Last month marked my first SGIM annual meeting and the largest conference I’ve attended since the start of the pandemic. After three years of mostly virtual meetings, I thoroughly enjoyed running into old colleagues and discussing interesting issues face to face. However, I couldn’t shake the nagging feeling that bringing so many physicians together from around the country was having a major climate impact exacerbating one of the largest healthcare challenges we face. The statistics bear this out. The global event industry has been growing rapidly, with average carbon emissions estimated at 3000 kg CO2 equivalent per attendee. Viewed another way, the industry is responsible for more than 10% of global greenhouse gas emissions, on par with the entire output of the United States.¹

One silver lining of the pandemic was that it demonstrated the feasibility of fully virtual and hybrid conference models. While these types of meetings can drastically reduce emissions, virtual options come with their own challenges—many of us have experienced digital meeting fatigue and relish the chance to reconnect in person.^{1, 2} Additionally, the cost of running parallel in-person and virtual options coupled with decreased revenue from virtual-only options can be significant barriers. But this does not mean we must go back to organizing meetings as in the past—there are numerous steps we can and should take as an organization to demonstrate climate leadership.

While general meeting locations are already chosen for the next few years, SGIM should thereafter incorporate environmental impact as part of the selection process. Priority could be given to cities that reduce the total number of attendee long-haul flights or to locations that serve as aviation hubs to decrease the excess emissions that come from multi-flight itineraries. We have a wealth of prior attendee data that could be analyzed to see which locations minimize overall miles traveled. Conference venues with easy access to public transportation should be favored over those that necessitate car rental. Sites with positive sustainability records ought to be given preference. Lastly, meeting planners could factor in the pre-existing climate burdens of a location, for example trying to avoid areas experiencing water scarcity or recovering from recent extreme weather events.

We could also think bigger than the current model of annualized central meetings. Multi-hub conferences with virtual interconnections show promise in reducing emissions, with greater decreases as the number of meeting hubs increase.^{1, 3} The seven existing SGIM regions offer a ready template for selecting meeting hubs. Another option would be to move to a biennial meeting format or alternate in-person and virtual-only annual meetings, potentially reducing the overall environmental footprint by half. Alternatively, we could trial a hybrid meeting format where the registration fee for in-person attendance includes funds for purchasing carbon offsets.

There is no perfect answer nor singular action to make conferences both intimate and sustainable. That doesn’t mean we shouldn’t try. Environmental impact should be a central factor in how we design and choose our future meetings. As stewards of our country’s health, we cannot afford not to.