Are overseas meetings a better deal than they used to be? Maybe,but what physicians value most is the opportunity to consult with colleagues beyond borders.
As U.S. hotel rates go up, up, up, meeting space gets tighter, and contracts become increasingly restrictive, are international destinations becoming a better deal? If you compare costs and benefits, are planners and their attendees who go offshore getting greater value than they did a few years ago? And--does it matter? That is, how important are comparative costs to planners when it comes to site selection, and to physicians and other healthcare professionals when they're deciding whether or not to attend?
Extracting the greatest possible value for attendees out of an international meeting begins with the understanding that healthcare professionals' decisions to attend are,
in the words of one organizer, "multifactorial." Among those things considered in making the decision:
* Subject matter and speakers
* Opportunities for informal consults with colleagues representing a richer variety of perspectives than might be possible at a U.S.-based meeting
* Opportunities for personal travel, perhaps with family
* And, weighed against all these other considerations, the necessary investment in time and money
The good news is that conversations with several planners reveal that cost is but one criterion in site-selection and attendance decisions, and it is not high on the list. There are many compelling reasons to meet outside the U.S.--a well-sited meeting offers physicians so many professional and personal benefits, as listed above--that cost is seldom a top concern.
[For a general discussion of factors affecting a physician's decision to attend a meeting, see "Taking the Pulse: The Fourth Annual Physician Preferences Survey" in the January/February 1997 issue of Medical Meetings--and watch for the upcoming Fifth Annual Survey in the January/February 1998 issue.]
For medical conference organizers, the important factors for success, in addition to having an attractive conference program and a working knowledge of attendee travel preferences, include:
* Local counterparts to help with organization and logistics
* Knowledge of local medical resources
* An attractive destination with suitable infrastructure
* Willingness to negotiate hard for rates
They Come to Hear and See Topping the list of reasons to hold a medical meeting at an international location, say medical conference organizers, is the opportunity for U.S. attendees to interact with physicians from many countries--attendees who can more easily travel to Europe or Asia than to the U.S. And that networking enables U.S. physicians to stay on the cutting edge of medical developments worldwide.
Why is that so important? Partly because medical advances do indeed originate all around the world, and partly because of the anomaly of U.S. medical practice: a strong research capability coupled with a conservative approach to implementation. In other words, many treatments and procedures may have their experimental genesis in the U.S.--but have their first practical application elsewhere. And it is practical applications that most interest physicians, as adult learning theorists are always reminding us.
"Our people come to hear and see the science and interact with those causing the science to move forward," says Cordie Miller, meetings coordinator for the International Society for Magnetic Resonance in Medicine (ISMRM). "At an international site, they are exposed to how other countries are doing it." In 1998, the Berkeley, CA-based society will hold its first Pacific Rim meeting, in Sydney, Australia. "We expect more people from Korea, China, and Japan than have ever attended," Miller says.
"People today fly from all over the world to a hospital in the jungle in Brazil to learn about specialized heart surgery called the Batista Procedure," says Asher Kimchi, MD, associate clinical professor at the UCLA School of Medicine and founder and chairman of the International Academy of Cardiology (IAC), Los Angeles. But doctors first learned of the technique, he says, at a medical meeting. Cardiomyoplasty, a surgical procedure to support heart function developed in France and Russia, was unveiled at IAC's and L.I. Communications' first World Congress on Heart Failure, held in Jerusalem in 1989. "Unless you attend an international meeting, it could take you many more years to learn of these procedures," says Kimchi. "International interaction can speed up the transfer of knowledge."
The transfer, of course, works both ways. "Physicians can also benefit by receiving scientific recognition for themselves on an international level," says Kimchi.
Bringing the Family On the personal side, meetings outside the U.S. enable physicians to take a no-fuss trip to a desirable destination, often at a lower cost than they would pay if they traveled on their own. "They benefit from our homework--we plan for them," says independent planner Ann Boehme, CMP, president of Meetings & Management Techniques, Valley Stream, NY. "We get a group rate, there's a lot of security--we check very carefully--and we provide lists of restaurants or do a dine-around. All that is done for them." Another plus: "They can go with their family and get a partial tax write-off."
It worked that way when the International College of Angiology (ICA) met in Istanbul in July. "When we meet outside the U.S., we generally have 20 to 30 percent U.S. attendance," says executive director Denise M. Rossignol. "But many people had not been to Istanbul before, so we got 40 to 45 percent. And a lot of them came with their families."
European destinations are the draw for the International Society for the Study of the Lumbar Spine (ISSLS). "When we go to Europe, we have almost the same number of attendees from North America as when we meet in North America," says Edward N. Hanley, Jr., MD, chairman of the department of orthopedic surgery at the Carolinas Medical Center, Charlotte, NC, and secretary of ISSLS. "And we generally have more accompanying persons and families, so our total is larger."
Using Local Resources The initial concern when determining the feasibility of a particular destination for a conference is local membership. Rossignol notes that ICA selects "countries that are active in the society, where we have members who can be the local organizing committee." Because long-distance planning, with differences in time zones, language, and culture, can be difficult, the local organizing committee is a must.
Local members can assist with protocols as well. "They can send letters of invitation to scholars, to help with their entry," notes independent planner Audrey Bird, CMP, managing director of International Meeting Planners, an independent meeting planning firm based in New York City. "In the Eastern European countries, for example, it can be difficult to get visas. Local members can also help you gain entry to hospitals or special medical facilities, such as treatment centers."
Medical resources figure prominently, just as they do for meetings in the U.S. When Boehme was evaluating Budapest as a site, she says, "I discovered a clinic doing a type of research that was not being done in the U.S. That was not only beneficial to our meeting, it was almost crucial to our success."
Switzerland has particular value for certain meetings, Boehme notes. "Because the population is stable, you can track people from birth to age 18. If you're doing research and clinical programs, that justifies almost any expense."
Both the U.S. and Europe are being considered for a clinical investigative meeting now being organized by independent planner Chris Pentz, CMP, president of Pentz Group Communications, Levittown, PA (and current president of the Philadelphia chapter of Meeting Professionals International). There are test sites related to the subject matter in several locations. "But the meeting probably will be in Europe because there are more sites there," says Pentz.
Where Are the Best Deals? Eventually, of course, planners do consider costs. But they don't agree on where you'll find the better deal. There are infrastructure basics to consider: The site must be served by adequate direct or connecting flights from all areas from which attendees are likely to come. And there should be hotels at various price levels. In addition to the top-ranked hotels usually considered appropriate for U.S. physicians, planners seek moderate-priced hotels to accommodate attendees from countries where incomes are lower (see "International Attendees: Mixed Blessing," on page 42).
"Turkey was relatively inexpensive," says Rossignol. Rates at the Istanbul Hilton were $135 single, $155 double, including breakfast, VAT (value-added tax), and service. In 1994, at the Marriott Marquis in New York City, the rate was $185 before taxes.
"New York was our most expensive meeting, and that's local, without shipping conference material," says Rossignol, who is based on Long Island. "I shipped 27 boxes to Istanbul in June, it cost $700, and it was still cheaper.
"And a lot of hotels outside the U.S. offer more," she continues. "The Hilton gave us free basic AV--you never see that in the U.S."
But Rossignol has found hotel costs in Frankfurt, London, Paris, and Rome even higher than in New York, so she avoids those cities. "If a hotel room is over $200 a night, no one will go."
Overseas Rates: Good Deals . . . Europe is the more affordable choice for the International Conference on the Macrolides, Azalides, Streptogramins and Ketolides (ICMAS), says Ann Wallace, executive director of the society and president of Wallace Communications, Atlanta, a medical meeting planning firm that serves as the secretariat for ICMAS. The society, which meets in warm climates in January, has been to Venice and Lisbon and will meet in Barcelona in 1998.
"The most expensive hotel in Barcelona is $183 per night," says Wallace. "A lot of rooms are in the $100 range in gorgeous hotels. You can find that rate in the U.S., but not in gorgeous hotels, and not in a warm climate in January. I'm being pressed to choose a warm location in the U.S., but we can't afford it." Not only are the U.S. hotel rates too high, she says, but there's no flexibility, which she needs because people don't make their attendance decision until mid-October, the deadline for submitting abstracts for presentation at the meeting.
The ISSLS's Hanley, who holds meetings outside North America in alternate years, agrees. Meetings in international destinations are more costly, he insists, "Only if you don't know what you're doing or get taken advantage of. Our costs, including hotel and function costs, are generally in the same range regardless of where we meet. Posted rates are high. But when you negotiate, a hotel rate in Singapore is no different from a comparable hotel in the U.S." (ISSLS met at the Shangri-La Hotel in Singapore in June.)
. . . Or a License to Steal? Other planners, however, say that Europe and Asia can be more expensive than the U.S., or give you less for your money. Bird is currently pricing hotels in three Asian destinations for an upcoming meeting. "Hotels are expensive in Seoul because the number of rooms is controlled," she reports. "Hong Kong is through the roof. Singapore is probably the most economical."
But she was stunned by prices she encountered on a recent site-inspection trip to London. Five-star properties were about $328 per night at current exchange rates. At Grosvenor House, the concierge level was $492 to $656. At still another hotel, the meeting room-rental rate was $1,640, cost for audiovisual construction was $13,120, and the daily delegate rate, which included lunch and a coffee break, was $106.60. But here's the kicker: The meeting room accommodates 100 people, classroom-style, and Bird's group has 40 people. "But they charge the daily delegate rate for the people who wouldn't be there," she says. That is, they charge for the full capacity of the room. "And there's no negotiation--it doesn't matter how much food and beverage there is, or how many sleeping rooms you use."
Pay more, get less seems to sum up the international experience of ISMRM, which meets outside North America every three years. The society was in New York City in 1996 and in Vancouver, BC, this year.
The rate at one five-star hotel in Sydney, next year's destination, is $205 per night. "The room is clean and nice but it doesn't have amenities--I'm not getting value for my dollar," says Miller. She also finds that most overseas hotels designated five-star would be considered four-star in the U.S. "The Sheraton in Sydney is part of their Luxury Collection and is stunning--just what I expected. But if you're not dealing with an international brand, there are lesser amenities."
Miller's experience with contract negotiation is similar to Bird's. "Contracts may not be as stiff as in the U.S., but their willingness to make concessions is less," she finds. "The comp policy might be one room per 25, but with a maximum of two comp rooms. In the U.S., concessions are never capped like that." Hotel costs and concessions are important to the society because "we pay for board members and staff."
As for other costs, "Convention center rental is significantly higher outside North America, but audiovisual and catering costs are comparable." But Miller cautions against generalizing when comparing sites within and without North America. "Even in the U.S., when you compare New York City and Denver, you find very different situations."
Air Rates--Do Group Fares Work? Airfares are another piece of the cost equation. But Hanley doesn't believe that they are significant at decision-making time. When he mentioned that the number of U.S. attendees is as much as two-thirds lower at his group's meetings in Asia than at meetings in Europe, he cited travel time, not cost, as the reason. "It's multifactorial," says Hanley. "Some people don't want to travel there because they're not adventurous. Others don't want to go because of the length of the air travel, not the cost. Over the last five years, the cost to fly to Europe has been about $800 to $1,200 in coach, and $2,500-$3,000 in business class. To Asia, it's $1,200 coach and $4,000 business class." Those are not significant differentials, he says.
But what about group fares or special rates? Planners agree that group airfares don't work for physicians, who want flexibility. "Group airfares are based on moving a group from point A to point B," says Wallace. "They're for incentives. Our attendees want to come early, come late, go to Paris first, or whatever."
Pentz notes that "Europeans are more used to group fares. If there's a world congress, they'll do the hotel, registration, and airfare all in one package. U.S. physicians probably would not travel on a charter flight--they're very much in control of their time. But they would enjoy special rates on a preferred carrier."
Miller certainly hopes that's true. For her upcoming meeting in Sydney, the official carrier, Air New Zealand, is offering special fares worldwide. "I hope U.S. attendees use the official airline," she says. "Air New Zealand leaves from Los Angeles, but it's in partnership with United, and the add-on fares from the eastern U.S. are very reasonable. People might use another airline because they have frequent-flyer miles," she acknowledges. "But we hope we've created a favorable situation for them." Costs do limit U.S. attendance at Miller's meetings. "A lot of people travel on grants or on their own money," she explains.
Keeping an International Focus As she goes through this cost-benefit
balancing act, Miller emphasizes that any
society that calls itself international must live up to its name. "When we meet in the U.S., we have to look at the costs for,
say, attendees from Japan. We can't alienate any group. We're an international
society."
Ultimately, however, "For medical meetings, cost is not the most important factor," says Bird. "People look first at when it is--are they free to go? Then they look at the subject matter, the presenters, what it offers in terms of interacting with their professional counterparts. The last thing they look at is the price. It could be such a dynamite program, they don't care if they have to go to Timbuktu."
The international attendees who contribute so much to the experience of U.S. physicians attending an international meeting also have a major impact on meeting planners. Because of them, "Your budget gets shot," says Ann Boehme, CMP, president of Meetings & Management Techniques, Valley Stream, NY. When Boehme planned a meeting for vascular surgeons in Seoul, South Korea, her budget was based on a $350 per person registration fee. But she learned that although U.S. physicians could afford that, physicians from some other countries could not because their incomes are so much lower. "In China, some physicians earn only $60 per month," she says. "So I needed other ways to bring in revenue, for example, exhibits and sponsorships."
Certainly, local attendees can boost meeting revenue. "If we anticipate that 250 members will attend, and another 200 local people attend, that would defray our costs," says Edward N. Hanley, MD, chairman of the department of orthopedic surgery at the Carolinas Medical Center, Charlotte, NC, and secretary of the International Society for the Study of the Lumbar Spine (ISSLS). But, he says, ISSLS provides several types of assistance to local attendees whose funds are limited. In "truly deprived" countries, the society pays all travel costs for a few attendees. Also, a discounted fee is offered to nonmember physicians in areas of the world where the meeting is held. In addition, ISSLS often combines its meeting with a two-day instructional course, which costs about $100 versus $500 for the scientific meeting, and is well attended. Another planner reports that for attendees from Third World countries there is a lower registration rate, though it is not heavily promoted. Although medical societies want to ease the financial burden for low-income attendees, they must impose limits. Otherwise, they'll create their own budget crises.
