THIS YEAR'S SURVEY is a tale of shifting demographics, with implications for the marketing strategies of CME providers. To set the scene, we begin with two sets of data from the American Medical Association, in addition to our own survey results.
Between 1990 and 2000, the number of female physicians increased by 87.6 percent. This should come as no surprise; the MM survey has reflected this growth year to year. When we first published this survey in 1994, 17 percent of respondents were female. This year, 26.4 percent of respondents are female. They are also younger than the total physician population — 58 percent of female respondents are under the age of 45, with the average age 44 for women, compared to 52 for men. And they are less willing to travel than their male counterparts.
The second set of AMA data: The proportion of physicians over the age of 65 grew by 15 percent between 1990 and 2000. There are now more physicians over the age of 65 than ever before. (Our age groupings are different from the AMA's — our oldest age category is “older than 55.”) Older physicians obtain more hours of CME than their younger counterparts, and are more likely to travel to attend CME meetings. Specifically, they earned 48.3 hours of CME in the 12 months prior to the survey, more than the overall average of 46.8 hours. They comprise 38.5 percent of all those respondents who attended two or more CME meetings requiring travel in the past 12 months.
What this means is that for the very near future, there are more physicians than ever before who are an identifiable group with a predisposition to travel to attend CME meetings. This is good news for CME providers who plan out-of-town meetings.
A second point about these data is that there are a couple of big questions that need to be answered, questions which are beyond the scope of this study. First, will this cohort of older physicians continue to grow as a percentage of the total physician population? A physician who is 55 years old in January 2003 was born in 1947 or 1948 — the early days of the baby boom. How many more will be coming up behind them? Second, will physicians of this generation remain in active practice longer than preceding generations?
Back to the present: It turns out, in fact, that physicians under the age of 45 have somewhat similar concerns, regardless of gender, when it comes to attending out-of-town CME meetings. Thus, we're concentrating in this survey on the preferences of physicians under the age of 45, and physicians who are women.
In general, physicians still obtain more hours — 37.4 percent of total CME hours earned — by attending out-of-town meetings than by any other means. But that's a far cry from 1997, when they earned 45 percent of their CME hours by traveling to meetings. Part of the reason for that steady decline is the increase in female and under-45 physicians, each of whom are less likely to travel to obtain CME.
For the first time since we began measuring gender differences, women as a group obtained more CME by attending local meetings (33.1 percent of their CME hours) than they did by attending out-of-town meetings (31.6 percent).
Physicians under the age of 45 — regardless of gender — still obtained a higher percentage of CME hours by attending out-of-town meetings (32.2 percent) than by attending local meetings (30.9 percent), but just barely. (See chart on page 34.)
One distressing trend continues. As the options for obtaining CME increase, physicians are earning fewer and fewer Category 1 CME credits. This is the sixth year in which credit hours earned have declined, and the trend seems to be accelerating. In 2000, the average respondent earned 63.7 hours; in 2001, it was 50.8 hours; in 2002, 49.4 hours; and this year the average number of Category 1 (or equivalent) hours earned has dropped to an average of 46.8 hours. That is a very large decrease in a fairly short timespan, and seems to indicate that alarm bells should be ringing at the highest levels of CME administration.
Destination: Deciding Factor
As has been the case in previous years, women physicians rate every factor affecting the decision to attend an out-of-town CME meeting higher than the general respondent sample. (See chart on page 30.) This year, physicians under the age of 45, regardless of gender, also rate every factor higher.
While respondents overall list location, length (time away from home and practice), speaker reputation, and meeting date first, both women and under-45s list location, length, speaker, and the inability to find local CME to meet their educational needs first.
Note that even though women and under-45s rank the reputation of the sponsor lower than the general respondent sample, the absolute numbers are higher.
Impact of 9/11
Last year's survey was in the mail when the September 11 terrorist attacks occurred. We did a small amount of re-surveying at the time. This year, we were able to ask questions in a more deliberate manner, and the results are both good and not so good. The good is that overall, 62.8 percent of respondents said they made no changes in their CME travel plans as a result of 9/11. The not-so-good news is that 30.4 percent of respondents indicate they are either choosing local meetings over out-of-town meetings, or attending fewer out-of-town meetings.
Asked whether they'd be willing to attend a CME meeting in a foreign country, just over half of all respondents said they would, and women were slightly more willing than the total respondent sample. A reminder to CME providers: In the very first survey, published in 1994, only 9 percent of respondents indicated that they would travel overseas for CME.
New York Sympathy Vote?
As usual, California and Florida remain the top domestic destination choices for physicians. (See chart on page 32.) However, the selection of California in particular may not say as much about the attractiveness of the destination as it does that there are simply more physicians in California than anywhere else, and that they have an affiliation for their home state. What is interesting is the stronger than usual third-place finish of New York. It is impossible to know whether this represents a sympathy vote for the city that suffered by far the greatest losses in the 9/11 attacks or whether it has simply been a matter of the amount of media exposure New York City received since the terrorist attacks.
After absences last year, Hawaii, Texas, and Louisiana are back in the top ten. Note the one-two showing of North Carolina and South Carolina and the continued presence of Washington State, as opposed to Washington, D.C.
Vive La France, Even More
Respondents were asked to write in their preferred international destinations. As mentioned in previous surveys, as the number of women in the sample group increases, so does the preference for France and/or Paris. In fact, when the “France” and “Paris” mentions are combined, they equal 48 mentions, while “London” and “England get a combined 34 mentions.
While both Canada and Mexico finish in the top 10 preferred destinations, all the rest are European: Italy, Germany, and Spain. There were also 17 mentions of “Europe.” In years past, when respondents were prompted with actual place names, Australia and the Caribbean finished higher. Do U.S. physicians have more top-of-mind awareness of European destinations?
Conference Centers Win
After years of following behind resorts and hotels, conference centers have become the No. 1 choice of respondents — in large part because so many under-45 physicians (57.9 percent) prefer them. It may be that this demographic group's utilitarian preferences (their concerns about time and their willingness to travel to attend meetings on topics they can't find near home) fit better with venues that are designed for learning experiences.
Hotels and resorts were the second and third preferred venues for the entire survey sample, but they were the first and second choices for women physicians. In a similar case, restaurants were ranked as the fifth-most-desirable venue by the entire survey sample, but fourth by women and under-45s. This is the second time in as many years that the restaurant option got so much positive response.
Note also that while only 10 percent of total respondents indicate a preference for meeting on cruise ships, down slightly from a year ago, that percentage is still far higher than it was when it first appeared on our survey in 1997 as the preferred venue of 2 percent of respondents.
Younger Docs Plan Ahead
Of total respondents, 67.4 percent say they need nine weeks or more to plan attendance at an out-of-town CME meeting. Among under-45 physicians, 69.5 percent say they need nine weeks or more. This compares with 62.2 percent of women (obviously more organized than their male counterparts) who need nine weeks or more to plan.
Thus, to accommodate the planning needs of the approximately two-thirds of physicians who need nine or more weeks to plan, a brochure or other notification of an opportunity to attend a CME meeting requiring travel must be in the hands of the potential attendees a minimum of about two months in advance.
The average respondent, regardless of age or gender, needs an average of 5.3 weeks advance notice to plan attendance at a local CME meeting.
Regardless of age or gender, a plurality of physicians (42.9 percent) prefer Friday as the starting day for a three-day out-of-town CME meeting. Thursday finishes a distant second, preferred by 24.1 percent of respondents. “No preference” finished higher than any other individual day of the week.
e-CME Lags Way Behind
CME conference organizers concerned about the potential for online CME to cut into participation in live meetings can rest easy. The Internet's vast potential as a learning tool for physicians remains largely untapped by our survey respondents. While 33.3 percent of total respondents say they use the Internet to obtain CME credit, they are not obtaining very much of it. On the whole, the average respondent earned 5.5 percent of total CME hours via online services or CD-ROM.
Interestingly, the indifference that women showed to using the Internet in past surveys seems to have ended. They now obtain the same percentage of CME online as the total sample. Physicians under the age of 45 make slightly greater use of the technology, with 47.4 percent indicating they use the Web to obtain CME. They earned 6.5 percent of their CME via the Internet or CD-ROM.
Asked why they do not use the Internet, 46 percent have no interest in using it; 25.3 percent say it is too frustrating to navigate; and 20.1 percent say it is not sufficiently interactive. A majority of respondents, regardless of age or gender, have access to the Internet both at home and at work. It seems that the potential of online CME is still just that — potential. Maybe when high-speed connections become the norm among physicians, usage will increase. Until then, physicians will obtain some CME online, but not nearly as much as they obtain at live meetings.
Finally, women physicians earn a higher percentage of their CME credits than their male counterparts by listening to tapes (10.1 percent versus 5.8 percent) or by reading journals (17 percent versus 13.8 percent).
THIS IS THE 10TH ANNUAL Physician Preferences in CME Survey. It is the longest-running horizontal study of physician preferences and behavior regarding their participation in CME. On August 23, 2002, Primedia Business Marketing Research (a unit of MM's parent company, Primedia Business Media) mailed cover letters and questionnaires to 1,200 domestic physicians selected on an nth-number basis from an American Medical Association file provided by Medical Marketing Service, Wood Dale, Ill. An alert postcard was sent on August 19, and a follow-up mailing was sent September 17. Letters in the first mailing were affixed with first-class commemorative stamps, and contained a one-dollar incentive and a postage-paid response envelope. A toll-free, fax-back option was offered as well. We received 261 usable surveys, a response rate of 22.7 percent.
MORE DATA AVAILABLE
This year's survey contains more data than ever before, as responses were cross-tabbed by gender, age, and by number of out-of-town meetings respondents attended in the previous 12 months. To purchase the full report, visit our Research Store at www.meetingsnet.com, or contact Ladonna Buschmann at (952) 851-4644, firstname.lastname@example.org.