For 37 years, the Austin-based Texas Medical Association's annual meeting hadn't changed much. Its name, "The Annual General Scientific Session and Program," said it all. Attention-grabbing it was not, and declining attendance year after year brought the TMA board of directors to a difficult decision: either do something drastic or let the annual meeting die a quiet death.

Enter Paula J. Rigling, CAE, CMP. On the TMA staff for several years, she was tapped by the board as director of conference & meeting management for the 38,000-member TMA when the individual who had run the annual meeting for nearly four decades retired. The leadership gave Rigling a mission: revitalize the meeting, make it something physicians wanted to attend, or find a way to kill it.

With attendance an increasing concern, many meeting planners can probably relate to Rigling's situation. Faced with the usual suspects in competition for physicians' time and money--demands of family life, the Internet, shrinking budgets--she created a three-year plan that began with changing TMA's educational philosophy and developing a completely revamped event. The efforts of Rigling and her staff is still a work in progress, but she shared with MM some of her strategies for pumping up annual meeting attendance.

Bridging Disciplines The first order of business was a brainstorming session. Taking full advantage of TMA's people resources, Rigling invited not only TMA staff and leadership, but also about 20 member physicians.

"We pulled together about 40 people who had never been asked to participate [in planning the annual meeting] before," Rigling says, and with the board's blessing, everyone from the CEO to the exhibits manager helped develop a new concept for the meeting's educational format, the top priority. Rigling gives credit to P.R. Gilmer, MD, a retired Houston pathologist, for shaping the group's new way of thinking--strong interaction across disciplines.

Before Rigling could implement the great new ideas, systemic changes had to be made. Educational offerings were regulated by the association's bylaws, according to Rigling, so any new format needed approval by house delegates.

"Our bylaws required specialty sections at the meeting," Rigling says, "such as a session on nuclear medicine. But when only 11 people show up for it, it's embarrassing for the speaker."

Rigling says that a resolution put before house delegates passed easily, "because they were simply ready to do something."

With the regulatory change approved, she and her team developed new tracks on topics like ethics, alternative medicine, medical economics, and technology. The "clinical practice of medicine" track offers a different discipline each year. This year, Rigling says, doctors will delve into the issues involved with elderly care.

But more important to drawing attendees, what emerged was a central concept that TMA's annual meeting would be the vehicle for physicians to share information across disciplines.

"In the past," Rigling explains, "we would have 30 separate specialty sessions at the annual meeting and a dermatologist, say, would get a badge and spend the whole day with about 200 other dermatologists without ever realizing there were 3,000 other doctors there." Now, instead of offering education tracks specifically for dermatologists, sessions are open to all disciplines.

"Once we created the new tracks," says Rig-ling, "we started to look at ways to promote the meeting. The first and quick fix was to change the name."

She called the staff together, provided "lots of chocolate and cookies" and told the group they would not be leaving the room until they came up with a name that would knock doctors' socks off. Rigling's strategy succeeded. TexMed 1998 was launched by the TMA two years ago.

Not Your Father's Session Part of TMA's plan for reinvigorated attendance was a transfusion of fresh blood. "We needed name recognition and we had to get out the message that this wasn't the same old thing. We wanted the young doctors' involvement, doctors other than our house delegates, so we targeted ads to the young physicians with slogans like, 'This is not your father's same old annual session.'" Rigling offered on-site childcare during meeting hours, another strategy to draw younger physicians. In its first year, Camp TexMed drew 31 children, and the numbers have steadily grown.

Rigling also uses a targeting strategy that creates a ripple effect. TMA offers category 1 Continuing Nursing Education credits at the annual meeting through the Texas Nurses Association. "We charge only $10 for nurses, physician assistants, and office staff to attend our meeting, and they can get all the CNE or CME they want or need," Rigling says. "And we promote this heavily to our members." (Registration at the annual meeting is free for physicians who are TMA members, says Rigling.)

TMA takes out ads in various newsletters for nurses and other physician support staff and uses some catchy comic relief in the ad copy--"Think $10 will buy you diddly-squat? Think again." The result is just what Rigling wants: "We've really increased the number of staff (who attend the annual meeting) and have found that they are frequently the catalyst for convincing the member physician to attend," she observes.

Pigs' Feet for All "We want to offer a full menu, a buffet of choices where physicians can sample a variety of educational tracks," says Rigling. There are at least 25 specialty medical societies in Texas, she says, and about 19 of them are managed by TMA. "We draw members of the specialty societies to our annual meeting by putting up a big tent where they, as separate entities, can join us," Rigling says. "They can hold their own annual meeting in conjunction with ours and we put no restrictions on them." In fact, if a specialty group needs a classroom or a place for lunch for their members, Rigling will set it up for them. "I leverage TMA's bargaining power for them," she says, "and sometimes we do share costs."

The tent concept is advantageous to all attendees: Specialists can gather in one place and conduct their own business and network, "and part of their programs can be pertinent to family practitioners," Rigling says. "A plastic surgeon, for instance, put on a suturing demonstration for family doctors and so we had about 200 people sewing pigs' feet in a ballroom. It was a great sight to see."

CME on CD Rigling found a way to use the Internet and high technology at TMA's annual meetings as a time-saver--and a draw--for physicians. Because of the sheer number of programs and events packed into the three-day event, many members said they were missing out on their specialty tracks and not getting their CME credits.

"We came up with "CME On Demand," Rigling says. "It's a miniature version of TMA's library at the annual meeting. We set up an information kiosk staffed by reference librarians; added carrels with PCs, audio, and CD-ROM; and doctors can check out a variety of programs, spend an hour, take the test, and get category 1 CME." When it was first introduced at TexMed 1998, 19 physicians used CME on Demand. Last year, 50 doctors used it, and Rigling expects more than 100 to plug in at TexMed 2000 in May. "It's become a popular thing because it exposes them to new materials," she says, "and to our library."

Rigling also takes advantage of the Internet for meeting marketing and needs assessment. She has 11,000 e-mail addresses of members that can be sorted by demographics. "For instance, our young physicians and students will get e-mails on the child care we provide at the meeting. Another example: We'll target our geriatricians with an e-mail blast announcing that Stanley Marcus, the 93-year-old founder of Neiman Marcus, will be a guest speaker this year. He'll talk about a patient's perspective on modern medical care."

But Is It Working? Rigling predicted it would take at least three years to show some real growth from the initiatives the TMA unleashed in 1998. Bad luck with the calendar put a crimp in the efforts--TexMed 1999 fell on Mother's Day and this year's timing, May 25 through 28, is Memorial Day weekend--but Rigling is nothing but optimistic. "I'm anticipating a slight decrease this year because of Memorial Day," she says, "but my goal is to change the meeting date to sometime in April, and that will be in 2002 and 2003."

TMA's marketing department monitors the profile of annual meeting attendees. Rigling says the latest statistics show the meeting is achieving success, especially with younger physicians. "We're getting more doctors in younger categories and who are newer in practice."

Another revealing indicator of success in Rigling's eyes is the declining percentage of attendees who come to the meeting to fulfill their official responsibilities with the TMA house and board. "These attendees just come, do their duties, and go home," she says. Last year, this number was 37 percent, down from about half in past years. It's a good sign, says Rigling, that doctors are more interested in education. Now, 64 percent of attendees come to the annual meeting for CME, and 47 percent attend for clinical updates.

Other positive indicators: * 79 percent of attendees rate clinical programs as good or excellent (up from about 30 percent)

* General sessions and education tracks are rated good or excellent by 77 percent of attendees, all up from less than 50 percent in the past.

The point, Rigling says, is that the quality is noticed and the long view is very optimistic. "The first year, we wanted the doctors to see the difference in their annual meeting," Rigling says, "and we did that with the new name and the new look. We're still waiting--but the long-term commitment from the board is there and that's the key."

If attendance at your annual meeting is flat or declining, you may need a fresh approach to promotion, according to Suzanne Ziemnik, director, division of CME, American Academy of Pediatrics, Elk Grove Village, Ill.,and presenter of "Basic Marketing and Promotion" at the Alliance for Continuing Medical Education's annual meeting in January in New Orleans.

Here are Ziemnik's key tips: * Budget it right. Funding is the best place to start--whatever the budget for your group's annual meeting, 25 percent of it should be used for promotional efforts.

* Make it Pop. A brochure has 18 seconds to sell the program--little time to explain the essentials and make the event pop. But even a catchy piece won't work if people can't read it. Before doing a fax blast, test it. "Colors can come out as a black blob on the other end," Ziemnik said. Double check the contact information. "We once had the wrong telephone number for the hotel and it was a fiasco."

* Time it right. It's never too soon to get promotional materials, brochures, and registration forms to members. For a national meeting, attendees should receive materials 14 to 18 weeks before the event; for regional meetings, an 8-week lead is good.

* Go online. A Web site for an annual meeting is standard these days, but you can do more online promotion. By creating links with affinity groups, you'll reach potential attendees who may not ordinarily hit your site. CME listserves can also be a good marketing tool. You can "offer 1,000 doctors an automatic reminder about your event," Ziemnik said.

MM's Marketing Tool When Paula J. Rigling, CAE, CMP, director of conference & meeting management for the Texas Medical Association, gets ready to plan a meeting, she first looks to the MM annual physician preferences survey (see Medical Meetings, January/February 2000, page 36, and visit "I give the physicians' survey to our marketing manager," Rigling explains, "and she uses the information throughout the year."