From ECR 2006
Drive for perfection has potential downside

Rinckside 2006; 17,1: 1-3.

verything functions like clockwork. You enter Vienna's Austria Center, collect your badge, receive a radio (why a radio?), pick up your conference bag complete with program and book of abstracts, drop off your coat in the basement (free of charge), and off you go to lectures, courses, and meetings.

Participants at the European Congress of Radiology are pampered. They get free water in small bottles and apples to crunch. There are hardly any queues. The congress infra­struc­ture runs smoothly. The professional organizers and radiologists responsible for staging the show display enthusiasm and initiative.

Everybody appears to like the annual ECR in Vienna. The number of attendees reached 16,000 this year, and more than 200 commercial exhibitors showed their products. Meanwhile, the ECR organization itself has become a major player in the medical congress market, arranging a host of different meetings and teaching courses for different radiological societies throughout Europe every year.

spaceholder red600   So why are some participants upset? Previously, most feedback about ECR and its organizers had been positive. Suddenly, there is criticism, and when you talk to people, you hear complaints. In medical terms, the pains are more moderate and diffuse than acute and terrifying. Something is wrong, but nobody can pinpoint exactly what that is.

Three days into the conference in March, I suddenly realized the cause of the discontent. ECR 2006 marked the end of an epoch. A congress has turned into an event. Professional event management has taken over and is organizing a flawless show. We have creative meeting solutions and new formats to liven up the scientific backbone of the meeting.

Why do people attend ECR? To mingle with foreign colleagues is one answer, though I doubt this is the main reason. The principal reasons are to keep up with cutting-edge science, refresh one's knowledge, get an overview of technical developments and the medical marketplace, and then yes, to meet people. Despite late-winter blizzards that have coincided with the past two conferences, Vienna itself is an attractive city for enjoying leisure time during out-of-congress hours.

Has the composition of the target group changed during the past decade? Are participants less interested in continuing education and scientific progress, and keener to be entertained and fed superficial information? Do they want to attend a trade fair and pay for it?

The line separating science (or in this case medical radiology), commerce, and entertainment, between seriousness and show, has become blurred. Walking into the Austria Center, you hardly recognize that ECR is a medical imaging congress. It looks like infotainment for people somehow connected to medical imaging. Not only this, individuality has been lost. Intermediaries arrange the congress on behalf of radiologists attracted by a circus sideshow. Watering down ECR to an infotainment show will, perhaps, appeal to the majority that follows the trend toward presentation over objective contents.

You are standing there, admiring the success, and watching the train depart in the wrong direction. Or are you on the wrong train? Is ECR catering to a younger generation of radiologists who tackle science, medicine, patient care, learning, teaching, and continuing education with a different approach from the generation before? Does the younger generation of radiologists want infotainment? I am curious to get some reactions or feedback. Are the organizers trying to tune in to the under-35 MP3 generation? Or are there other reasons?

ECR appears to be moving off focus, albeit slowly. Of course, a major conference of this size, with a target audience that ranges from private-practice radiologists to scientists, is not meant to be a purely scientific or educational endeavor. Rather, it is a combination of these two components, with social elements and a sales fair as well.

I do not intend to criticize without providing possible solutions. I am just describing the situation. Turning back the wheel never works. The question is not whether something is right or wrong, but what the consequences will be. Perhaps this does not matter. Yet I predict that genuine scientific presentations and discussions will move to smaller "elite" conferences in the future.

Infrastructure Innovations

The organizers of ECR say that it is the world's most innovative congress. It is the first congress to offer a digital preview system that enables speakers to prepare their presentations, upload them in advance into a centralized computer system, and test their functionality. It offers the possibility of copying them onto CD-ROM and having them included in eECR, the electronic congress. So all presentations are available on a central server, which also means that everything is copied, want it or not.

Every year trots out a new feature like this one. Last year, registration badges contained a chip that, for the first time, made it possible to tag and trail participants. Big Brother is watching where you are and when. Not all attendees appreciated this kind of surveillance. Some even stopped using the internal messaging system, believing it could be bugged.

spaceholder red600   EPOS, the electronic poster system, is another example of well-meant but overabundant perfectionism. It has democratized the poster sessions, and presentations are now basically standardized. EPOS has leveled poster presentations.

Watching congress attendees staring at the EPOS screens, you realize that there is hardly any contact between neighboring screens. There is no academic exchange. Participants sitting in front of their monitors have mostly retreated within themselves, creating an air of autism.

Paper posters promoted conversations and exchange. This social and scientific contact is lacking with EPOS. EPOS is useful for animations and novel presentations, but it cannot recreate the environment of ad hoc discussion that could happen when several people met, often incidentally, in front of one poster. The individualism of paper posters might be off-putting to some people. But at least they allowed congress delegates to walk through exhibitions, assess single posters at a glance, and grasp their essence within seconds. EPOS does not allow this.

One does not need EPOS at a conference. Everything could be watched from home over the web. ECR already offers such presentations. You don't have to attend the conference, just pay a small fee, and your learned paper will show up in the EPOS system.


ECR introduced radio and television coverage this year. All participants received a miniature radio. Most people must have thought that it was a nice gift to take back home for their children. I did not see anybody listening to the radio during the meeting. Why should they? They went to Vienna to talk or to listen to people. The same holds for the television program which, to add insult to absolute dispensability, was periodically interrupted by CNBC news. Participants do not attend ECR to watch television. Radio and television coverage does not fit the social dynamics of a conference of this kind.

I personally missed the welcome additional information from ECR Today, the daily newspaper that ECR Radio and TV have replaced. I used to take my copies of the newspaper back to my hotel, and back home, to read about those sessions I had not attended.

spaceholder red600   The most striking feature of ECR for me this year was the expansion of company-sponsored satellite meetings. While they were usually limited to lunch sessions, they also now run in parallel to proffered papers, competing with scientific sessions. There has never been a clear-cut distinction between the presentation of "clean" scientific results and "sponsored" results. There has been a gentlemen's agreement, though. The buck stops here. Sponsorship of scientific events can be advantageous and ethical, as long as both sides agree to this unwritten law.

Satellite symposia are considered to be sales shows, even if attendees receive CME points. Be careful. These points might not be recognized in all countries. There is no free lunch.

Succinct Expressions

The annual review of advertising slogans and mottoes at ECR used to be an entertaining game. But even this has been replaced by marketing fast food. ECR itself claims "We make congresses – and it shows." Shows with a capital "S"?

spaceholder red600   Some slogans are empty talk, some aggressive or offensive, some are rude, some likeable. They have no influence on sales. At least they do not increase them.

One company promotes itself with the message "Proven Outcome," and adds that it is "Setting the trend again." For trend, see the earlier discussion. In medicine, a proven outcome requires outcomes research, that is, the study and eventual improvement of the end results of healthcare. This would be counterproductive for sales. Most likely, they mean "Proven Income" [1]. We also have "Let's make things better." They aren't so bad, are they? "Inspire the next." The next what? "Life from inside." From inside what? "Imagination at work" will be turned into "Imagine it works."

One of the worst mottoes is the oft-quoted "Making medicine work." This implies that medicine does not work without that particular company. Doctors are morons. There are even worse slogans, not to be discussed here. Why this lack of subtlety and lack of cultural and historical understanding?

I prefer the catchphrase, "Sense and simplicity."

I should add that these comments do not imply any endorsement or sanction of certain manufacturers. They are just subjective reflections.


1. Proven Outcome at South Carolina Heart Center. We see a way to generate an additional $720,000 in annual revenue via increased cath lab capacity (www.medical.siemens.com/...). [The page has disappeared: "We recently updated our website and the page you are trying to access is no longer available."].

Citation: Rinck PA. From ECR 2006: Drive for perfection has potential downside. Rinckside 2006; 17,1: 1-3.

A digest version of this column was published as:
ECR's drive for perfection has potential downside.
Diagnostic Imaging Europe. 2006; 22,5: 15-16.


spaceholder orange "Thanks for the well writ­ten ar­tic­le by Peter Rinck ("ECR's drive for per­fec­tion has po­ten­tial down­side," May 2006). It is im­por­tant for the ECR to look cri­ti­cal­ly at the im­pact of any chan­ges based on feed­back from at­ten­dees and hard data wher­ever poss­ible in our evi­den­ce-based cli­ni­cal world.

"The elec­tro­nic posters, EPOS, have some good and some bad points. I used to en­joy walk­ing past each poster to read the title and scan the con­clus­ions to decide if it war­rant­ed fur­ther in-depth study. I can no longer do this. I need to open each poster in­di­vi­dual­ly, and that is im­poss­ible from a time and pa­tien­ce per­spec­tive.

"The ECR's de­sire to go paper­less has other sad im­plica­tions. It was a great shame that ECR Today, the dai­ly news­paper, was not pro­duced in March. In pre­vious years, I have found the news­paper to be a good source of in­for­ma­tion, both about re­cent key pa­pers and forth­coming events. People often read the paper du­ring the meeting and on the train back to their hotel. I took the issues back home with me to ensure I miss­ed no­thing. I think the news­paper should be rein­stated.

"The organizers cannot just­ify con­ti­nua­tion of the radio channel and TV station with­out a stra­tegy or argu­ment. Where are the data to show that radios and TV were used? I spe­ci­fical­ly looked and found that they were not used con­struct­ive­ly. I fail to see how you can re­place an essen­tial service (the news­paper) with­out an accu­rate eva­lua­tion of its re­place­ment.

"The other item miss­ing from this year's mee­ting was the Imagine section (pre­vious­ly called Matrix). This area was one of the con­gress high­lights, and it dif­fe­rent­iat­ed the ECR from all other meetings. ECR staff told me this dis­play area was stopp­ed because no­body attend­ed it. I find this in­com­pre­hens­ible. The area pro­vided an op­port­uni­ty to talk to some of the key re­sear­chers and under­stand some of the issues in­volv­ed in fu­tu­re pro­ducts in the deve­lop­ment pipe­line. These in­di­vi­duals also ap­parent­ly gained a great deal from the inter­actions with a wide va­rie­ty of po­ten­tial cli­ni­cal users. This sec­tion is ir­re­place­able and should be rein­stated. In some respects, the or­ga­ni­zers are like parents treat­ing at­ten­dees as small chil­dren. They think they know best what the at­ten­dee wants, and in doing so they stifle in­di­vi­dua­lity and flair.

"I only hope that the Rinck­side column stirs some people into action and makes people take a cri­ti­cal look at the fu­ture of the congress. The ECR must respond to the needs of the ave­rage at­ten­dee. The abi­li­ty to pre­sent high quality, state-of-the-art basic ra­dio­logy prac­tice should be high on the list."

Dr. George Ratcliffe
Senior Strategic Analyst
Henley-on-Thames, United Kingdom

spaceholder orange "With a con­sent­ing smile, I have read Peter Rinck's column about the ex­ces­ses of the ECR. In many in­stan­ces, he hits the nail on the head.

"Above all, the sa­tel­lite sym­po­sia have to be stopped: Com­mer­cial pre­sen­ta­tions blended with pseudo­scien­ti­fic in­for­mation and a lunch bonus, compet­ing with actual con­fe­rence lec­tures! It re­minds me of foot­ball: Those who want to grow (i.e., le Fe­de­ra­tion Inter­na­tio­nale de Foot­ball Asso­cia­tion) in­crea­sing­ly rely on enor­mous spon­sor­ship, and in the end the spon­sors take con­trol.

"The re­marks con­cern­ing EPOS are also cor­rect. Elec­tro­nic posters can be put on the web and be read any­where, but at con­gres­ses, the in­spec­tion and per­ambu­lation of real posters has always had per­so­nal cha­racter.

"The com­mer­cia­li­za­tion of a major scien­ti­fic plat­form has assumved alarm­ing pro­por­tions and will lead to a fur­ther shift in the struc­ture of the par­ti­ci­pants. At one end of the spec­trum will be in­creas­ing "medi­cal amuse­ment tourism" with lunch sym­po­sia, con­gress radio, and Mo­zart cho­co­late balls. At the other end will be specia­list scien­ti­fic con­fe­ren­ces, bring­ing to­gether ra­diovlo­gists who will pay for their own sau­sage and beer at small-scale meet­ings."

Dr. Christian Lauer
Dienst Medische Beeldvorming
Waregem, Belgium

spaceholder orangeUser sub­mitt­ed feed­back or con­tent: Users are solely re­spons­ible for the con­tent of their sub­mis­sions. How­ever, while Rinck­side does not and cannot re­view every sub­mis­sion and is not re­spons­ible for the con­tent of these mes­sa­ges, Rinck­side re­serves the right to de­lete, move, or edit sub­mis­sions that it, in its sole dis­cre­tion, deems ab­usive, de­fama­tory, ob­scene, in vio­la­tion of copy­right or trade­mark laws, or other­wise un­accept­able.

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The Author

Rinck is my last name, and a rink is an area of com­bat or con­test. Rink­side means “by the rink.” In a double mean­ing “Rinck­side” means the page by Rinck. Some­times I could also imagine “Rinck­sighs”, “Rinck­sights” or “Rinck­sites” …
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