KENT SEPKOWITZ casts doubt on the medical profession's conventional wisdom

As an infectious-disease specialist, I could go each year to the meetings of the Infectious Disease Society of America in September; the Interscience Conference on Antimicrobial Agents and Chemotherapy in October; the Conference on Retroviruses and Opportunistic Infections in February; the Society for Healthcare Epidemiology of America in April; the American Society for Microbiology in May; and, every other year, a summer international conference on AIDS. If I want to focus on AIDS in particular, I could add several more.

Is the pace of medical discovery really so blistering that only a circuit of nonstop meetings can accommodate the headlong rush of new information? Or is the constant conference part of the drug companies' scheme to hypnotize the doctor class and create a fleet of medical Manchurian candidates?

More salient, probably, is the oddly powerful urge to convene; the surest evidence of professional probity in America is attendance at an annual meeting. Profession by profession, we've become a Meetings R Us collective in which no one can speak without the authority of the group and no group can speak without the authority of a members vote.

So, doctors are suckers like everyone else. Other than wasting some time, does it much matter? Well, yes.

The medical convention is bad for doctors, bad for patients and bad for everyone in between. The state of constant meetings has introduced to medical work the same false urgency that 24-hour news has imposed on the production and presentation of news. With the rare exception of a true calamity (anthrax, AIDS, West Nile, mad cow), we don't have enough to talk about. So we sex up the facts to create the next urgent crisis. It's all vigilance, all panic, all the time.

This is easy enough. There is pandemic flu and avian flu and resistant bacteria and always AIDS, the mumps, measles and tuberculosis in its old and new strains. In the end, we don't even have to exaggerate much.

But other than AIDS, they are not grand-scale public health crises, at least not right now. Diagnosing and managing these infections is what infectious-disease doctors do. And we should do it methodically, carefully, quietly, in a way that respects the natural pace of science – its fits and starts, in which a step forward is followed by two steps back when the "breakthrough" is reconsidered.

The 24/7 conference treadmill has warped the necessary deliberative (though often boring) medical discourse. At the meeting, hyperventilation takes over. Never mind all the past letdowns. Like the Democrats and Republicans every four years, we are certain – certain – that this meeting will prove to be the one we can't afford to miss.

To be sure, there is a role for humans congregating with other humans, even in the day of conference calls and e-mail. The wizened get to see old friends. Newbies can stand timidly at the edges and envy the vets' camaraderie. And in 20 years, I have been at a few genuinely hair-raising meetings.

The early AIDS conferences were a source of drama and genuine awe. And the urgent need for information, spit out as fast and to as many people as possible, made perpetual meetingdom necessary. This harks back to the 19th century, when medical meetings were critical. Robert Koch announced his findings on the bacterial basis for tuberculosis at one. Louis Pasteur and Joseph Lister presented theirs, redefining the worlds of bacteriology and infection. Their results, and those of other era brand names, were sometimes met with derision, at other times with acceptance. Either way, meetings were where medical progress happened.

source:www.dallasnews.com