Intended for healthcare professionals

Rapid response to:

Head To Head

Are international medical conferences an outdated luxury the planet can’t afford? Yes

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.a358 (Published 26 June 2008) Cite this as: BMJ 2008;336:1466

Rapid Response:

Confessions of an Oncotourist

Confessions of an Oncotourist

By way of economy I am able to conflate my rapid responses to two BMJ debates in sequential issues of the journal, commenting on my double life as a key opinion leader and as someone who enjoys the luxury of international medical conferences. Many, many years ago, in the golden age of the popular journal, “World Medicine”, I coined the term “oncotourism”. This described an activity in which I was actively involved, thoroughly enjoyed, secretly ashamed of, and like the subject itself demonstrated uncontrolled growth at the primary sites with a propensity to metastasize. I look back over a long career in breast cancer research and wonder whether my journeys were really necessary. On many occasions my club class flights and accommodation at glamorous conference resorts were paid for by industry and other occasions from “slush funds” in my academic department’s account. I could never have afforded to lay out for myself but I tried to reassure my conscience that all this was a reward for my years of self denial in eschewing private practice. Thus I have seen the world at other’s expense and enjoyed the sightseeing and camaraderie enormously. In addition my knowledge has grown and my wits sharpened in the cut and thrust of academic debate. I’ve taken the odd modest honorarium at industry sponsored events, when 7-11 hours of jet lag has been rewarded by, the now going rate of $3,000.

So who loses and have I sold out? Of course I leave others to judge, but I honestly believe that my advocacy of adjuvant endocrine therapy for early breast cancer has spared many women the toxicity of chemotherapy and added to the thousands of lives saved over the last 20 years. Furthermore there have been many occasions when I refused to toe the party line and have never avoided controversy. So I’ve had fun, industry’s sold drugs, lives have been saved then who’s lost out? Now at last I have found a genuine reason for guilt – my carbon foot print is all over the face of our beautiful globe. Perhaps as penance I can suggest a partial remedy - Stop the proliferation of unnecessary meetings with the usual suspects repeating the same data every other month all around the planet. In any one year we have the San Antonio, ASCO, EBCC, St. Gallen, Milan, ESSO and ASBO conferences. This year alone I can add the Düsseldorf meeting, St Petersburg White nights and the Mexican society of Senology, to my list of invitations. We must inhibit this proliferation; someone needs to invent an oncotourist inhibitor. (OI)

I would like to suggest that we only need one big International meeting a year to hear new data after which all we might need is for the big wigs to report back to local or regional meeting for the young and the lame that haven’t yet started to collect air miles. (Oops another tax free perk) Their time will come. Until that time comes I will have to live with my guilt that is best expressed in the immortal words of the great poet Anon.

"Michael had a little scam, its feet were black as soot, And everywhere that Michael went His sooty foot he put." Yours Sincerely, Mike Baum

Professor Michael Baum ChM, FRCS, MD, FRCR hon. Professor emeritus of surgery & visiting professor of medical humanities. University College London The Portland Hospital Great Portland Street London W1N 6AH Tel. +44(0)20 7034 8890 Fax. +44(0)20 7034 8883 Michael@mbaum.freeserve.co.uk

Competing interests: Often receive conference expenses and honoraria from industry.

Competing interests: No competing interests

28 June 2008
Michael Baum
Professor emeritus of surgery
The Portland Hospital W1N 6AH