Seventh Annual Physician Preferences Survey In 1994, only 16 percent of respondents to this survey were female. In seven years, the percentage has doubled. Know This: They are tough customers when it comes to CME. By the way: The electronic revolution in CME is fizzling.

There are three major findings from the 2000Medical Meetings Physician Preferences Survey: First, women are now a force to be reckoned with in continuing medical education (CME). About 30 percent of the 238 respondents (160 mail surveys; 178 Web-based surveys) are female, up from 17 percent when we first published this survey in 1994. They travel less than their male counterparts and they appear to have no interest in online CME. Most important of all, perhaps, is that the decision to attend an out-of-town meeting looms larger in their lives. When asked to rank factors influencing their decision to attend a conference, they ranked everything but location and sponsor reputation higher than their male counterparts.

The second major finding: Online CME is not all it's cracked up to be. More physicians may be using the Web, as an American Medical Association study reported in December, but not to obtain CME. After rising dramatically for the past three years, usage of the Web for obtaining education credit declined this year--even among physicians who responded to the online version of our survey. Part of the reason: Our female respondents, almost a third of total respondents, indicate they are not interested in it.

Third, more and more physicians are deciding not to travel to obtain CME. Seven years ago, only 6 percent of respondents had not attended any out-of-town meetings; last year, the figure was up to 18 percent, and in this survey 24 percent of male and 27 percent of female respondents did not attend any out-of-town meetings in the past 12 months. Only 43 percent of women and 51 percent of men plan to attend two or more out-of-town meetings during 2000. (For more on this trend, watch for "Resuscitating Live Meetings," upcoming in MM's March/April issue.

Travel: Tough Choice for Women Every year, we ask physicians to rank a series of factors and their influence on the decision to attend an out-of-town CME meeting. (See chart at left.) Overall, the most notable change is that speaker and sponsor reputation are now ranked higher than the meeting date, although meeting location is still the top factor influencing the decision to attend, as it has been since 1996. (In the 1994 survey, subject matter was the top factor; in 1995 the number-one factor was speaker reputation.)

Separating male responses from female, the results show little difference in the ranking of factors, but there was an important overall difference: Women attributed greater importance to every factor than men, except for meeting location and sponsor reputation. Women gave the same degree of importance to those two areas as their male counterparts did.

In plain English, it appears that deciding to attend an out-of-town CME meeting is a much bigger deal for women than men. Common sense supports this; if a woman physician is also a mother, for example, both her profession and her children make tremendous demands on her time.

A further clue to the importance of managing time appears in the amount of CME credit earned by female physicians at out-of-town meetings. (See chart on next page.) While male respondents obtained a little more than 40 percent of their total CME credits at out-of-town meetings, women respondents obtained 80 percent of their total credits this way. This suggests that when women do decide to travel to attend a meeting, they make sure they obtain the most CME credits possible in return for their investment.

E-CME Fizzles While the total percentage of physicians obtaining CME from electronic media has declined this year, online CME has nonetheless had an impact as another channel for obtaining CME credit--if only among male physicians. None of the women respondents reported earning CME online. For the first time since we started asking the question three years ago, a higher percentage of women say meetings, both local and out-of-town, are among the ways they obtain CME. (See chart at left.) Are women attending more meetings? No--it's just that 14 percent of male respondents are using electronic media as an option for obtaining CME. That necessarily cuts into the overall percentage of respondents who obtain CME by attending meetings, reading journals, or by other means. This year, 13 percent of male respondents and 14 percent of female respondents say they are obtaining their CME by other means. The most-often-cited specific example is AudioDigest audiotapes, produced by a subsidiary of the California Medical Association.

Destinations: Oranges and Sunshine If location is still the most important factor affecting the decision to attend an out-of-town CME meeting, then destination preferences, as well as the desire to learn, must be taken into account by medical conference organizers. There were few surprises, as California and Florida remained top physician picks for meeting locations. As we've stated in previous surveys, a location can be important because it is near home as well as because it is an attractive travel destination. With that in mind, it is worth noting that 44 percent of women respondents and 57 percent of men respondents picked their home state as one of five preferred meeting destinations.

Among international destinations, there was a real gender division. France, with 14 percent of responses, was the most popular among women. The United Kingdom, also with a 14 percent response, was most popular among men. Overall, Canada, the Caribbean (in this case including Bermuda and the Bahamas), and Europe were the most popular destinations. Note that respondents were asked to write in their top international destination preferences; the most-cited individual preferred destination was London.

Resort Rush Resorts and hotels remained the top venue choices of both men and women respondents (see chart at right). Conference centers, which finished second in respondent preferences last year, fell back to third place. Note that for both male and female respondents, "other" has become the fourth choice. Write-in responses in this category ranged from cruise ships to "wilderness." In the resort and hotel categories, many respondents named specific hotel chains and in some cases specific properties. Note also that 11 percent of both male and female respondents chose "hospital" or "own facility" as a preferred CME venue.

FRIDAYS First The most preferred months for attending an out-of-town CME meeting were January, February, and March; March was most preferred by women respondents. The most preferred starting day for attending a three-day out-of-town CME meeting was Friday (see chart at left), and with 38 percent of respondents, Friday was especially popular among women. Tuesday remains the least popular starting day for a three-day conference, as it has since we began asking this question in 1994.

Going for Groups Both men (44 percent) and women (35 percent) were most likely to be practicing medicine as part of a group practice. While 24 percent of male respondents are still in solo practice, only 8 percent of female respondents worked in a solo setting. The next most common practice setting for women, after group practice, was academic medicine. By contrast, only 10 percent of male respondents were in academic medicine. It is also worth noting that 17 percent of female respondents were practicing in "other" settings; most often cited by respondents were locum tenens arrangements.

In a dramatic shift from earlier studies, 40 percent of women and 37 percent of men indicated they had no affiliations at all with network HMOs, which seems to confirm news reports in the business press that physicians are beginning to reject such arrangements. On the other hand, 33 percent of women and 27 percent of men had more than four affiliations with network HMOs.

Similarly, 40 percent of women and 46 percent of men respondents received no financial support from the organizations they were affiliated with to defray the cost of attending CME meetings. At the other end of the scale, 29 percent of women and 27 percent of men had 75 percent or more of their CME expenses paid for by the organizations they worked for.

Members Only Medical societies and associations must be proving their value, because membership is popular among respondents. In fact, only 2 percent of respondents indicated that they belonged to no medical professional organization at all. Men respondents were most likely to have more than two memberships, while 56 percent of women indicated they belonged to one or two associations. Thirty percent of men belonged to four or more associations, compared to 21 percent of women.

Methodology Using an nth-number random list of physicians in active practice supplied by Medical Marketing Services (MMS) of Wood Dale, Ill., we mailed 1,000 surveys with a dollar incentive enclosed. We received 160 usable responses, for a 16 percent response rate. We also posted the survey to our Web site, and sent e-mails to a list of 5,000 physicians, supplied by MMS, and checked to avoid duplication. We received 178 usable responses, for a 3.56 percent response rate. Special thanks to Nancy Terrell, Adams Business Media, for creating the Web survey.

At the behest of Bruce Bellande, executive director of the Alliance for CME, the 178 respondents to the Web-based survey were asked why they participated in CME.

* 81 percent of respondents said they participated to meet state-based licensure requirements.

* Another 66 percent said they did it to obtain or maintain privileging/credentialing with hospitals, HMOs, or other health care institutions.

* 50 percent said they participated for "other" reasons, of which the most common given was "to learn, to keep up to date."

What was heartening was the response to the question "Which of these reasons is most important?" Fully 42 percent said the most important reason they participated in CME was "to learn; to keep up to date" and variations on that theme. The next largest response was the 38 percent of respondents who said the most important reason was to satisfy licensure requirements.