There’s a typical array of clinically relevant articles in the upcoming issue of the Journal of the American Medical Association, but I’m betting that just one will go viral among doctors: A powerful broadside against conferencesby that renowned mythbuster of medicine, Dr. John P. A. Ioannidis of Stanford.
“Dr. John Ioannidis has spent his career challenging his peers by exposing their bad science,” is how The Atlantic summed him up in a rich 2010 profile headlined “Lies, Damned Lies and Medical Science.”
After many years of questioning assumptions and seeking harder data on everything from surgery customs to drug studies, Dr. Ioannidis is now taking on a major cultural institution of medicine: The conference. (Some might call it “the boondoggle, junket, fuel-wasting, resume-padding, often-not-peer-reviewed conference.”) This latest target is particularly striking given that the Atlantic piece says that “His work has been widely accepted by the medical community; it has been published in the field’s top journals, where it is heavily cited; and he is a big draw at conferences.”
Dr. Ioannidis begins his JAMA piece by estimating that conferences by medical societies and the like may well number more than 100,000 a year if you include local meetings; they are a dominant feature of all health-related fields. He asks:
Do medical conferences serve any purpose? In theory, these meetings aim to disseminate and advance research, train, educate, and set evidence-based policy. Although these are worthy goals, there is virtually no evidence supporting the utility of most conferences. Conversely, some accumulating evidence suggests that medical congresses may serve a specific system of questionable values that may be harmful to medicine and health care.
Read his full piece in JAMA here, but here’s the chunk I thought packed the most punch:
Are medical congresses dinosaurs doomed to become extinct? The future will tell. Medical conferences will disappear if physicians stop paying attention to them, if they do not give them value, and if they do not attend them; and, of course, if funders do not fund them. One option is to let evolution and history run its course. However, many interests favor the maintenance of professional meetings that promote the massive sovietization of medical disciplines. Thus, natural selection may not be able to operate effectively.
Eventually, some evidence should be accrued on whether specific types of current conferences offer advantages compared with other means of serving the same needs, including social networking tools, remote conferencing, and re-purposed meetings. For example, re-purposed conferences could be designed to be entirely committed to academic detailing. All their exhibitions and satellite symposia would deal with how to prescribe specific interventions appropriately and how to favor interventions that are inexpensive, well tested, and safe. Such repurposed conferences could also focus on how to use fewer tests and fewer interventions or even no tests and no interventions, when they are not clearly needed.
Readers? Do conferences serve uniquely useful and efficient purposes? Everything I’ve read so far suggests that social networking cannot take the place of conferences, and that in fact, F2F time is ever more highly valued and sought after in this era of virtual relationships, but perhaps medicine is a special case?