With the COVID-19 pandemic curtailing travel and preventing large gatherings, professional otolaryngology and physician societies have had to cancel meetings or quickly take them online. “Replacing meetings virtually is better than doing nothing, but people are anxious to have in-person meetings again. It’s definitely been missed,” said Michael Stewart, MD, vice dean and chairman of the department of otolaryngology–head and neck surgery at Weill Cornell Medicine in New York City and executive vice president of the American Rhinologic Society.
Explore This IssueSeptember 2020
The pandemic may have a lasting impact on the future of medical societies, as well as the ways in which physicians gather to present research, collaborate, and even recruit residents, fellows, and faculty. It’s also possible that some of those societies may not weather the storm.
Why In-Person Meetings Are Important
Although Zoom and Webex have been around for years, in-person meetings allow for experiences that may be impossible to replicate online alone, including panel discussions that allow for detailed questions, informal learning from colleagues and peers in a social setting, and generally catching up with the latest advances in the field.
“The essence of the meeting is to weave together community and content,” said Albert L. Merati, MD, surgeon and chief of laryngology at the University of Washington in Seattle and past president of the American Broncho-Esophagological Association (ABEA) and American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS). “You cannot focus on content and lose sight of community, and vice versa.” Dr. Merati added that the reason the ABEA’s completely virtual 100th annual meeting this year was a big success was because it focused not just on papers, but on connecting its members virtually.
For residents who are interested in fellowships, society meetings are a place where we can sit down, have a cup of coffee, and just chat about things in a more informal way. I’m going to be very curious to see how this impacts our match coming up. —Gaelyn Garrett, MD, MMHC
Another reason many otolaryngologists enjoy meeting in person is that while some subspecialties like pediatrics may have hundreds of thousands of doctors, Dr. Stewart said, otolaryngology is a small, tight-knit subspecialty of about 11,000. “Our meetings are large but not unwieldy,” he said. “The size of our specialty means our meetings are particularly enjoyable because of the possibility of knowing a lot more people. The missed connections part of not having in-person meetings is going to be more acutely felt.”
In-person society meetings are valuable for a variety of career and personal reasons, including:
Recruitment. Meetings offer recruitment opportunities, particularly in academic medicine. Young residents and fellows attend to look for first jobs; national meetings are opportunities for face-to-face interviews.
“It’s a great ‘first date’ to decide who you may want to invite for an in-person visit to your facility,” said Dr. Stewart, who set aside several hours to meet with multiple candidates last year and decide who his team would invite to New York for interviews. “We’re going to miss the opportunity to meet potential faculty members, and I’m sure the residents are going to have the same experience.”
Gaelyn Garrett, MD, MMHC, vice chair for clinical operations at Nashville-based Vanderbilt University Medical Center’s department of otolaryngology and president of the Triological Society, believes the majority of residency programs aren’t holding in-person interviews this year, something she says is a game changer on both sides. Dr. Garrett, director of the laryngology fellowship at Vanderbilt, said the program made it about halfway through in-person interviews this year before conducting the remainder virtually. “You lose that close person-to-person interaction. For residents who are interested in your fellowships, society meetings are a place where we can sit down, have a cup of coffee, and just chat about things in a more informal way. I’m going to be very curious to see how this impacts our match coming up.”
Disruptive change brings opportunity for the prepared. The COVID-19 pandemic has accelerated trends that were already emerging and will certainly have long-lasting impact on the ways we do so many things as a society. —James C. Denneny III, MD
Another effect of in-person meeting cancellations is that medical students and residents will miss out on interacting with seasoned otolaryngologists from across the U.S. “For many residents, our meetings are the first time they present to a clinical professional society,” said Triological Society Executive Vice President Myles L. Pensak, MD, chair of otolaryngology at the University of Cincinnati College of Medicine in Ohio.
Disseminating information. Information sharing is always a big part of meetings, but otolaryngologists still communicate via email, text, and virtual get-togethers, as well as streaming educational opportunities. “I think there’s definitely some good that has come out of this as far as how we disseminate information,” said Dr. Garrett. “And I think ultimately, when we do get back to in-person meetings, virtual communication is just going to be an expanded way of discussing things.
The AAO-HNS has found many avenues to disseminate information throughout the specialty and healthcare community at large during the pandemic. These have included new position statements focusing on tracheotomy, elective surgery, and urgent and nonurgent patient care; reporting tools and research on anosmia; the COVID-19 podcast series; publication of COVID-19-related papers in Otolaryngology–Head and Neck Surgery; and resources like the Guidance for Return to Practice in Otolaryngology-Head and Neck Surgery. Likewise, the Triological Society’s journals, The Laryngoscope and Laryngoscope Investigative Otolaryngology, continue to publish COVID-19-related papers.
In terms of scholarship, Dr. Pensak said submissions to the Triological Society’s journals, The Laryngoscope and Laryngoscope Investigative Otolaryngology, are up between 25% to 30%. “When elective surgery and nonurgent and nonemergent office visits were cancelled, physicians had more time on their hands,” he explained. “It seems, without the usual time constraints, a number of folks have been able to focus attention on projects that needed to be brought to fruition.”
Additionally, big meetings provide opportunities for networking in a broader way. Bumping into someone in the hall has resulted in Dr. Stewart being invited to participate in projects that have gone on to be published or developed into courses. And Dr. Pensak has met some of his most important mentors, who live thousands of miles from him, at meetings.
Potential Fallout for Societies
Many may not realize that societies’ large in-person meetings often provide much of their operating revenue. Not holding them can be a big drain on a society’s finances. Dr. Stewart said that without meetings, some small subspecialty societies may suffer a death blow, though he suspects most will make it. “The Rhinologic Society will face a revenue shortfall this year that will hurt us,” he said, “but we do have reserves, so we’ll survive.”
One silver lining, however, is the savings realized from not actually hosting a meeting, including food and beverage expenses—a gallon of coffee from a convention center can average between $100 to $200. “If you look at your balance sheet, a lot of the cost to a society is actually running a meeting,” said Dr. Garrett.
Societies will also lose conference registration fees and the support that comes with industry partners paying to physically exhibit the latest technology. With virtual meetings, some are concerned they may not see the same return on investment.
Additionally, pharmaceutical regulations and internal corporate policies may make it difficult for industry partners to switch to new operational protocols, according to Jami Lucas, executive director and CEO of the American Academy of Otolaryngic Allergy and its foundation. “That doesn’t mean we give up, though,” Lucas said. “Corporate partners are our partners for a reason. We represent a segment important to their industry. We just need to work together to find new ways to ensure that the access and bi-directional communication continues.”
Having a strategic plan in place has helped the AAO-HNS absorb the impact of the pandemic so that it won’t create a financial burden for its members, said James C. Denneny III, MD, AAO-HNS executive vice president and CEO. Dr. Denneny explained that the AAO-HNS follows best fiscal practices under the guidance of the AAO-HNS executive committee, secretary-treasurer, and finance and investment subcommittee. These practices guided the decision to transition the AAO-HNS 2020 Annual Meeting & OTO Experience—a reliable revenue source—to a virtual version this September (see sidebar).
“We’ve been able to build our financial reserves through operational savings over the last several years, and that’s allowed us to maintain the current level of services that members expect, as well as to offer $100 vouchers that practitioners can use to offset dues or educational offerings,” Dr. Denneny said. “As we address the ongoing challenges that the COVID-19 pandemic presents us as a medical society serving members who are on the front lines of this public health crisis, we aim to overcome these obstacles through new initiatives already underway and innovation, rather than seeking to add to the financial burden our members are already experiencing.”
For the Future
As virtual meetings get up and running, physicians may rethink whether they want to take a week or two away from their lives to attend in-person conferences. At a time when travel itself has become rare, some physicians may prioritize family vacations over annual meetings. “It isn’t that people don’t want to travel and see each other,” said Dr. Merati, “but there won’t be eight weeks of professional travel for me next year. And when I do take off two weeks, going somewhere with my family will be my first priority.”
Society memberships may also fall off if doctors don’t pay their dues or are inclined not to renew. And since meetings have a way of impressing young physicians who may want to join, recruitment will be affected too. “Residents, students, and brand-new faculty attend the meetings and meet people there who guide their careers, and that isn’t happening,” said Dr. Stewart. “There’s going to be some loss of engagement, mentorship, and career development for young otolaryngologists if this goes on too long.”
Dr. Denneny feels confident in the future of the AAO-HNS after witnessing what he calls the “exceptional response” of its members when asked to serve in the worst of times. “Disruptive change brings opportunity for the prepared,” he said. “The COVID-19 pandemic has accelerated trends that were already emerging and will certainly have long-lasting impact in the ways we do so many things as a society.”
Dr. Merati agrees, noting that preserving specialty unity overall will benefit from maintaining connection to the field as a whole. “This serves everyone in the long run, whether through advocacy or advancing the universal cause of otolaryngology for patients and practices,” he said. “Whether virtual or in person, big meetings in general support the breadth of otolaryngology and serve us all well.”
Renée Bacher is a freelance medical writer based in Louisiana.