Commentary

Why Professional Relationships Matter


 

An editorial in a recent issue of the Journal of the American Medical Association asked, Are medical conferences useful? The author concluded that we go to too many meetings, adding 10,000 tons of carbon to the environment for each moderate-sized meeting (JAMA 2012;307:1257-8).

I give the author credit for playing the environmental card – a card that a fellow from a green state like Oregon can’t dismiss – but the rest of the logic hardly stands.

It is argued that meetings preserve the status quo, serving as marketing platforms for pharma and device manufacturers while contributing little to science or practice, and that important findings can be released electronically without meeting presentation. The author misses the point that formal and informal discussion of the research findings is often more important than the presentation itself. Other reasons for attending meetings were completely opaque to the author. The editorial finishes with the question: "Are medical congresses dinosaurs doomed to become extinct?" This supposition feeds the common myth that meeting attendance is declining across the board.

I like to look at the data rather than accept dogma. I reviewed the attendance at three meetings I usually attend: the American College of Surgeons Clinical Congress, Digestive Disease Week, and the annual meeting of the American Surgical Association (ASA). Attendance at these meetings has remained constant over the past several years. There is little evidence that medical congresses are in danger of going extinct, unless we are overtaken by an Ice Age we cannot foresee. Even in countries where health care reform and reduced reimbursement have been the norm for decades, medical conferences are well attended.

The value of attending medical conferences is a blend of learning the science and practice of surgery, program and policy development (otherwise known as committee work), idea sharing, and relationship building. But how important is each of these? Here’s a little time-allocation exercise. When you attend a conference, how much time do you spend in the meeting rooms? How much time are you in the corridor, at the exhibits, or talking over a cup of coffee?

Rather than rely on my own experience to answer these questions, I conducted a straw poll at the recent ASA meeting. I found that most surgeons spend about 30% of their time in the meeting sessions, 20% of their time in committee and board meetings, and 50% of their time talking over coffee, over a drink, over dinner, or on the golf course. Eager for information, younger surgeons spend more time in the meeting rooms. Eager to learn through direct conversations and to re-establish friendships, older surgeons are more likely to converse outside the meeting rooms.

Why is this important? Your colleagues who don’t go to national meetings say that they can get all the new information they need from the Internet, journals, and local lectures and conferences. They are correct. What they can’t get is the face-to-face communication with a peer from across the country who may have some insights on problems that both are wrestling with close to home. The science of relationships is very similar to the science of societies. By living and working closely with each other, we all get smarter, and better solutions are developed in this manner than by individuals sitting behind their computers designing the next video game or mining the Internet for insight.

When the work product of a group is calculated, adding the IQs of the participants together underestimates the intellectual power of the group. This phenomenon has been termed "collective intelligence." The power of "groupthink" has been recognized in the science and technology sector for some time. For example, the Massachusetts Institute of Technology has a Center for Collective Intelligence, and new science is rarely funded by the National Institutes of Health these days without evidence that the aims of the project will be addressed through team science, which brings together diversity of training and intellect to focus on the problem at hand.

So what does collective intelligence have to do with a medical conference? The collective experience and wisdom of meeting attendees is amazingly helpful at deciphering which new findings are truly innovative and field changing and which are less likely to change our world. Upon returning from meetings and visits to other departments of surgery, I usually catalog one or two changes to my practice, or new thoughts for questions that need answering, that have been inspired by a meeting conversation or a scientific discussion. Most of our good papers have come from such inspiration.

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