![\"Richard](\"http:\/\/www.bmj.com\/site\/blog\/icons\/bmjh7648e.jpg\")
\u201cDoctors are not interested in health\u201d is one of my many wild generalisations. My evidence is my experience, a 40 year collection of anecdotes, and the observation that a thousand page medical textbook usually comprises five desultory pages on health and 995 pages detailing disease. Now I have further evidence.<\/p>\n
I\u2019ve just attended the World Cardiology Congress in Dubai, an event with more than 10 000 attendees and an A4 programme that is 370 pages long. Not used to such extravagant events, I imagined every session packed with enthusiasts.<\/p>\n
In fact when I arrive at a session on \u201cPrevention of cardiovascular disease in emerging economies: the role of pharmacological intervention\u201d I discover that I\u2019m the third person apart from the two chairs and the three speakers. Nobody else arrives, but the session begins.<\/p>\n
The first speaker is from China and tells us that stent insertion has been increasing by 30% a year since 2000 but that very little has been done on prevention. He observes as well that 50% of doctors and 70% of cardiologists smoke. It\u2019s perhaps some sort of justice that the doctors\u2019 lack of interest in health and prevention extends to themselves as well as their patients and potential patients. During this first talk, the man sitting in the front row realises that he\u2019s in the wrong session and leaves. This reminds me of my brother\u2019s first performance at the Edinburgh Fringe, when there were seven people on the stage and four in the audience; and because of audience participation it was later eleven on the stage and none in the audience.<\/p>\n
We then have two excellent presentations on prevention in Brazil and the role of the polypill, and the audience has grown by three. (One, I suspect, might be the wife or mistress of one of the speakers. Global conferences can be a good time to arrange an assignation with your mistress. I hasten to add that I write this from imagination not experience and have no evidence whatsoever that the woman in the audience with the short skirt is anybody\u2019s mistress.) Although we now have five in the audience, I note that two of them are looking at their Blackberries.<\/p>\n
I must admit that the title of the session made me suspicious that the organisers might be pandering to some \u201chigher agenda.\u201d Why \u201cemerging economies\u201d rather than \u201clow and middle income countries?\u201d Perhaps because business, the sponsors of the meeting, are more interested in these countries with huge populations and rapidly growing economies than they are in countries like Rwanda or Sri Lanka. The same considerations might explain the emphasis on drugs rather than lifestyle or public health interventions.<\/p>\n
After this session I go and chair another session on prevention (which is why I am here), and now we have an audience of about ten, only five of whom are from the same place as the speakers. During the session, however, one gets a phone call and leaves and three others, who have sat at the back, leave. Perhaps they got a better offer.<\/p>\n
I didn\u2019t go to any other sessions, and perhaps they were all equally empty. It might have been that those at the conference followed the advice of a colleague: \u201cOnce I\u2019ve learnt three things at a conference I head for the beach or a bar. With luck that happens in the first 20 minutes.\u201d I was told, however, that a session on stents was full to overflowing. Stents mean money, drama, and even beautiful women and a slot on the television.. Prevention, in contrast, is boring, all about what doesn\u2019t happen rather than what does. Plus, were it to be successful it would put cardiologists out of business. Then there would be no more conferences in exotic venues.<\/p>\n