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I love conferences. Euretina I love above all others, and when it came to London in 2014 I was determined to attend. A few weeks before the conference was scheduled to begin a well-known pharmaceutical company sent me an email inviting me to attend a focus group, along with a colleague on the Welsh rotation, taking part after hours during the conference. The dinner to follow was to be at a fancy London restaurant and the actual focus group itself was only scheduled to last an hour and a half.

My colleague, a quiet, intelligent chap with a high sense of morality, was dubious about the benefit to the company of our attending and was reticent about accepting the offer. From my perspective the benefit was dinner at a fancy London restaurant and the opportunity of seeing how focus groups function. The topic was coming up with a definition of treatment failure in a medical retina condition. “What could two registrars possibly contribute to this group?” he said. “Relax,” I replied. “There will probably be many people there; you know how these industry things are. It will just be an excuse to tell us about their products. You won’t need to say a thing.”

Being more intelligent than me he did not seem entirely convinced. He was of the opinion that it would be a small gathering, our participation would be mandatory and we would be expected to provide well thought out opinions in return for dinner, unlike the usual industry affair. This school of thought was further supported by a follow-on email a few days later which thanked us for our decision to attend and offered a £300 award for our attendance. No industry dinner I ever attended after a conference offered any money to attend. Usually all that was required was a half decent buffet dinner and a bottle of wine.

Despite his reservations I steamrollered him into attending and a few weeks later we arrived at the posh hotel reception area where the focus group was due to take place. There were no milling crowds of conference delegates carrying identical bright blue bags with a picture of London on the side. There was no big sign with an industry logo. More importantly, there was no long table with half-filled glasses of wine on. My friend looked at me and raised an eyebrow in an “I was right” sign. “Relax,” I said, less certainly. “I’m sure there will be plenty of people here.”

“The collected wisdom of ophthalmology looked at me and after a second to digest what I had said resumed arguing among themselves as if I had said nothing at all.”

A Scotsman in a suit welcomed us and led us to an impressively attractive woman sitting behind a table with a list of delegates. A very small list. “How many people will be here?” I asked. “Thirty?” Hmm. Thirty wasn’t so bad I thought, though less than I had anticipated. Much less. “Oh no,” the ludicrously attractive woman replied. “Now that you two are here, 13.” Thirteen. An unlucky number. I had been wrong and the consequences of this fact did not require any elaboration. We would be with 11 experts and be expected to provide a useful function, the consequences of failure being humiliation the likes of which we had never before experienced.

My anxiety was not helped by the fact that the group of 13 was further split in half and in my group there were famous medical retina personalities, including an ex-president of the college, as well as people whose faces I recognised but could not quite place. We were the only registrars. Sitting down at a small conference table, palms sweaty, the group leader started the discussion and I watched as the titans of the profession clashed and debated the issue. Studies were quoted and when opinions differed energetic justifications were required and everybody was certain of what they thought. The trouble was that everybody seemed to think something different to everybody else.

From my perspective I was also fairly certain. The only definition of success was complete drying of the macula and anything short of this could only be failure. Trouble was, nobody else seemed to share this opinion and I had nothing to back it up other than a form of gut instinct and a few charming but utterly evidence-based-medicine free anecdotes. I thanked my lucky stars that the level of debate was such that neither me nor my colleague could have contributed even if we had wanted to. Which we did not.

Without warning the lady attempting to keep control of the focus group, until then rather ineffectively, hushed everyone. Looking directly at me and my colleague she asked us what we had to contribute. Important and somewhat irritated faces looked directly at me. In stuttering sentences I put forth my opinion and tried to back it up with a charming anecdote, which was difficult with such a dry fearful mouth. Would I be ripped to pieces like the lady at the far end had been? Would I be out-studied and out-knowledge based? The collected wisdom of ophthalmology looked at me and after a second to digest what I had said resumed arguing among themselves as if I had said nothing at all. I was reminded that the ‘predator’ from the movie franchise of the same name did not bother attacking weak or vulnerable prey, considering it beneath their honour and dignity. Luckily, my friend, when asked, simply said “Well I agree with you all really,” which would have been an utter impossibility as everybody had completely different opinions. But at least I was not the Omega male. Perhaps I was the Psi male instead, second to last.

The focus group finished and the invigilator asked for a summary of our findings. As absolutely nothing had been agreed there were no actual findings and the most nebulous paragraph in history was concocted to include everybody’s viewpoint that was impressive in its length and in the fact that it conveyed no information whatsoever.

Over dinner in the fancy London restaurant I asked one of the industry representatives what the company could have possibly gained from this exercise. She replied that there was a lot of information to process and it would be very useful indeed but I could not see how. A few months later my friend and I were invited to a second focus group by the same company. You will perhaps not be too surprised that we both politely declined the offer.


The views expressed are those of the author and do not represent those of the editorial team or the publisher.




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Gwyn Samuel Williams

Singleton Hospital, Swansea, UK.

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