This past week the government shut down has caused at least one meeting the Regulatory Affairs Professionals Society convention in Boston to witness several of their FDA faculty drop off the program and return to Washington rather than give their talks. This may be a temporary occurrence but as a trend national CME meetings are witnessing fewer and fewer federal government faculty and attendees.
Over the last few years, the medical meeting industry has seen several challenges such as increased government regulation and oversight as well as shrinking budgets and slow economic growth. For example, earlier this year we reported that the U.S. Department of Defense and the Army restricted attendance of service members to national CME conferences. Prior to that, DOD decided to close its CME office altogether.
More recently, a scandal involving an excessively expensive government conference for the General Services Administration (GSA) held in Las Vegas led to the White House issuing guidelines calling for a 30% decrease in conference and travel expenditures and requiring high-level approvals for attendance at outside conferences, such as the AMSUS annual meeting. "The guidelines were adopted by federal agencies including the Department of Defense, Veteran's Administration, and the Department of Public Health Services"—all of which have nurses, doctors, and healthcare providers as employees who need CME.
Consequently, MeetingsNet recently reported the difficulty medical meeting planners continue to have because of this scandal as well as other budget constraints. Specifically, the article looked at a meeting organized by John Class, the deputy executive director of AMSUS: The Society of Federal Health Professionals, which offered continuing medical education (CME) credits to medical professionals employed by the federal government. The Bethesda, Md.–based organization was established in 1891 and chartered by Congress in 1903 to advance the knowledge of healthcare within federal agencies.
The 2012 AMSUS Annual Continuing Education Meeting, slated for November 11–16 in Phoenix, "was a casualty of the federal crackdown on meetings stemming from the" GSA incident. Accordingly, "Class was forced to cancel his group's annual meeting in 2012, scale it back in 2013, and relocate it for 2014 and 2015." Now, with budgets even tighter and the federal government shutdown, the article examined whether "short-term savings in federal travel expenditures are coming at a long-term cost in learning and collaborating."
The ASMUS "annual continuing education conference is unique in that it brings together military and civilian healthcare professionals from the Armed Forces, Public Health Service, and Department of Veterans Affairs, who work in all disciplines. There is a significant segment of international participants as well, who come from both military and civilian backgrounds in their own governmental health communities. The AMSUS annual meeting normally attracts 2,000 to 2,500 delegates."
However, due to the GSA scandal, Class said that as the 2012 meeting approached, it was uncertain "if he would get even half that number." Why? The tougher "approval guidelines for conference attendance were having a dramatic effect, with the most challenging hurdles found at the Department of Defense." Class explained that government employees "had to fill out significantly more paperwork just to ask to attend a meeting," and "attendance required approval by the Deputy Secretary of Defense."
In the past, there was less bureaucracy—DoD "would divvy the money out to the various hospitals for conference travel, so each hospital might send 30 people—maybe more, maybe less, but the decision was at the hospital level."
Consequently, "about a month before the 2012 meeting, the DoD still had not approved anyone to attend the conference, at which point AMSUS decided to cancel. Shortly after that, the DoD announced that it had officially suspended attendance for Army personnel at all non-DoD conferences for the remainder of 2012 (as noted above)."
The low attendance was not the only reason for cancellation. Class explained that ASMUS also did not have speakers because many were from DoD, the VA, and the Public Health Service—who were subject to the same restrictions. Thus, his meeting lacked the "quality" it had given in the past.
"Fortunately, AMSUS had cancellation insurance and was able to mitigate financial damages. A nonprofit organization that relies on conference revenue for operating expenses, AMSUS settled with the vendors and venues, but is still working through the claims process." However, "the networking, collaboration, education, and 30 hours of CME that AMSUS offers its members" could not be replaced.
In addition, due to the travel restrictions, ASMUS had to "rethink" where to hold its meetings;" finding areas that "are in close proximity to military medical populations to make it easier for more people to attend and to reduce per diem costs." Thus, meetings planned in Boston (2014) and Minneapolis (2015) had to be relocated, the article noted.
"AMSUS is currently working through the process and hopes to sign new contracts in Washington, D.C., and San Antonio. Nothing has been finalized yet, he adds. The return meeting to Seattle has already been inked for 2016."
Back in 2013, But Smaller
Class explained that the challenges remained for the 2013 conference, however, attendance this year could be "approved by the Secretary or Undersecretary of the Army rather than by the Deputy Secretary of Defense."
"The 2013 meeting will take place in November at Washington State Convention Center in Seattle, as scheduled, but the event will be much smaller than in previous years. Class expects 1,000 attendees—less than half his typical turnout, even with a new reduced registration fee." Class noted that many people will be "paying their own way," so ASMUS tried to make the event as affordable as possible, including working with vendors and hotels to assist reducing the costs.
Class noted that the ASMUS meeting averaged to "$10 per CE hour for an in-person meeting,"—not including travel and per diem. "That's not to mention all the networking and collaboration that occurs at the meeting," he added.
In 2011, registration was $410 for members and $510 for non-members. This year, the rate for members was reduced to $300, the rate for non-member civilians was raised to $625, and a new rate of $325 was instituted for non-member federal employees.
AMSUS secured some additional sponsorship dollars to help reduce the registration fees, but not enough to offset revenue losses. "We put a sponsorship program in place but dollars are tight all over. We do have a couple sponsors for this year already but not to the extent that we hoped for," Class says.
AMSUS also may lose revenue from a smaller exhibition hall, the article noted. "We had been averaging over 250 exhibitors and we anticipate that number will be drastically cut this year," says Class. "As you can imagine, the feedback we are getting is that exhibitors are waiting to see what attendance may be like before committing—a Catch-22 for us." In all, revenue will be down more than 50 percent for AMSUS, compared to past years.
From Committee to Abstract Submissions
"AMSUS was also forced to alter the way it plans the educational program," the article noted. "Previously, the voluntary planning committee—made up of DoD, VA, and Public Health Services members—would put together the educational programming by discipline, with tracks for nurses, physicians, medics, pharmacists, family practitioners, and so on. In turn, the planning committee was in charge of selecting the speakers."
This year, in part because of the uncertain status of some government speakers, AMSUS decided to institute an abstract submission process, the article noted. ASMUS received almost 300 abstracts and will present about 250 at this year's meeting. One of the benefits Class noted of abstracts is that speakers who submitted them are confirmed to attend the meeting as well.
"Also, the sessions now will be organized by topic; for example, clinical, operations, logistics, mental health, and so on. Given the variety of submissions, Class explains, this proved to be a better way to organize the content."
Long Term Impact
"A recent study by Rockport Analytics, The Value of Government Meetings, found that it may actually cost the government more in the long run to cancel meetings and restrict federal employees from attending outside meetings," the article noted.
"Researchers cited a canceled DoD meeting, the Military Health System Conference, as an example. The conference is similar to the AMSUS meeting in that it is for military medical professionals and offers CME credits—about 21 hours' worth."
"The researchers contacted several accredited providers and found the average cost per CME credit to be $760. Based on conservative assumptions, the report estimates that $1.1 million was saved on CME credits alone. That CME has to be obtained one way or another by military medical personnel to stay accredited. AMSUS offered even more hours of CME than MHS, which means that those employees have to seek it elsewhere."
In light of the restrictions, Tom Sullivan, president of medical education company Rockpointe Corp., expects to see more government healthcare workers seek out online, local, or pharmaceutical industry-supported CME (which typically has a reduced cost).
It could be five years before government employees are attending conferences at the level they were in 2011, says Sullivan. The "perfect storm" of the scandals and the sequester have made government officials leery of conference spending.
"The Rockport study also looked at the impact of restricting federal employees from attending non-government meetings, citing the National Space Symposium as an example. While the National Aeronautics and Space Administration saved $550,000 by not sending employees to this conference in 2012, the report concludes that those attendees will likely have to schedule other trips and meetings throughout the year to make up for missed education and networking opportunities."
While Class is hopeful that the government restrictions on meeting attendance will subside in the next few years, there are several pending pieces of legislation that would make the White House guidelines on travel law.
Class is also hopeful that non-government meetings like AMSUS can fill the void if meetings like the DoD's MHS conference are canceled or scaled back. "We assume all of the risk, so rather than having a separate conference, they could combine things with ours," he says. "We could certainly incorporate any sessions in our tracks."
As healthcare moves toward an integrated team approach, "we provide a great platform for all these people to get together."