How Green Is Your Doctor?

June 27, 2008— -- As environmentalists debate the effects of emissions standards and oil consumption on our carbon footprint, the newest edition of the British Medical Journal tackles another source — medical meetings.

In 2006, 15,000 doctors, roughly 3,500 of them from Europe, attended the American Thoracic Society meeting in San Diego, adding more than 10,000 tons to their collective carbon footprints through air travel, according to a recent study.

And that meeting is considered to be one of the smaller ones — a fact that has some doctors asking: Given the pollution from traveling to them, are international medical meetings worth it?

"Low energy light bulbs, improving the insulation of our homes and driving less will contribute. But if we stop going to international conferences we can make a significant difference and be seen to be giving a lead," wrote Dr. Malcolm Green, a professor emeritus in respiratory medicine at the Imperial College in London, in an British Medical Journal editorial. "By finding new ways of communicating with our colleagues in other countries, we can save time, energy and carbon emissions."

Also, Green feels it could start a trend.

"Doctors are big users of conferences, so this would have an effect on its own. And they should show leadership," he told ABC News.

Could Teleconferences Work?

Green, who noted that he has attended conferences for more than 30 years, said that technology enables people to achieve the goals of a conference without moving people so many pollutant-filled miles.

"Organizations such as oil companies, financial institutions and inter-governmental bodies have regular and highly successful conference calls and videoconferences," he wrote. "Some are so vivid that in the heat of discussion members forget they are separated by oceans. At a recent transatlantic conference a participant in New York asked his colleagues if they would like coffee and several hands were raised in London."

But other doctors disagree, saying that the face-to-face contact of conferences is necessary, and videoconferencing is not a convincing substitute.

"At my first videoconference the distant audience wisely stayed out of camera range," wrote Dr. James Owen Drife, a professor of obstetrics and gynecology at Leeds General Infirmary in the U.K., in an opposing British Medical Journal editorial. "My last one was punctuated by unexplained, far-off laughter. For relating to people, videoconferences are less effective than mobile phones."

While he recognizes the importance of watching our carbon footprint, Drife feels that the face-to-face contact of meetings is irreplaceable, and can even be inspiring.

"The most inspiring lecture I've heard on the needs of women in the Third World was at a conference in Rio: An audience of several hundred delegates stood and applauded," Drife told ABC News.

"It's hard to say whether that is the main reason that I now spend part of my time with the World Health Organization in developing countries but I think it's a factor. Without being physically there in Rio, I wouldn't have seen the shacks and favellas that abut against the fashionable beaches."

Drife also believes that the contact can be inspiring to people in those areas.

"What is needed is sustainability, and I increasingly think that this is best achieved by local 'champions' who are talented and willing to remain local rather than seeking to emigrate," he said. "Such people need to be discovered, inspired and empowered and to do that you have to meet them."

Meeting of the Minds

But even less idealistic meetings can be beneficial, said one conference organizer.

"We also look at the meeting as a place where young investigators can represent their research and get feedback," said Dr. Monica Kraft, an asthma researcher who chairs the American Thoracic Society's International Conference Committee.

"I just think it would be challenging to try and do that via videoconferencing and have everyone engaged."

Kraft said she also benefits from informal interaction at conferences, and notes that doctors who attend would miss out on the impromptu discussions they have outside of the formal meetings.

"There are many meetings that take place outside of the presented symposia," she said.

Green disputed that contention.

"Chance social meetings play little part in networking for scientific communication," he said.

While she called the videoconferencing replacement "an interesting premise," Kraft wasn't prepared to say the carbon footprint was too great to justify the face-to-face meeting.

"There's so many other entities around the world that can use improving via the environment," Kraft said, continuing that she wondered why medical meetings would be a target to stop.

Kraft noted that the American Thoracic Society puts videos from the conference online to allow doctors who couldn't attend to benefit.

That may help, as some doctors don't necessarily need to fly to the conference and could view it online, said Dr. Aldo Iacono, the medical director of lung transplantation at the University of Maryland Medical Center, who presented at the 2006 American Thoracic Society meeting.

But Iacono said the conferences are still a boon to researchers and clinicians who benefit from collaboration with their peers and need feedback on research and want others to adopt the new treatments they have developed.

"It enhances your ability to show your work like an artist at an exhibition, and it can make your work more believable if you're able to answer questions and defend it against the arguments that are brought up," he said.

While Green foresees a time when, "huge international conferences will be as outdated and unsuitable for a modern world as the dodo, the fax machine, carbon paper, and the horse drawn carriage," other doctors don't think that time has come.

If international medical conferences were to halt, the idea would be to see results, and Drife is unconvinced that others would follow physicians' leads.

"I feel modest as a doctor about my abilities to persuade others to change their behavior, unless this is directly related to medical matters," he said. "Politicians and pop stars would have a lot more influence than doctors if they did less flying."