It's here again.


The leaves turn. The air chills. Hordes of travelers clog airports, all in migration and intent on renewing our annual tradition: Gather the tribe. Eat too much. Drink too much. Renew old acquaintances. Rekindle old rivalries. Listen politely, or not so much, to people spout things that we don't believe for a minute. Maybe in the end, if we're lucky, we learn something of value to take back home.


Yes, it's the Academy of Ophthalmology's annual meeting. This profession's own bloated little monument to excess. And as we do after Thanksgiving, this month's other monument to excess, most of us (to ourselves, anyway) will ponder on the flight or the drive home—Why do we keep putting ourselves through that?!


There's been no shortage in recent years of argument against annual medical conventions such as this one. That there are way too many meetings is universally accepted. Live CME events at these meetings have spotty effectiveness at best in terms of real education of physicians. The expense, both in lost revenue while away from the practice and in direct costs for travel and lodging for physicians and staff, is higher every year, with dubious return on investment. And exhibitors—they're never satisfied.


Every new medium that comes along—videotapes, CDs, DVDs, the Internet—is going to supplant live meetings and spare us all of this. Until the next one comes along.


And yet, every year, we come back. Probably, if I may torture the Thanksgiving analogy just a little further, for the people. With all due deference to the speakers and lecturers and the hard work they put in, most physicians will say that it's the hallway conversations, the diagram on the cocktail napkin, the conversation in a shared cab ride that produce the most memorable ideas and most lasting value.


I'm all in favor of finding a way to make this and every other meeting more useful. Is it all just too much? Yes. Can it be done better? Hope so. But until someone finds a way to replicate those behind-the-scenes, personal contacts, this is what we have. I've seen suggestions that we need to cut back and not have meetings like this every year. But that would be like canceling Thanksgiving, and only an ogre would support that, right?


Right?