That just about sums up how the hospital industry and the American Hospital Association feel about the AHA's annual summer convention.
After 95 Julys, Augusts and Septembers in often sweltering locations like Dallas, New Orleans and Orlando, the AHA is pulling the plug on its traditional convention following this month's meeting in San Francisco.
Next year's convention in Philadelphia will feature a new but sketchy format and will be co-sponsored by the Middle Atlantic Health Congress, which was lured by the AHA to give up its annual spring convention in Atlantic City in 1996.
The congress is sponsored by state hospital associations in Delaware, New Jersey and Pennsylvania.
Richard Wade, the AHA's senior vice president for communications, said he was not at liberty to disclose the details of the financial incentives needed to sway the group, but he described the arrangement as "very good" for Middle Atlantic.
Beginning in 1997, there won't be a convention as the industry has known it, and what exactly will replace it hasn't been finalized.
After months of debate, the AHA's board of trustees made the formal decision to phase out the convention at its March meeting (April 3, p. 4). But the decision seemed almost logical after Richard Davidson took over as AHA president in 1991 and began shedding the AHA's historic fee-for-service activities. Under Davidson's leadership, the association's stated goal has been to focus AHA resources on two main activities: advocacy and education.
Davidson also moved the AHA president's office to Washington from Chicago, and the association's annual policy meeting in Washington has become the AHA's flagship gathering.
Attendance at this year's AHA Washington meeting in January hit a six-year high of 2,725.
However, AHA executives maintain that they did everything they could to save the annual summer convention, including: replacing dozens of conflicting mini-educational sessions with big-issue sessions having broader appeal, setting aside dedicated exhibition time, moving educational session rooms to the convention floor, and replacing the formal presentation by the AHA president with a town-hall-style gathering.
"We tried everything," Wade said. "We just didn't see any growth pattern in attracting back top management."
Convention attendance hit a recent low at the 1993 meeting in Orlando, Fla., which drew just 3,327 people, including speakers, AHA staff, press and exhibitors (See chart, p. 47).
Anyone who walked the convention floor in Orlando felt the angry stares of 422 vendors, who bought booth space only to show their wares to one another.
"There's always a perception by exhibitors every year that things aren't quite as busy as the year before, and there aren't any decisionmakers walking the floor," said Jeff Gruber, vice president of sales and marketing for Fischer Mangold, a Pleasanton, Calif.-based emergency physician services company. "But Orlando was the worst that I've seen it."
Gruber attributed the problem to the many sites to see in Orlando, which drew attendees away from the convention, and to the AHA, which Fischer Mangold and many other exhibitors felt didn't do enough to attract people to the trade show floor.
"We didn't feel that the AHA was going out of its way for the exhibitors, and we made our feelings known to the AHA," Gruber said.
The association responded to the concerns of the exhibitors the following year at the convention in Dallas by shortening exhibit hours and reducing events that conflicted with those hours. Still, the number of exhibitors dropped by 9% to 384 in Dallas from 422 in Orlando.
During the Orlando meeting, AHA executives blamed the poor showing on, among other things, flooding in the Midwest. It also was the first year in recent memory that Baxter International opted not to throw its usual mega-party for conventioneers (July 19, 1993, p. 40).
Speculation aside, the low turnout was a sign that the gathering was running out of steam, despite an upswing in attendance in Dallas.
Wade blamed a number of external forces for the convention's demise:
Time constraints on hospital senior managers that reduced travel.
Vendors becoming more selective about exhibit commitments.
Growing diversity among the educational needs of hospital executives that made it difficult to put together a meeting with mass appeal.
The development of specialty meetings by the association's personal membership societies and other organizations that offered to link special-interest attendees with vendors catering to those particular audiences.
Also apparent to AHA watchers was the dwindling role of the association's 218-member House of Delegates, which meets en masse once a year at the convention. Unlike the American Medical Association's House of Delegates, which engages in open debate on AMA policy issues, the AHA's house primarily performs a ceremonial role.
The house is the AHA's ultimate policymaking body. Yet, it rarely served as the ignition to new AHA policy, typically rubber-stamping recommendations made by the AHA's board. In most years, the house's actions were limited to approving nominations for the AHA board.
Earlier this year, the AHA board passed a bylaws change that exempts the house from meeting physically once a year. The change permits house members to link up electronically via teleconference, phone or fax.
"The House of Delegates will no longer meet as a group unless it has to," Wade said.
But other observers suggested that it was the deteriorating quality of the educational programming that gnawed away at the annual convention.
"Most people attend meetings for the educational component. Then comes networking and exhibits," said Jim Dolph, president of the New England Healthcare Assembly. "If the educational programming isn't powerful, then the primary reason to go isn't there."
The assembly is a not-for-profit corporation that puts on an annual meeting and exhibition for healthcare executives in Boston in March. Representatives of five Northeast state hospital associations have seats on the assembly's board.
Dolph suggested that the decline of the AHA convention was linked to the emphasis the association placed on Washington-based advocacy after Davidson arrived on the scene.
"I don't think it's any more complicated than that," he said.
Dolph said the phase-out of the AHA convention will make the assembly's meeting the largest general healthcare conference featuring a trade show. In fact, the assembly's meeting may get a boost in attendance and exhibitors with the end of the AHA convention.
And that may come at a critical time for the assembly. Although the number of exhibition booths at this year's meeting climbed nearly 16% to 310, total registration hit a five-year low, dropping more than 6% to 6,750 (See chart, p. 47).
Other more focused healthcare gatherings also may get a boost from the decline of the AHA convention, although some don't need it.
Total registration at the Healthcare Financial Management Association's national institute, for example, tipped 1,400 for the third year in a row in June. It's one of the hottest meetings on the convention circuit because of its specialized financial audience to which vendors can target products and services.
The HFMA also controls the number of exhibitors to keep a balance between healthcare executives and vendors, said Richard Clarke, president of the Westchester, Ill.-based group, which represents financial managers.
At this year's national institute, held last month in Chicago, the HFMA had 156 equal-sized exhibit booths, up from 149 booths at last year's national institute in Washington.
Clarke said the HFMA has a waiting list of more than 30 vendors that want to exhibit at the group's annual gathering. Consequently, the national institute won't experience an explosion of exhibits because of the demise of the AHA's annual summer convention.
"We may gain some attendance but not a significant amount," he said.
Another group that may pick up some of the AHA spillover is the Federation of American Health Systems, a trade group representing about 1,000 investor-owned hospitals.
The FAHS hosts an annual meeting and trade show that's considered another one of the rising stars on the healthcare convention circuit, particularly with the market changes being paced by for-profit hospital chains like Columbia/HCA Healthcare Corp.
Attendance at the FAHS annual meeting in Dallas earlier this year inched up to 2,015 from 2,007 last year, and the number of exhibiting companies followed suit, creeping up to 232 from 230. But those figures still represent the highest in each category over the past five years (See chart, p.47).
And if there's no AHA convention, said Thomas Scully, FAHS president and chief executive officer, "we may become more popular with vendors. I hope they all come to us."
The FAHS already may be feeling the effects of the AHA convention phase-out. Space at the trade show at next year's FAHS annual meeting in Washington in March is sold out.
If Hill-Rom Co., the nation's largest maker of hospital beds, is any indication, vendors that spent money on exhibit space at the AHA convention will just spread it elsewhere.
"I'm sure we'll save some money, but most of it will be diverted to other areas," said Tim McMullen, vice president of corporate accounts and managed care at Hill-Rom.
The company, which is a subsidiary of Batesville, Ind.-based Hillenbrand Industries, historically has had one of the largest exhibit booths at the AHA convention. McMullen declined to say how much Hill-Rom spends annually at the AHA gathering.
Although the company had no plans to abandon the convention, McMullen acknowledged that the meeting drew fewer and fewer people to the exhibit floor who were in the position to make decisions about hospital bed purchases.
"Those decisions have been pushed down to the front lines," McMullen said. "And those people are attending more and more specialty shows."
He said the company has followed the market and is exhibiting its products at more nursing conferences and other specialty shows.
As for what will replace the AHA convention, association executives either aren't sure or aren't saying.
In past interviews, AHA officials said the options included a spring meeting without a trade show or combining some of the convention's activities with the annual congress held each winter in Chicago by the American College of Healthcare Executives.
Wade said the AHA also is considering a series of regional meetings-maybe four or five a year-that would be tailored to key issues in those regions. Although the meetings wouldn't feature a traditional trade show, they would offer opportunities to vendors to sponsor or underwrite a component of a regional conference, such as a specific educational session, he said.