Conferencing is Better in the Public Square

A senior academic leader recently gave me well-intentioned career advice: attend more conferences. The logic is straightforward. Conferences have long been the go-to-venue to increase visibility, expand your network, and create opportunities beyond your regular work and immediate network. I considered the advice seriously. The more I considered it, the more I recognized that I am, for all intent and purpose, conferencing on a regular basis, just not in the way academia recognizes, incentivizes, or yet, acknowledges.

This post unpacks my disconnect with that well-intentioned advice and makes the case for a different way of conferencing, based on my own experience (or “lived experience,” as the kids say, as if there’s another kind).

What Conferences Are Supposed to Do

Conferences are designed to accelerate scholarship and careers by cultivating conversation, feedback, collaborations, and knowledge. In the ideal version, a conference is a high-intensity environment for critique, community building and learning. You present early work to solicit constructive critiques before they harden into Reviewer #2 comments (IYKYK). More than anything else, the main purpose of conferencing is the conversation they stimulate, the relationships nurtured, and the career opportunities created.

The Reality of the Modern Academic Conference

The typical conference experience often falls short of that ideal. Content is siloed into a single specialty and often subdivided further into tracks that mirror existing disciplinary boundaries. Talks are constrained by time and format, and often do not permit methodological clarity or rigorous debate. The Q&A session is short, frequently deferential, performative, and shaped by hierarchy and social dynamics. Poster sessions include some truly excellent work, but also include too many overly ambitious, infeasible, or poorly conducted projects that will never travel beyond the hall. Even when the science is strong, apart from a select few podium presentations at major specialty conferences (hello cardiology), the reach is limited to the few audience members who are often your or your co-presenters’ mentors, advisors, collaborators, and friends.

The costs are not trivial. Registration, flights, hotels, and missed time add up quickly. So do the less visible costs, including childcare, recovery time, and the opportunity cost of being away from the work that actually moves ideas forward.

After nearly a decade of conferencing two to three times per year, when I ask myself, “Did this conference change my research or career?” the answer has too often been a resounding No.

Modern Conferencing Lives in the Public Square

If the purpose of conferencing is exchange, then the public square is where exchange happens at scale.

A curated social media experience is continuous. It is not limited to one annual meeting. It is not restricted to one society or discipline. It is not constrained by the same relational power dynamics. Ideas can breathe on their own and are judged less on the credentials of those espousing them. You can participate when you want to, follow the evolution of an idea over time, and engage in dialogue with people across the globe within your field as well as those outside who can offer fresh perspectives.

The public square is an incredible way to solicit feedback. Conference feedback is important, but it is limited due to constraints of time, format, social norms, and expertise in the room. It is unlikely to solicit honest input from the range of experts that are often needed, ranging from content, theory, methods, translation, and policy. In contrast, the public square offers the opportunity to elicit feedback across a wider spectrum of expertise. The signal-to-noise ratio depends on curation of who you follow and engage with, but when it works, it is far closer to robust pre- and post-publication peer review than casual commentary. It is specific and timely.

The economics matter too. The public square has dramatically lower costs. No travel. No institutional gatekeeping. That matters for equity, but it also matters for efficiency. If your goal for attending a conference is knowledge exchange, why pay the overhead of hotels and convention centers to do what can be done better with an internet connection?

The Public Square has Tangible, Meaningful Benefits

For me, the benefits are not abstract. I have found the public square indispensable for learning new methods, tracking emerging evidence, and picking up practical insights I would not have encountered in my usual lanes. The back-and-forth is often richer than conference Q&A because it is not constrained by the clock or by the social norms of not upsetting the wrong person. It also draws from a broader audience: subspecialists, methodologists, policy leaders, trainees, and members of the public. That mix is hard to replicate at conferences. Good ideas are not concentrated by geography, discipline, or even within academia.

The public square is where preliminary work in abstracts and preprints gets vetted, and where post-publication debate happens in real time. A recent example was the vigorous discussion on X of a recent flashy Nature Medicine study on time-of-day for immunotherapy. That conversation inspired my own AAOx2 post contributing to the critique which collectively led to an editorial investigation covered here (where I am quoted).

Another vivid example was a study our team published on the limited evidence base supporting the American Thoracic Society (ATS) clinical practice guidelines that effectively define the standard of care for lung disorders and many critical care illnesses. We had shared our findings by email in advance of publication, but the then-Chair of ATS still launched a diatribe on X (since deleted). Within 48 hours of publication, there was a substantive back and forth exchange that amounted to the equivalent of a letter to the editor and a letter in reply. On the usual publication timeline, that would have taken months!

The public square has also amplified my teaching. Through tweetorials, videos, and Substack posts, I interact with far more trainees and colleagues than I ever could at an in-person meeting. Instead of speaking to a room of ten or twenty, the same content can reach thousands, persist, and be revisited. Just as important, the public square flattens the usual gatekeeping. The activation energy is lower, especially for trainees at institutions without deep benches of scholarship and mentorship. This has led to back-and-forth exchanges, email messages, and invitations to trainee-run podcasts (Diagnostic Excellence on The Good Omen and Evidence-Based Medicine on Baseline Observations).

These interactions have produced tangible rewards. Through conferencing in the public square, I have secured two contracts, received two real job offers, and started several collaborations. They have also expanded my peer network. Several of these relationships have become real-life collaborators, mentors, mentees, and friends. That is the spirit of conferencing, achieved more consistently and with far greater reach than the typical meeting.

None of this requires pretending social media is perfect. It is not. It is noisy, performative, and yes, occasionally toxic. But those are design problems, not fatal flaws. With careful curation of who I follow, mute, and block, the public square can approximate what conferences are supposed to do, and in my experience, far exceeds them.

What We’re Really Letting Go Of

If we allow that the public square can accomplish or even exceed the goals of conferencing, then defending the primacy of the conference model becomes harder to justify. What often gets defended is not learning or critique, but the infrastructure of academic signaling. Conferences remain a reliable way to add to CVs and build the case for national visibility, promotion and leadership selection. The problem is treating the conferences as the sole, or even the best venue for discovery, feedback, networking, and opportunities.

The public square is not anti–human connection. Many things are better face-to-face, like relationships and collaborations. The public square is a vital first layer for discussion, critique, and dissemination, and developing connections that would have otherwise never been possible in the conference model that often requires social capital and networking skills to succeed. The relationships and ideas generated through conversation can then spiral into further offline conversations, remote collaborations, site visits, mentee-mentor relationships, contracts, and job offers. These are real, tangible, and meaningful benefits.

If the goal in academia is exchange, networking, and collaborations, then we should stop pretending the hotel ballroom is the only or even the best way to achieve that in modern times. Until then, the best conferencing will keep happening where the conversation is already taking place, in the public square.