Operation: Medical Meetings

It’s not quite brain surgery, but meeting planning for brain surgeons and other medical professionals likewise can benefit from steady hands and a cool demeanor.
   Medical meeting planning presents myriad strategic and logistical hurdles, often daunting even to seasoned professionals. From an ever-changing matrix of regulations to complex site-selection criteria, the field demands a high level of specialized knowledge.
   M&C talked to a number of medical planners and the vendors that serve them to explore the problems they face and the solutions they have found.

Lead times
One morning this fall, a stream of international attendees from pharmaceutical/health-care giant Novartis arrived at the Westminster Hotel in Livingston, N.J. Planner Uwe Tittman asked to speak with the general manager. He wanted to schedule a meeting - starting at that very moment.
   "They just drove up to the door and said, ‘Look, we’d like to have a meeting for 30 people,’" says the surprised GM, Richard Verruni. Fortunately, a meeting room was available, and the Westminster banquet staff went into high gear, setting up in 15 minutes while the attendees waited in the lobby.
   "It’s the first time I’ve seen that in all the years I’ve been in the hotel business," Verruni says.
   For his (and Novartis’) part, Tittman claims it was a unique situation "based on a misunderstanding of the administrators planning the event" that is "unlikely to happen again." Typically, Tittman says, such meetings are planned at least two weeks in advance.
   It’s better than 15 minutes, but two weeks seems brutally short for organizing even a brief event. Yet, Verruni continually sees meetings for pharmaceutical company employees planned just days in advance. These meetings are generally for 30 to 50 attendees and last for two or three days. They usually consist of a general session with breakouts and require a sizable amount of A/V, as well as wireless Internet.
   "Yes, lead times are getting shorter," attests Laura J. Smith, operations manager for Novartis Centralized Sourcing and Meetings Express, based in East Hanover, N.J. Smith is an employee of Philadelphia-based Maritz McGettigan, which was enlisted by Novartis to leverage buying power and save money across advertising, promotion and meetings. Six other pharmaceutical companies are working with Maritz McGettigan on similar initiatives.
   With budgets tight, Smith notes, money for meetings often is freed up at the last minute. And, in her case, because meeting space at Novartis’ headquarters is quickly being converted into offices, meetings must go off site. "Competition for internal conference rooms is fierce," says Smith.
   Fortunately for Novartis, the six-month-old Meetings Express program, part of a broader consolidation effort, was designed specifically to streamline events of fewer than 60 attendees. Since many internal meetings of that size have similar needs, they are run similarly, using the same contract addenda and a standard agenda, depending on whether the focus is a tactical discussion, team building, a special event, or a sales or marketing program.
   "Meetings Express isn’t necessarily here to address short-term meetings," says Smith. However, she points out, most of them are planned only about a month in advance. Meetings devoted to marketing a recently approved drug aren’t handled by Meetings Express and are planned with even less lead time, because Novartis - or any pharmaceutical company - wants to get the medicine on the market as quickly as possible.
   Lead time for educational meetings also is shrinking, says Mila Kostic, director of continuing medical education for the University of Pennsylvania School of Medicine. "There is so much new medical information coming out. For any medical meeting that historically took a year or two to plan, we don’t have that luxury anymore," she says.

Long Odds in Las Vegas

Mandalay Bay's Danielle Babilino

It’s a huge convention destination - and growing bigger by the hour - but Las Vegas doesn’t really want medical meetings, say planners such as Cheryl Abraham. "They don’t like medical people," says Abraham, executive director of Symposia Medicus, a nonprofit CME provider in Pleasant Hill, Calif. "Doctors and nurses, by and large, don’t gamble."
   Medical groups with fewer than 500 attendees have particular difficulty booking in Vegas, says Abraham. The most popular hotels, she notes, offer a brief booking window - usually two to six months out - during which small groups can fill the empty spaces in the hotel’s meetings calendar.
   "Las Vegas is a challenge, because we don’t select the hotels, they select us," says Donald Wilk, Ph.D., director of continuing education for University Learning Systems Inc., based in Boynton Beach, Fla. "Next year we’re at the Excalibur four times. We’re hoping they don’t change their minds."
   Yet, Vegas’ attitude toward small meetings is changing, according to Danielle Babilino, vice president of hotel sales for Mandalay Bay. A new 1,122-suite tower connecting to the property’s 100,000-square-foot conference center is being specifically marketed to small meetings. "Now we can book accommodations and meeting space for our smaller programs, one, two and three years out," Babilino says. "We’ll take bookings as far in the future as they want to go." -- J.V.

Site selection

While site selection is always a complex calculation, various quirks in the medical industry make the task seem downright algebraic. The decision involves a number of factors. 
   " Regional access. "We’re having smaller, shorter meetings, but more meetings," says Susan Moore, conference manager at Atlanta-based Meditech Media, Ltd. Many of these events now are held regionally, Moore adds, since doctors can’t afford to be out of the office for more than a day or two. So, she seeks out places that are a short drive away from the majority of her attendees. Other planners mention the importance of making sure such facilities have enough parking for drive-in attendees.
   " A place to play. For some medical planners, particularly those who handle association events, site selection requires finding a balance of affordable (for attendees paying their own way) and family friendly.
   "The challenge is trying to balance pricing with an attractive venue, because some of the participants want to take extra days and bring their families," says Chris Hunt, executive vice president of the Norwood, Mass.-based Infusion Nurses Society. Hunt is eager to accommodate these delegates, since they give a serious boost to his room block via pre- or post-meeting nights at the hotel.
   " Space to spare. Since many medical events revolve around education, space needs often are intense. "Among the frustrations we run into is they don’t have enough of the larger breakout rooms for us," says Beth Torrey, vice president, conferences and exhibitions, for Boston-based trade show producer M/C Communications. Torrey says her group sometimes has to alter its program if sessions can’t be shoehorned into the available space.
   " Security considerations. Medical planners place a high premium on controlling the space they use, so they can keep proprietary data from falling into the wrong hands, says Dennis Edwards, senior vice president of the Greater Fort Lauderdale Convention & Visitors Bureau. "They like having a building where they can pretty much take control, and they don’t want anybody else in the building," Edwards adds. To ensure a secure site, a beefed-up security presence and even strategic checkpoints are some options that are available when medical groups take over Fort Lauderdale’s convention center.

Attrition

When 30 percent of the 15,000 attendees of the American Thoracic Society’s 2003 annual meeting booked outside the block, Deborah Richardt, CMP, took action. "I created a survey that asked, ‘Why did you book outside the block?’" says Richardt, the New York City-based society’s director of meeting services.
   To her surprise, Richardt received 2,000 replies with widely ranging comments. Some said their institutions had cut per diems, forcing them to find less expensive accommodations. Others claimed they weren’t aware that booking at other hotels hurt the association. Some cost-conscious doctors had simply found cheaper rates on the web.
   "Our doctors are computer-savvy. It’s their lifeblood," says Richardt. "Because they have great knowledge of what they can do on the web, there’s going to be more abuse than with some other kinds of attendees. The medical market is very much like that."
   Joanne Kramer, associate director of meeting services for the New York City-based American Lung Association, found doctors’ affinity for the Internet to be an attrition threat right before a meeting for 60 doctors this past fall. Kramer booked the meeting a year out at the Flamingo Las Vegas. A few weeks before the event, she got a call from an attendee who said he found a cheaper rate on the hotel’s website. "This makes me want to tell my attendees to book online," says Kramer. 
   After initially balking, the hotel finally allowed Kramer to add to her block those attendees who booked via the website. In the end, enough attendees booked within the block to meet the group’s commitment. Regardless, Kramer is miffed.
   "I wouldn’t go back to Las Vegas," Kramer says. "They don’t really care about small meetings. It was hard to find a hotel that would work with a small group." (For more, see "Long Odds in Las Vegas" on page 48.)
   In general, medical meeting planners’ solutions to attrition are similar to those throughout the industry. To keep from facing attrition charges next year, Deborah Richardt is reducing the number of rooms in her block from 7,500 to 5,900 for her 2004 conference in Orlando. For meetings further out, she’s considering offering incentives for attendees to book in the block, including food credits or comped rooms for exhibitors. "We’re trying to find ways to give deals," she says.
   Other medical planners simply are eliminating attrition in their contracts. Emily Floyd, logistics specialist for the Bethesda, Md.-based American College of Cardiology, says she won’t sign a contract containing the contentious clause.
   "We’ve had a lot of success," says Floyd, "but we’re lucky to be a fairly big meeting. Because we go to the cities over and over again, the hotel community and city know what to expect."
   Eliminating the clause, however, doesn’t get rid of the problem, lawyers point out. Instead, the contract must specifically state that attrition penalties will not be levied.
   Donald Wilk, Ph.D., director of continuing education for Boynton Beach, Fla.-based University Learning Systems Inc., used to leave attrition clauses out of his contracts. His CME meetings, which typically draw about 100 doctors, are on the other end of the size spectrum. "We’re small enough that we can get away with it," he says.
   Recently, Wilk has learned to ask hotels to add a note to his contracts that frees him from blame.
   "I’ve been reading about attrition," he says. "You have to follow all the rules."

Ethical guidelines

The past few years have seen great strides in divorcing the promotion of pharmaceuticals from continuing medical education (CME), though some steps remain to be taken.
   In 2002, the Washington, D.C.-based Pharmaceutical Researchers and Manufacturers of America released the PhRMA Code on Interactions with Healthcare Professionals, which presented guidelines for supporting unbiased education for doctors. According to the code, pharmaceutical companies are not to fund lavish medical meetings and dinners, nor are they to market their drugs during these meetings. The fact that pharmaceutical companies have voluntarily adopted the code has made medical education planners’ jobs easier.
   The University of Pennsylvania School of Medicine already has a stringent policy regarding pharmaceutical money, CME director Mila Kostic notes, but now that the PhRMA Code is out, "it’s easier to talk to people on the other side. We have the same agenda."
   In fact, the pharmaceutical companies "really behave better," Kostic says. She admits that in prior years, they would try to interfere with education, but in the past year, that hasn’t happened.
   In April, many of the precepts behind the PhRMA Code were solidified into law when the U.S. Office of the Inspector General laid down its own rules for pharmaceutical company behavior.
   The OIG’s rules require departments that fund meetings and other scientific projects to be completely isolated from the marketing body of the company. Also, pharmaceutical companies must form a compliance division, or at least have a compliance officer, to ensure they exert no control over doctors’ prescribing practices through meetings or gifts.
   Some companies have long had separate departments for supporting education. Those that haven’t are creating them now, according to Kostic. "Virtually every company I have come in contact with has really started restructuring," she says. "They are very sensitive to that issue."
   Another tack drug companies are taking is to outsource meetings, sometimes to multiple third parties, thereby keeping their fingers out of education entirely.
   "Medical education and event planning companies work in a triangle with us to address physician programs," says Laura J. Smith of Novartis. "The medical education company is purely focused on what it does best - content development. And we never touch the content."
   Even though pharmaceutical companies have their guidelines, planners of continuing medical education are still waiting on one additional code, the Revised Standards for Commercial Support, to be released by the Chicago-based Accreditation Council for Continuing Medical Education. 
   "It’s the most important document for all CME providers," says Mila Kostic, who explains that all accredited CME providers must follow these rules. "But they’ve been postponing the final version," she notes.
   According to Murray Kopelow, M.D., executive director of ACCME, the council has been working on revisions and will convene next in late March, when the Revised Standards might be released.
   CME providers are not sitting on their laurels while the standards are being discussed. Not only do they already strictly adhere to the original Standards for Commercial Support, released in 1992, but most also go above and beyond the rules to guarantee unbiased education.
   Kostic’s department has its own letter of agreement that details the University of Pennsylvania’s rigorous rules on pharmaceutical support. Funds are taken from a combination of sources, including multiple pharmaceutical companies, nonprofit entities and doctors’ registration fees.
   "It’s really hard to go after pharma dollars in this setting," says Kostic. Due to pharmaceutical company hesitancy to fund unrestricted grants, she adds, "you have to go to 25 or 30 companies to get enough money." But it’s important to do it this way to help "keep the relationship truly in the spirit of ‘no strings attached,’" she notes.
   Similarly, at a scientific congress such as the Oak Brook, Ill.-based Radiological Society of North America’s 60,000-person annual meeting held in Chicago, funds come from a variety of sources. Exhibitor fees, advertising and registration fees all pay for the education, according to Steve Drew, the society’s assistant executive director for scientific assembly and informatics.
   On the other hand, all of these rules might not be changing anything, says David Haberstroh, CMP, associate manager of professional meetings for MediCom Worldwide Inc., based in Morrisville, Pa. For example, he says, according to the rules, doctors with conflicts of interest over a medicine being discussed may not speak about that medicine. However, notes Haberstroh, such doctors often can still speak to groups if they steer away from the conflicting topics.
   "All the rules are saying is, have some ethics and integrity when dealing with doctors and companies you work for," says Haberstroh.

Budgets

While the pharmaceutical industry is ahead of the curve on the stock market, the days when that meant an outpouring of excess into meetings have passed, thanks to the influx of industry regulations mentioned above, which ban activities and perks that can make the meeting seem like a junket. As a result, planners have the head-scratching task of finding ways to make their events upscale without appearing to be lavish.
   "When we bring in advisory boards, it’s not like we are wining and dining them, but we will do what we need to do to make them comfortable," says Valerie Richard, executive conference manager in the Boulder, Colo., office of Melville, N.Y.-based OSI Pharmaceuticals. She notes that internal controls on meeting costs are much more stringent. "Our research and sales staffs have been asked to look at moderately priced hotels. The company has a strict travel policy," she says, adding that OSI often hosts high-end receptions rather than holding dinners, to split the difference between moderate and lavish.
   Richard is far from the only planner wrestling with the impact of medical regulations on meetings budgets. "[The guidelines] are vague, and you have to think about things a lot more before you commit to anything," says Paula Kramer, meeting planner at Metairie, La.-based Med Meetings. "There’s still so much gray area," she adds, pointing out that the guiding phrase "moderately priced" means very different things in New York City vs. less-expensive destinations.
   "We’re not doing quite as many off-property events," says Alexis Baba, manager of meeting services at MedPoint Communications in Evanston, Ill., who says although hotels are willing to be "aggressive" in their pricing, ancillary costs really add up. Under industry guidelines for certain events, "you have $125 per person to spend, and once you add in ground transportation, that’s where we get slammed," she says. 
   Baba as well as others point out that keeping the whole event on site gives a planner the added benefit of better leverage when negotiating. 
   Denise Baran, vice president of operations for Sacramento, Calif.-based Spectrum Events, hit on a solution to budget regulations that prohibit entertainment by selecting properties or facilities that have built-in attractions. "Quite often you find a facility that’s got entertainment added, like a themed restaurant," says Baran, who adds she gravitates toward "unique meeting space that also can be used for social functions." 
   Then there are cases in which a site’s pedigree actually can work against it, as Meditech Media’s Susan Moore points out. "In some cities, because of our history, I can get a better rate at a Ritz, but because of the name, I don’t go there," she says. "Sometimes it’s the perception, not the bottom line."
   For medical association planners, as with much of the association industry, budget concerns play a huge role in every aspect of planning, since members generally pay their own way to attend, and many have seen their own profits cut by managed-care payment caps.
   "Since a lot of our members are funded by universities or hospitals, we’re very price-sensitive," says Joyce Gambino, director of meetings and conventions at the Chicago-based Society of Thoracic Surgeons. Since Gambino’s group is very space-intensive, she’s had to come up with creative ways to maximize the use of room sets. "Every time you turn a room over, it’s costly," she notes. With up to 15 simultaneous breakfast sessions plus parallel sessions at larger seminars, Gambino relies on a multipurpose room setup to keep expenses down.
   "If we know we’re going to be doing a lunch in the room, we may seat people in crescent configuration so it’s ready for the lunch," Gambino says.
   Chris Hunt of the Infusion Nurses Society also wrestles with reining in the cost of his group’s space. "We only do classroom-style," he says, explaining that because attendees are on site for six full days of education, "asking them to try to balance a notebook on their lap is a little much." In addition, because two concurrent general sessions don’t require preselection, Hunt says he has to figure on more than 50 percent of the meeting’s 1,000 attendees going to either one. 
   Hunt also finds using the same room sets saves money. He even mandates in his contracts that the society’s space be exclusive, so resetting the rooms - many of which include labor-intensive A/V wiring - doesn’t sink his bottom line.