When China Medical Tribune, China's largest medical newspaper, asked my organization, the Goodwin Group International, LLC, to help plan the 1st Beijing International Gastroenterology Summit: A Journey into Chinese Medical Education, I was very excited. Although I've organized conferences in more than 35 countries, surmounting language barriers, cultural differences, and other challenges, China was a completely new experience for me. I was eager to look past the Western stereotypes and finally experience the art, history, and rich traditions of this ancient culture.

We had met the team at CMT through other work in the past, and now they charged us with planning the conference's global marketing strategy and helping attract commercial support. We also served as a cultural liaison, helping prepare American faculty for travel to China, and assisting the Chinese in interpreting and adapting Accreditation Council for CME guidelines.

The two-day event, held in November 2005 at the Sheraton Great Wall Hotel, was the first in a planned series of East Meets West conferences. It was designed to give Eastern and Western medical leaders the opportunity to exchange the latest scientific information and develop collaborations for researching and treating digestive diseases.

Trying to organize a successful medical symposium across two languages, several time zones, and thousands of miles presents many obstacles — both on the cultural and the logistical front. Our partnership with the CMT team made all the difference. As with any international meeting, establishing a relationship with a local point person or team who can navigate the hurdles will save you enormous cost and time — but choose wisely. Business ethics are not the same as in the United States. Be prepared for surprises. Business transactions can be viewed, quite literally, as an exchange of favors. A Westerner can easily misinterpret the message behind gifts or other offerings. Western meeting planners who are not open to different perspectives may find it difficult to operate in this environment.

CMT is affiliated with the Ministry of Health, so its team benefits from an outstanding network of key opinion leaders and close relationships with leading hospitals and universities. These relationships make a big difference — much more so than in the United States — in helping to bring in top faculty, boost attendance, and even attract commercial support.

In addition to selecting an expert partner, it's important to learn about the country. China is a complex puzzle and must be studied carefully. “Westerners often make the mistake of thinking of China as a total market,” says Xiandong Huang, director of information services at CMT. “It is actually very fragmented. Different cities represent completely different challenges. The people, their style of communication, their way of negotiating, even the language can change completely from one part of the country to another.”

Here are some other lessons I learned planning a meeting in China.

• Double Your Travel Budget

  It's probably a good idea to visit China in person early in the planning process. As with most cultures outside the United States, people are more comfortable doing business with people they like and trust. Be there to personally conduct site tours, meet key players, and show how committed you are to the program. With all the cross-cultural challenges, don't underestimate how hard the process will be. Budget time and money for misunderstandings, outright mistakes, and several trips back to the drawing board. You may have to visit several times to help iron out problems.

• Clarify Conference Calls

  With a 12-hour time difference between the East Coast of the United States (my company is based in Arlington, Mass.) and Beijing, be prepared to change your schedule. Telephone conferences can take place late at night or early in the morning. This particular program involved Chinese faculty at several facilities and even military hospital groups.

  To facilitate the calls (and help overcome language barriers), we sent a written agenda several days in advance. Everyone had an opportunity to add items to that agenda prior to the call. We also took careful notes, and highlighted where we had questions or where we were not certain that we understood correctly. We would send an e-mail with meeting minutes the next day, with our questions highlighted. This really helped people clarify points and ensured that the whole team understood the next steps.

• Avoid Western Prices

  Negotiating venue contracts can be tricky. You might want to let your local partner take the lead here, or you may find yourself paying Western prices. In fact, we tried an experiment with the Sheraton hotel chain. I contacted the international desk and negotiated the best rate I could get. But the local team did much better by approaching their contacts at the Sheraton Great Wall in Beijing.

  Hotels and conference centers will not proactively offer things like comp room nights, discounted food and beverage, or extra conference rooms unless you ask for them up front. Also be sure to think about all of your logistical needs in advance. Don't assume that certain technology services or support staff will be available unless you specifically include those needs in your contract.

• Translate in Tandem

  Remember that two main languages are spoken in China. Cantonese speakers will have a hard time understanding spoken Mandarin, although both can read the same set of characters. Be careful when you hire a translation team to specify which language you want. (You may want both, in certain cities.) In the case of our conference, we leveraged the expertise of bilingual physicians to help us interpret panel discussions. That was effective because they could place comments in context for the audience.

  Order dual projectors and the appropriate support staff. Get your faculty slides in advance. Have slides of every lecture dual-projected in Chinese and English — and project both languages side by side during the talk. Simultaneous translation is an expensive and very inexact science in China. Having the slides translated will support your communications efforts a great deal.

• Solicit Funding Early

  Attracting additional commercial support for an international meeting held in China requires advance planning and careful coordination. Leverage your local partnership to approach commercial supporters in China, but be aware that product managers may not be interested if they are unfamiliar with your program.

If you approach global marketing teams and get them excited about your program, they may be able to motivate local players to get on board. However, this means that you need to plan your marketing strategy at least a full calendar year in advance. Global influence can only happen during the fall strategic budgeting season. You will need to have core messages and marketing materials (in dual languages) available no later than August the year before your event. Otherwise, you may find that prospective supporters love your event, but have no funds available for your cause.

Be aware that most countries have very different views than U.S. docs on the appropriate roles of commercial supporters in developing program content. Trying to run everything according to ACCME guidelines won't work — at least not yet. Most pharmaceutical companies expect full control over content. Explaining the ACCME guidelines should help with your negotiations, but change happens slowly in China. Working with the right opinion leaders will also help. But remember, this is a different culture. It is simply unrealistic to expect a foreign culture to completely accept rules that are so different from their traditions. It will be viewed as cultural imperialism if you try to force people to do things your way.

Peers Across Borders

In the end, the 1st International Beijing GI Summit was very successful. More than 550 opinion leaders from across China traveled to Beijing to hear new ideas, network with peers, and learn about new technologies. Commercial supporters ranged from international pharmaceutical companies all the way down to local manufacturers of generic drugs. In total, 20 different organizations came together to support this two-day forum.

The conference success augurs well for future international meetings in China. “In addition to the weekly news printed in the pages of CMT, we have found that physicians respond strongly to live forums where they can gather to learn from world experts,” says Zhang Wei, CMT president. “We are lucky to have some of the finest physicians in the world right here in China — but we also can benefit from hearing Western perspectives on core topics in medicine. This is why we have begun partnering with leading medical organizations such as Harvard University, The New England Journal of Medicine, and top hospitals in the USA and Europe, to bring key opinion leaders to China for intensive seminars on topics such as HIV/AIDS and gastroenterology. The response from attendees at these debate-style symposia has been extremely positive.”

Despite the challenges, it is exciting to see a new opportunity for physicians from outside of China to connect at last to this center of culture, history, and traditional medicine — and to see China slowly opening the door to Western influence in healthcare.

China Raises Physician Standards

Forthcoming changes in China's healthcare system could open more doors for Western CME providers. The Chinese government announced in 2002 that all clinical doctors at township hospitals should have the qualification of assistant medical practitioner by 2005, and by 2010 all rural doctors should have reached this standard. This may prove difficult for many rural doctors, since they combine part-time physician work with their normal farming activities. A third of employees at township hospitals do not have a professional medical education, according to the Department of Community Health and Maternal and Child Health at the Ministry of Health.

These new regulations will affect millions of doctors in 690,000 village clinics and 48,000 township hospitals across China. That represents a huge need for quality educational materials — and an enormous opportunity for CME providers who can create the relationships and infrastructure to meet that need.

In addition, trends show a growing interest in learning about Western medicine. In 2002, just over 1.2 million Chinese doctors, or 84.4 percent, practiced Western medicine. The number of doctors trained in Western medicine has risen consistently in recent years, increasing by 15 percent between 1995 and 2002, according to Epsicom Business Intelligence. But an interest in Western medicine does not automatically translate into an interest in Western CME companies. It would be a big mistake to discount China's outstanding thought leaders when introducing a Western program.

As for content, the most compelling topics in CME will focus on chronic diseases, such as hypertension and diabetes, which cause approximately 70 percent of the total deaths each year in China.