While many observers of the AHA and the ACC (including myself) have been critical of the close relationship of these organizations to industry, it is clear that the ESC has a much cozier relationship with industry than its US counterparts. Here’s one way this could impact attendance: a substantial percentage of ESC attendees have their travel and registrations costs paid by industry. To the best of my knowledge this type of wholesale support no longer occurs at US meetings, though I believe that foreign doctors often have their trips to ACC and AHA organized and paid for by industry. The ESC estimates that about half of all “delegates” receive financial support for attendance, but doesn’t know what percentage of that comes from industry as opposed to support from universities or other nonprofits. But it seems likely that this support may well play an important role in the rise of the ESC.But there are other challenges that face US investigators. The fact that the path to regulatory approval is much longer in the US than Europe is lost on no one in industry. As a result, new innovative technological and medical trials are increasingly not only migrating outside of the US for their tests runs, but increasingly are being conducted primarily outside the US. This leaves many large American academic centers scrambling for tidbits from industry to fund their existing research infrastructure. (Some companies have capitalized on this hunger for cash by offering post-market studies with rosy financial incentives in an attempt to gain product market share, only to find some quickly become subjects of whistleblower lawsuits.) This same hunger for cash has increasingly converted once happy researchers with "protected time" to unhappy clinicians with productivity quotas as the financial noose is tightened in many research centers.
America still has fine institutions and creative thinkers, but the fiscal challenges of our health system, current health care recession, and regulatory climate make the promise of speedy innovation in America more limited than anytime in our history.