made accessible for conference attendees or conference absentees to access alike. This could mean that we could have open discussions about topics that could be better integrated into practice and improve overall care of patients and that’s a good thing indeed! I wonder if this will become a more frequent practice soon?

    The other thing that is possible, and that would be nice to see is more is “multi-disciplinary” participation in conferences (speakers and delegates), instead of conferences being run largely by doctors. Some of the best conferences that I have attended have been those focussed on international EM development which attracts a range of attendees -- including paramedics, non-medical policy makers. Another amazing conference where I once attended in Asia actually had a patient advocate speaking to a group doctors, and a “team building -- motivational speaker” in another session -- how novel!

    It is great to know that people like Richard Lehman are not afraid to highlight the deficiencies of conferences -- “They are a showcase for authority figures, pharma-funded research, half-completed work in the form of abstracts and late-breaking sessions;”, Who can argue that this is not one of the many faces of conferences, and Andy, I would join you in thinking that we are all complicit to this in some way or form, especially if we don’t speak up. However, I see another side of conferences at the same time, with great potential, some of which is highlighted above. Here’s to a movement that conferences develop as “forums of great learning, exchange of ideas, community building exercises that service better patient care and better education” . Great thought provoking post. Thanks. Bish :) @trainthetrainer

    • Hi Bishan

      Great comments

      I am yet to be at a major conference so I’m mainly sharing my own ignorance here but as someone trying to get trained in EM, i can see how we have to be a part of the system of publishing and presenting. Not that it’s not important to publish and present just that it’s often done to CV build rather than benefitting patients.

      I suppose that would be an interesting (and of course somewhat hyperbolic…) question: does what is required to have a “career” harm your patients?

  2. My my… what a great hot potato you’re discussing there! I’ve been two 2x major conferences and both times I’ve felt very inspired but not because of the talks themselves but because of meeting great thinkers and enthusiastic colleges. Then I go home and listen to the same lectures from podcasts or videocasts (USC Essentials for instance), and engulf all the wisdom. I can adjust playback speed, rewind when I miss a crucial word, fast forward when I’m loosing interest and even listen/watch again to make sure the wisdom stays forever.

    So for me it would be plenty enough to just meet the people. But then again, there must be some carrot to get the colleges together and I don’t see what can replace the lectures. Or actually I do -- but I will not say it aloud here :-)

    An ICU friend of mine though said it just the way it is: we meet to get drunk but the friendship and collegial trust we establish while drinking helps us save lives when we are back and stuck with that difficult case needing multiple expertise.

    Cheers!

    • The answer is obviously beer then…

      The lectures are certainly a talking point as it provides a topic for discussion.

      I’m going to the Dublin conference in June and really looking forward to meeting the people primarily. I am presenting a poster but I’m not sure it’ll be life-changing!

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