Ronald G. Evens, MD, is professor emeritus of radiology at Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri. Dr. Evens received his medical degree from Washington University in 1964. In 1971, he was appointed director of the Mallinckrodt Institute of Radiology, and during his 28-year tenure, Mallinckrodt became one of the most renowned radiology departments in the world. He served as president of St. Louis Children’s Hospital from 1985 to 1988 and of Barnes-Jewish Hospital from 1999 to 2005. He has contributed to radiology literature by writing more than 250 articles and books and has served as president of several highly regarded radiology organizations.
Pandemics, defined as a disease prevalent over a whole country or the world, have substantial short- and long-term consequences that are dependent on a variety of factors. Critical factors determining overall consequences include the severity of the disease, duration and geographic extent of the pandemic, the ability to limit or at least control the disease, and resultant impact on other key aspects of society, such as the economy.
The COVID-19 pandemic has produced unprecedented world-wide spread with increasing fatalities and a range of severe medical complications for survivors. As I write this editorial (in mid-April, 2020) on the impact of COVID-19 on major professional meetings, such as the RSNA Annual Meeting in Chicago and other large conferences planned for fall and winter of 2020, it is difficult to predict the state of individual and public health and the world economy later this year. However, safety recommendations for public and personal health, as well as the extent of economic recovery will clearly be major determinants of consequences for major professional meetings.
Professional societies and organizations sponsor meetings to accomplish and promote many goals, primarily focusing on Education and Research. Other important goals include policy making, career and personal skill development, marketing by vendors of equipment and new technologies, as well as interacting with colleagues at the meeting itself and associated social events. Professional meetings serve as focal points for professional societies, not only as sources of revenue, but also for recruitment of new members. In addition, national meetings act as major drivers of regional economies for a host city because the meeting “community” encompasses meeting planners, attendees, convention centers, hotels, restaurants, transportation, and more. For example, cancellation of the annual meeting of the American Chemical Society in Philadelphia, a meeting with approximately 15,000 attendees, likely resulted in loss of more than $30 million to the city.
The short-term impact of COVID-19 is already apparent as organizations canceled essentially every national and international meeting, extending well beyond the scope of Radiology and cancer imaging, for the spring and summer. Many meetings were canceled for the first time ever in the history of an organization. Cancellations occurred long after organizations and cities had completed preparations for a meeting. Most participants also had paid fees for registration and costs of travel. The timetable for when to cancel or resume future meetings remains uncertain. I know that Washington University has already canceled many meetings and events through the month of September.
As the world collectively emerges from the short-term restrictions and impact of COVID-19, participants in professional meetings will face new sets of considerations, challenges, and realities moving forward. My goal is to consider issues related to the goals of professional meetings in the long term.
1. Education and Research—Challenges to education and research programs extend far beyond professional meetings. Most readers will have a personal understanding of the challenges when an educational program is dramatically changed by following shelter in place and social distancing rules. Grade and high school students are working at home, and college students are participating in courses online. I predict a major review of the importance of the classroom setting and “face-to-face” instruction, particularly at higher levels of education. Many college courses are already online with generally favorable reviews. Online education costs considerably less than “face-to-face” classrooms and lecture halls, which extends to reductions in tuition and other expenses (housing, travel, etc). The same cost-benefit factors and considerations will impact professional meetings, and it is likely that there will be fewer participants, fewer meetings, and probably fewer societies.
2. Policy Making--This is a major mission of a few organizations (such as The American College of Radiology). Can this be effectively performed by video conferencing? My experience with video conferencing (e.g. Zoom) has been very positive. Some suggest that video conferencing produces shorter, yet more effective and focused discussions.
3. Personal Skills and Career Development--These goals are often highly specific to individuals. I suggest that most personal skill development programs are best carried out at smaller events or programs at a university and represent a small part of national meetings of professional organizations. Career development presents a more complicated issue. I know that my career was heavily influenced by participation in national meetings and their sponsoring organizations, but this aspect of a national meeting likely is important to a small number of radiologists. If gathering restrictions continue (e.g. restrictions of gatherings of 50 people or more), larger organizations may be able to plan smaller satellite meetings to help professionals work on specific skill sets or networking for career development.
4. Marketing and Sales—This certainly is an important consideration for major national and international meetings such as the RSNA Annual Meeting (just spend some time on the Exhibit floors!) but a much smaller factor in most meetings. I started attending meetings in the 1970s, when almost all annual events had an equipment exhibit. However, economics in the 1980s forced companies to concentrate on a few large and national and international meetings. I predict that economics will prevail again and future professional meetings will have fewer and smaller exhibits with the need for less floor space.
5. Meeting Colleagues and Attending Social Events—Interactions with colleagues at the meeting itself and social events held in conjunction with the meeting represent one of the most important “soft” missions of a national or international professional meeting. Meetings provide the opportunity to “catch-up” with known colleagues. Perhaps of even greater value, meetings are a venue for “chance” meetings with new colleagues who may become valued collaborators, co-workers, and/or mentors. While regarded as a highly valued part of a professional meeting, this “soft” mission is hard to evaluate. Relationships with some of my best friends and colleagues began at a major professional meeting. The Annual Meeting of the Mallinckrodt Institute Alumni at the RSNA Annual Meeting is one of the highlights of my year. But to be successful, colleagues must be there. Video conferencing cannot provide this experience. The longterm impact of this “soft” but important part of professional meetings will continue so long as the meeting continues.
The current pandemic will have a major impact on all major professional meetings, not just in Radiology and cancer imaging. The extent and duration of this impact remains difficult to assess and quantify at this time. The impact will be easier to predict once this pandemic has some degree of “control”. The extent of the harm on personal health, public health, the profession of radiology, the field of cancer imaging, the economy, and economic impact on meeting participants and host venues are all areas that must be assessed by each sponsor of a professional meeting. The optimist would predict that the world will be back to “normal” in a few weeks or months, a successful vaccine and treatment will be developed soon, and the economy will be back on a positive growth rate shortly afterwards. In my view, this optimistic scenario will not happen.
More likely what will occur is that the COVID-19 pandemic will slow, however it will remain a threat that will force tough decisions regarding when and to what extent to change the current rules of personal and business conduct. No matter how fast (or slow) the world moves towards “normal”, professional meetings will be impacted. Some educational activities will move online. Attendance will likely fall due to factors including an increased opportunity for online education, a forced re-evaluation of the value/cost ratio of attending a national meeting for several days, the dramatic impact of the economic downturn, and anticipated slow recovery on medical institutions, universities, imaging departments and centers, and professionals in clinical imaging and imaging research.
Even when this pandemic is over, important considerations will remain for professionals in imaging and other fields. Persons will more closely evaluate the value of attending a professional meeting and likely reduce the number of meetings attended each year. Is “inperson” attendance necessary with the availability of video conferencing and local educational sources, particularly as professional meetings expand on initial successes with virtual participation? This evaluation will differ for academic versus private institutions and groups. The world-wide economy will not recover immediately, resulting in tighter budgets for staffing and less money for travel to meetings by persons at medical centers, universities, and industry. How many sales personnel, administrators, faculty, technicians, and trainees need to attend a meeting in person? How much exhibit space and overall size of meeting venue really are needed? How many restaurant dinners are scheduled?
Professional meetings will still meet many key objectives but will be different in size and scope. The most successful societies and organizations will be planning ahead not just for the next meeting, but how to adapt and evolve their meeting format over the next decades.
I close with my advice to the current leaders of organizations sponsoring major national and international professional meetings:
■ Plan for the long-term starting right now.
■ Recognize that the impact of this pandemic is not just short-term. Major decisions to address include determining if a currently planned meeting should continue as scheduled, and equally important, how to refine future meetings for the new professional landscape.
■ Evaluate what is important (and not important) about the current list of society missions and activities at a meeting.
■ Identify the important participants and stakeholders for your meeting (radiologists, technicians, scientists, physicists, vendors, society staff, etc.) and get their input about priorities.
■ Review your revenues (meeting, dues, subscriptions, contributions) and expenses and evaluate their importance to the meeting and missions.
■ Make the hard decisions regarding viability in the future with reduced attendance by 10%, 20%, or more.
BE PREPARED is more than the Motto of the Boy Scouts. It is wise advice for organizations.
Let's make this pandemic more than just another crisis we survive. We can use lessons from the pandemic to improve our professional meetings and make our field stronger in the long run.