The changes all around us

I have attended AAPA annual conferences since the late 1970s, and while I don't attend every year, I attend more meetings than I miss. Thus over the years I have had the luxury to observe the changes the profession undergoes just from experiencing the conference. This year's conference caught my attention because there were some characteristics about it that appeared to me to be quite different from those before it, maybe indicating some new forces of change.

The impact of the country's depressed economy was evident most everywhere. Driving into Las Vegas, the large number of vacant homes and storefronts was hard to ignore, and rush hour traffic on the freeways was much lighter than the last time I'd been there several years ago. As I approached the convention center, some of the hotels and casinos were closed, as were a surprising number of nearby businesses. After I parked and had checked into the hotel, I noticed that the large casino in the lobby was alive with the persistent sounds of slot machines, but, unlike previous Las Vegas conventions, many of the machines were sitting unused. My first impression was that conference attendance was low, but I as I picked up my name badge at the registration area, I was told that conference attendance was actually quite high.

The most striking change was the decreased size and glitziness of the exhibit hall. At the last AAPA conference I attended in Las Vegas, in 2004, the culture of the conferences exhibitors was permeated everywhere, and the exhibit hall was massive, exuding the feel of a high tech amusement park. The opening of the exhibit hall in that era had grown to take on a stampede-like ritual, with a mob at the opening of the hall descending on the exhibits like shoppers at the mall at the opening bell of the holiday shopping season. However, with fewer exhibitors handing out fewer goodies, the opening of the exhibit hall this year was a sedate event. Clearly the weak economy (combined with substantial cutbacks in pharmaceutical industry support) has altered the conference experience. While this change was most profoundly displayed in the exhibit hall, it was also apparent throughout the rest of the conference, as the previously prominent pharmaceutical company presence of past conferences was conspicuously subdued.

Of course, much more change than just that was observable, changes that to me seem gradual and not all that surprising. The profession continues to appear increasingly younger, likely in part due to my personal perspective as an aging member, but also because newly graduating cohorts continue to grow larger and the average age of enrolled classes continues to drop. I also observed that younger PAs I met were likely to practice in specialty settings, while older PAs practiced in primary care, which mirrors recently published data showing that a large proportion of the past decade's growth in the profession entered specialty care. I also observed one constant that really hasn't changed over the years – that fundamentally the PA profession consists of individuals who are, always have been, and are likely to continue to be folks I really like and am proud to be one of.

Frankly, I don't know what to make of these changes. I never really felt all that comfortable with the increasing glitziness of the conferences, so this moderation strikes me as a welcome change. However, I suppose the important question is this: With a weaker economy and less outside support, will our professional organization and its annual conference meet the needs of a dynamic and growing profession to help take us into the future?