Going Global - Really How three medical groups partnered to build overseas meetings for both American and international attendees.

Last February, the American Academy of Pediatrics held its first meeting in India, CME 2000, in collaboration with the Indian Academy of Pediatrics. Held in Mumbai (formerly Bombay), the conference drew 150 U.S. attendees and about 500 Indian physicians, along with local bureaucrats and government representatives - a major boost to AAP's visibility in India and the surrounding nations.

But the most dramatic news came afterwards, when the Indian Ministry of Health asked the president of the Indian Academy of Pediatrics to head a national task force on pediatric health issues. The Indian and U.S. pediatrics organizations will now continue to work together to improve children's health care in India, says Suzanne Ziemnik, director, division of CME, AAP, in Elk Grove Village, Ill.

The partnership is an outgrowth of the AAP's new goal of integrating international programs into its strategic plan. Rather than generate revenue, "We see the [overseas] meetings as a break-even situation," Ziemnik explains. The AAP aims to increase international participation at its annual meeting in the U.S., and to attract new members.

A Two-Year Courtship But creating partnerships overseas is a huge undertaking. "Unless you have a well-established relationship, you need a minimum of two years' lead time," she says. "There are time zone differences, communications barriers, currency differences. You need to develop financial agreements, identify faculty."

The dialogue between the two groups began about two years ago, when the AAP invited IAP leaders to its annual convention and held a mini-planning session with them. The IAP returned to the next annual convention for an update, and in the intervening months the two organizations communicated through numerous e-mails and conference calls.

To help prevent misunderstandings, the two groups forged an agreement, specifying the distribution of tasks and the financial arrangements. "We actually had no problem," says Ziemnik, adding that in the future, agreements could even be looser.

The AAP assumed the cost of marketing to U.S. attendees, and of travel-related costs for U.S. faculty and staff. The IAP assessed a registration fee for its members based on its expenses; then the AAP factored in its own costs and added them on to the registration fee for U.S. attendees.

The two societies also collaborated on commercial support, agreeing which companies, and who within those companies, would be approached, Ziemnik says. They decided to approach Johnson & Johnson, for example, because the company is interested in international outreach.

The program content was another reflection of the partnership between the organizations. "We didn't just walk into another country and plunk down our course. We collaboratively designed the program and utilized faculty from both countries," says Ziemnik. For example, the program included sessions on malaria, because, as Ziemnik explains, "It's a problem American doctors don't usually see, but Indian physicians do."

To expose U.S. physicians to health care realities in India, the IAP took attendees to grand rounds in local children's hospitals, and to orphanages. The field trips were one of the most popular aspects of the program, Ziemnik recalls - something she will plan more of in the AAP's next international venture.

Last fall AAP staff members met to define their international vision, set priorities, and coordinate efforts across departments. In addition to holding more conferences overseas, the AAP plans to market its publications and programs internationally, continue translating its journals, and launch more online initiatives.

As for meetings, one idea the AAP is considering, says Ziemnik, is taking a consortium approach, where instead of holding conferences country by country, it will do a live program in Europe one year, then in Asia the next, establishing regional, rather than national, relationships and agreements.

For Ziemnik, the payoff for the India meeting was personal as well as professional. She found her first trip to India "unbelievable and magical. It was incredible to see, as a staff person, the impact of what you do in a third-world country. It put things in perspective. I realized how fortunate we are. [Now] when I sit in a traffic jam, I think, `Oh, well. I have a car.'"

A True Exchange The Massachusetts Medical Society in Waltham also made its first overseas symposium a collaborative effort. In April, under the banner of its publication Journal Watch Women's Health (www.womenshealth2000.org), MMS held a one-day event at Le Carrousel du Louvre in Paris. Women's Health in the New Millennium drew about 750 attendees from 18 countries.

"Our objective is to change [medical practice] in both countries," says Mark Danderson, director, international business development, MMS. "This isn't about Americans telling the French how to practice women's health, but to exchange ideas so we'll learn something from the French that will change medicine here, and they will learn something from us."

Like the AAP program, the Paris symposium may have generated an ongoing international dialogue. Members of the World Health Organization attended the meeting and expressed an interest in working with the MMS, says Danderson.

France was chosen as the destination because "a lot of the global experts in women's health are in France," says Jennifer Goodwin, president of the Goodwin Group, the Jamaica Plain, Mass.-based communications company that managed the event. An effective collaboration takes a strong willingness on the part of organizers to learn about the other culture. Ten months into the 18-month planning process, the MMS brought in Goodwin because she could act as a bridge between the two countries. She is fluent in French and has lived in Paris.

To help with the faculty selection process, the MMS set up an advisory board, with members from both the U.S. and France. They chose 26 speakers, half from France and half from the U.S. The program brochure reflected the French-American partnership - each page had conference information in French and English.

More important, the format of the program reflected its dual cultural nature: Each session featured a French and U.S. physician addressing the same topic from their two different perspectives, comparing how hormone replacement therapy or breast cancer, for example, is handled in each country.

Meetings, Italian-Style The Cochrane Colloquium (www.cochrane.org) took a different approach to its recent international meeting. An organization with centers in 15 cities worldwide, Cochrane members analyze the results of clinical trials and evidence-based medicine. When the program planning committee hired Alice Daum-Coen, senior vice president, director of conferences and meetings, Corporate Consulting International, based in Street, Md., as senior conference manager for the VII International Cochrane Colloquium in Rome, they asked her to move - all the way to Italy.

Daum-Coen relocated to Milan, where the organizing committee was based, and lived there for six months - as the only non-Italian serving on the committee. The six-day Colloquium, held in October 1999, drew 1,100 attendees from 48 countries.

Daum-Coen was not fluent in the culture or language of the meeting destination. She took a crash course in Italian before she left; even so, she found diving into meeting management, Italian-style, was quite the challenge. The first thing she realized was she had to become an "instant flexible manager. I had to adapt not only my style and demeanor, but how I went about getting tasks completed," she says. "I learned very, very quickly never to need anything tomorrow."

"I was always anticipating [what needed to be done. In the U.S.] we're a deadline-driven society. We understand the printer is waiting. In that culture, you negotiate with the printer."

Before going to Italy, Daum-Coen tapped the expertise of U.S. planners. "I am active in Meeting Professionals International. I feel comfortable asking colleagues about things I need to be aware of. The single biggest thing planners need to understand is, sometimes it's better to ask the questions than to always do the talking. Become as conversant as you possibly can in that culture. Don't try to go against the flow."