by Michael J. Shapiro | April 01, 2016

"Everyone says they want innovation at medical meetings," says Ellen Shortill, director of convention and meetings for the American Speech-Language-Hearing Association in Rockville, Md., "and yet, such meetings are the most resistant to change of any I've ever done in my life." Shortill made that point at a "Future of Medical Meetings" session this past January at the Professional Convention Management Association's conference in Vancouver, British Columbia, and she received applause from a roomful of medical-meetings stakeholders.

Ellen Shortill, Director
Convention and Meetings,
American Speech-Language
-Hearing Association

One of the factors hampering progress is that many associations in this highly specialized segment discourage the use of social media during meetings, a frustrating if understandable stance in a profession rife with myriad industry- and government-mandated rules, restrictions and proprietary concerns. A case in point is recalled by Berlin-based digital health-care consultant Len Starnes, who spent nearly 20 years in marketing for big pharmaceutical companies. A few years back he created a hashtag for a European medical society's meeting because they hadn't established one. "When I reached out and told them, they said, 'How dare you? Only the medical board will decide if and when and how and who will use the Internet to cover the conference.' And I thought, 'You have no idea what's happening out there, do you?'"

What's actually happening, says Starnes, is that doctors in some fields have very much embraced social media as a means of communication and education, and many societies and associations are awkwardly trying to keep pace. When one medical conference attempted to ban tweeting from presentations last year, the attendees replied with a resounding, "'You've got to be kidding.' They just ignored the ban," says Starnes. "And afterward, the organizers were picked to shreds. They were laughed at."

These incidents shed light on a core tenet of modern technology -- the democracy of information -- and how often that is at odds with traditional organizations. "They still think that they control access to medical-specialty information," observes Starnes. "They really believe that it's their domain. That's why they have real problems with using the Internet and social media -- they lose that position they've always enjoyed. It's a deep-rooted problem."

Freeing the content
Since becoming an independent consultant several years ago, Starnes has made waves with his critiques of traditional business models (one example: "The Medical Conference Is Dead, Long Live the Medical Conference," a slide presentation that looked at the impact of social media and digital technology).

Len Starnes
Digital Health-Care Consultant

"The classic medical-society conference is deeply conservative," Starnes says. "They've been doing these conferences for almost 100 years and they haven't changed much."

The most visible, obvious reaction to this problem is the FOAM movement, otherwise known as Free Open-Access "Meducation." It's a community and growing trove of medical education resources that can be publicly accessed anywhere and anytime. The FOAM movement's popularity is particularly strong among emergency medicine and critical-care physicians, who regularly share articles and research, and participate in discussions on public social media channels. While the movement is platform-independent, one need only to look at Twitter to see its impact: The #FOAMed hashtag, which didn't exist until June 2012, was used in nearly 900 million Twitter posts in 2014.

As the FOAM movement disrupts the traditional peer-reviewed medical journal process, its implications for medical education and meetings are likely to grow in significance over the coming years. Not only are more medical practitioners using social media as a result of the movement's burgeoning popularity, but the open-access ethos is a direct attack on the traditional medical-society model.

The changing attitudes about medical education and information underscore a real conflict for medical societies, affirms Dr. Steven E. Aks, an emergency physician and medical toxicologist affiliated with Chicago's Cook County Hospital. Aks serves on the board of the American College of Medical Toxicology and also has become an active participant in the FOAM movement. "In general, societies view education as a member benefit, and they want to be the exclusive source of that," he notes. "If it gets outside of their firewall, they lose control of it. And I do think that the FOAM movement is threatening to the societies in that sense."

Aks acknowledges that the lack of peer review and formal processes can be a problem with the FOAM movement, and reading information critically and considering its source is more crucial than ever. By the same token, attempting to muzzle those sources would be pointless, he adds. "It's better to have open access and share the knowledge than to contain it," he says.  "And the societies, if they want to survive in this changing environment, have to come up with better content that needs to be delivered on-site in a creative way. So it's really putting new challenges to the specialty societies to up their game as well."