You think you've got problems? Imagine seeing the group that constituted 80 percent of the attendee base at your trade show suddenly become 50 percent. Now imagine continuing to grow your attendance without a hitch. Here's how the crew at SEMCO stay on top of their show.

*READER'S ROI * As the structure of healthcare changes, so does the composition of your audience.

* Exhibitors are a great informational resource about the marketplace.

* If your educational program is worth paying for, you don't need commercial support.

Don't talk to Mark Simmering about the impact of managed care. He's already been there, done that.

"Our core attendee base, from the show's inception [in 1980] to 1993 or 1994, was independent home healthcare dealers," says Mark Simmering, executive vice president and chief operating officer of Atlanta-based SEMCO Productions, operators of the Medtrade medical products trade show. "They were 80 percent of our attendees; we knew that they sent 2.5 people per physical location, and so on. The show had been developed for, and tailored to, that group."

But a variety of audience-analysis techniques--attendee surveys, telemarketing, Point of View on-site polling machines, careful review of categories checked on registration forms--uncovered major changes. Although the audience was growing, dealers accounted for only 50 percent of the total.

A key reason for the shift was that under managed care, hospitals were pressured to release patients sooner, often to sub-acute care facilities. "Medical equipment is now used in nursing homes, long-term care facilities, and hospices," says Edward C. "Ted" Conrad, SEMCO's president and chief executive officer. Consequently, a wide range of decision-makers and -influencers attends. Today, attendee categories include dealer/supplier, hospital buyer, pharmacy buyer, discharge planner, doctor, rehab professional, and service technician.

Embarrassed No More The Medtrade show held at the Ernest N. Morial Convention Center in New Orleans October 7 to 10 is directly descended from the 1980 DME (Durable Medical Equipment) Industry Trade Show, but it barely resembles its ancestor. Responding to market changes, the show organizers today solicit a much broader range of exhibitors and attendees and have added a co-located show for pre-owned capital medical equipment, reshaped the seminar program, and developed intensive conferences on managed care and wound care.

The result is a blockbuster event where 1,200 manufacturers exhibit 250,000 medical products and services to some 40,000 registrants (including exhibitor personnel) from 100-plus countries. By those measures, it is the country's largest medical products show. However, according to industry publication Tradeshow Week, the RSNA (Radiological Society of North America) Scientific Assembly & Annual Meeting is larger in terms of net square feet--389,520 in 1996, versus 321,110 for Medtrade. Last year RSNA had 631 exhibiting companies and 27,250 attendees (not including exhibitor personnel).

The original DME show had 79 exhibit booths tucked into a corner of one hall at the Georgia World Congress Center (GWCC) in Atlanta, and attracted a mere 400 attendees. "We were embarrassed," says Conrad.

He's not embarrassed anymore. Medtrade moved to New Orleans this year because it has outgrown the GWCC--it needed more contiguous exhibit space. The show has achieved international stature and is going abroad. Medtrade Europe will be held in Luxembourg, April 1 to 3, 1998. And there will be a Medtrade Africa pavilion at the South African International Trade Exhibition in Johannesburg, October 6 to 10, 1998.

But what made SEMCO plunge into this market in the first place?

The Potential of Wish-Fulfillment An off-the-cuff remark plus thorough research indicated the need for such a show. Also, SEMCO had a gap in its own "product line." The company focused on leisure shows, which are cyclical. "We wanted something more stable," says Conrad.

As Conrad tells it, a medical products marketer who had married a former SEMCO employee happened to attend a SEMCO-produced boat show and commented, "I wish there was a show like this for our industry." Alert to the profit potential in wish-fulfillment, Conrad dispatched his advertising director on a fact-finding trip.

That research revealed that there was no show for home healthcare equipment dealers, whose products were mainly sickbeds, walkers, and wheelchairs. "Those dealers went to surgical or hospital shows, where they were treated like stepchildren," Conrad recalls.

Accu-Back, Inc., which sells ergonomically designed pillows and support belts to dealers and distributors, exhibited in the 1980 show. "Every state had its own show--the industry was hurting for a national show," explains Robert M. Ross, president of the Costa Mesa, CA, company. "We're a West Coast company, and I needed East Coast exposure." Today, Ross is still getting that exposure. Not only does he write a lot of business, he says, but also "it's an opportunity to educate the professionals who can recommend our products."

In the DME show's second year, the name was changed, for clarity, to National Home Health Care Exposition. But as the event expanded to include sub-acute care facilities, and international attendance grew, the name became inadequate. In 1992, it was changed to Medtrade.

The change in audience composition has been "the most definitive factor" in refocusing the show, says Simmering. By seeking more buyers in the new categories, management provided exhibitors with increased sales opportunities.

Help from Exhibitors Exhibitors also help management redirect its attendee promotion efforts, Simmering notes. "During the sales process, exhibitors ask, 'How many of X buyers do you have? That's who I want to meet.' " Account executives then can pass that intelligence on to show management.

Product lines were changing, too. "We've kept abreast of the products the end-user needs," says J. Christopher Corsbie, director of marketing. "In some areas, especially asthma and other respiratory illnesses, there has been significant growth in the products and services available. The message of what the end-user needs is carried to the show by the dealers who represent those products." Product proliferation is a plus for Arnoldus A. J. van der Steen, an importer from Steimel, Germany, attending Medtrade for the second time. Why Medtrade, with Dusseldorf's Medica and Hanover's Interhospital so much closer? "It's important for me to see new products," he says emphatically. "If it's already in Germany, it's too late for me."

Also appreciative of the show's expansion is Meir Raskas, president of Advanced Medical Concepts, Pikesville, MD, a rehabilitation medical equipment dealer. "Diversification allows us to do one-stop shopping versus having to go to several shows," says Raskas. "We found some fairly new products and negotiated some strong contracts."

Breadth of exhibits attracted first-time attendee Catherine Graham, product specialist for Delta Medical Concepts, Inc., Butler, PA, a "post-mastectomy boutique." Says Graham, "The manufacturers' reps we talk to recommend Medtrade. It's more all-inclusive than any other show."

Conrad himself plays a pivotal role in keeping the show attuned to its markets. "I'm the R&D center of SEMCO," he quips. He subscribes to 250 publications per month and seven newspapers a day.

Focus Area Vs. Co-Located Show As Medtrade grew, some products were grouped into focus areas. But exhibitors who preferred not to be with all their competitors could opt out. Several focus areas, including respiratory, pediatric rehab, sports medicine, and Comtrade--computer and automation technology--are identified on the floor plan and with on-site overhead signs. Separate direct mail pieces promote new focus areas, for example, the Test Kit/Diagnostics Expo, which debuted this year. Test kits for blood glucose, drug abuse, pregnancy, and HIV were shown.

"The test kit market numbers are staggering," says Corsbie. Consumers like home test kits because they offer convenience, low cost, and privacy. And the kits appeal to dealers and pharmacists because they are cash-and-carry products, not Medicare or Medicaid reimbursables.

"If a product line appeals to the core attendee, it's a focus area," Simmering explains. "But if it's targeted at a different attendee base, it's a co-located show." This year SEMCO launched the co-

located MedResell, displaying pre-owned capital medical equipment, and promoted it with a mailing to likely prospects. Exhibits included diagnostics and radiology equipment; ambulances and emergency power systems might be added next year. MedResell had its own seminar program, held adjacent to the exhibit floor. And the International Association of Medical Equipment Remarketers endorsed Med-

Resell by holding its annual fall meeting there.

Who Buys Used Ultrasound Scanners? "There's a much greater interest in pre-owned equipment today," says Corsbie. "You can get wonderful equipment at a fraction of the price of new. It's of interest to hospitals and clinics. And we have a high percentage of international attendees, some of whom might even want to outfit an entire hospital."

Agreement is voiced by Frances Lee, international trade specialist with the U.S. Department of Commerce's International Buyer Program, which annually supports about 20 shows by promoting international attendance. "Medtrade is recognized as a world-class event that is drawing increasing numbers of international buyers," says Lee. "MedResell offers the opportunity for buyers, especially from emerging markets, to purchase more on a limited budget."

Among the 27 exhibitors at MedResell was GE Medical Systems, Milwaukee, showing its Gold Seal brand ultrasound scanner, mammography system, and computed tomography system. MedResell is the "first show of this kind" to target pre-owned medical equipment, says Global Gold Seal manager James D. Ficke. Because the Department of Commerce supports the show, and New Orleans "tends to draw Latin Americans on their vacations," Ficke was expecting Latin American attendees. "Our focus here is international," he said. "For domestic, I'll be at RSNA."

Also exhibiting was Medical Equipment Company, Winnetka, IL, with medical lasers and ultrasound equipment. The company was seeking exposure to "purchasing people from hospital networks, brokers, and dealers," said operations manager Steven Seltzer. But he considered MedResell "a hard mix with home health care." Still, he'd had "good conversations" with about 15 attendees that morning. "If I can get one solid lead, I'll be happy."

Attendance was light at MedResell, but this was only its first year, and it was away from the main traffic pattern. The humble beginnings of Medtrade itself demonstrate the risk of drawing premature conclusions.

Free Seminars, Paid Conferences As the exhibitor and attendee bases evolve, the Medtrade educational program must keep pace. About 70 percent of the 300 free seminars relate to business operations. Other areas of growing interest are fraud and abuse, and legal and ethical issues.

"All topics are based on attendee feedback and the pulse of the industry," says director of education Louis C. Feuer, MA, MSW, himself a frequent speaker on healthcare topics. Keeping a finger on that pulse involves reading countless industry journals and attending healthcare shows worldwide.

Because most seminars cover operational, not clinical, topics, few offer educational credit. Sessions often are sponsored by exhibitors, who recommend speakers. Nevertheless, Feuer keeps a tight rein. Every prospective speaker must submit an application that gives his or her credentials and states learning objectives. "If it smells like a sales call, it's rejected," says Feuer.

Besides the seminars, there were two intensive conferences. The Fourth Annual Managed Care Conference, a full-day program, had 250 preregistrants, including attendees from Nigeria, Japan, Germany, and South America.

New this year was the two-day Wound Care Conference. According to conference medical director Tamara D. Fishman, DPM, a podiatric physician and chief executive officer of the Wound Care Institute, 15 percent of all diabetic patients will develop a foot ulcer. Of those, 20 percent will undergo amputation, but 50 percent of them can be saved through the advances in wound care.

But physicians won't necessarily gain new knowledge if they learn only within their own hospitals--what Fishman calls "incest learning." Thus this conference. Because the need is global, she adds, "what better forum than Medtrade [with its] international interaction?"

Educators Promote, Too Fishman and the Miami Beach-based Wound Care Institute helped promote the conference and Medtrade itself. "The Wound Care Institute has a Medtrade section in each of its newsletters, and we've done bulk mailings," says Fishman. "I supplied Medtrade with disks for mailing to our membership base. And we marketed it ourselves by fax, e-mail, and on the Internet." Fishman anticipated 75 to 100 attendees at this first conference. But thanks to the extensive marketing efforts, attendance exceeded 200.

Although the seminars are free, the fee for the one-day Managed Care Conference is $195 and for the two-day Wound Care Conference, $325. How are the fees justified to attendees?

Says Feuer, "We have to charge. We organize these conferences; cover speakers' hotel costs and sometimes their airfare; and provide breaks, lunch, and a program book." That's very different from the seminars where speakers are sponsored by exhibitors or even self-sponsored. If attendees protest the perceived inequity, "We tell them we're considering whether we can continue to give away 300 free seminars."

Staying in Focus Next year a "very diverse financial conference" will be added, says Conrad. "There is a great need for capital in health care. And the financial problem is global, not just in the United States."

Also, Medtrade management next year will announce Diabetes 99, an expanded version of the Wound Care Conference, with workshops and exhibits.

With constant diversification of exhibitors, attendees, and the educational program, does Medtrade risk losing focus?

"There's always a risk," says Conrad. "But as long as we keep asking questions and finding out what's new, as long as we bring exhibitors more buyers and show

attendees more products, we're fairly

safe."

Tom Fitzgerald thinks so. Fitzgerald is president of VGM Group, Waterloo, IA, a home medical equipment buying group that has exhibited at Medtrade since 1987, increasing its space from 10-feet-by-20-feet to 50-feet-by-50-feet. "The industry has changed," he says, "and this show has changed to meet the needs of the people who come."

Medtrade management has an innovative approach to boosting attendance: encourage groups that meet concurrently with Medtrade to bring their meetings to the show.

One such meeting is the Life Care Planning conference, held last year at a hotel. "I told their planner they could use our hotel room blocks, our negotiated rate, and our shuttle buses if they moved their meeting to the convention center," says Louis C. Feuer, MA, MSW, director of education for Medtrade. This year, the two-day conference was held at the convention center, and "we've added 300 potential attendees to the show."

Feuer notes that as education became a major reason for attending Medtrade, many groups brought their meetings to the city, but not necessarily to the exhibit floor. Now, "we try to bring in as many of those ancillary groups as possible." About 85 associations and medical groups, including equipment dealers, nursing agencies, and home healthcare organizations, held their meetings at the convention center this year.

When a rapidly growing show relocates after 17 years in one city, housing presents some challenges.

Obtaining the required room blocks has not been difficult, maintains Jane Malloy, housing manager for Destination Travel, Atlanta, who has handled Medtrade housing for about 15 years. "We have to show the hotels our numbers and our history," including the annual growth rate.

The greater concern was moving from Atlanta to New Orleans. "New Orleans doesn't have as many large convention hotels," Malloy notes, "so I had to use 40 hotels--about 15 more than we usually work with. And that means 15 more reservations managers. I hadn't worked with New Orleans hotels and didn't know what to expect. But they were good to deal with--very professional." Malloy booked the 39,000 room-nights she needed, and exhibitors had adequate room blocks, she says.

Malloy's success supports show management's decision to use a housing firm. "Doing housing in-house is intensive from a negotiation perspective," says Mark Simmering, executive vice president and chief operating officer of Medtrade producer SEMCO Productions.

"A housing firm that has a substantial presence typically has some influence."

Meanwhile, Simmering found that even though New Orleans usually pulls 5 percent to 10 percent more attendees for healthcare shows, "there was a lot of resistance from our exhibitors," partly because there were fewer hotels. To ease those fears, he says, "we had a fam trip for our top 40 exhibitors and let them meet with all the hotels." Exhibitors covered their own airfare, but the hotels housed and fed them. "The CVB was integral--they invested time and effort--this might even have been their idea," says Simmering. "Sallee Pavlovitch [associate director of sales] was wonderful."