Conferences, East vs West

I'm in Chicago attending the American Transplant Congress. Some thoughts:

1. People finish their talks on time. The sessions finish on time. They must be rehearsing and timing their talks. This is something Dr Nundy always used to emphasise at Sir Ganga Ram Hospital. We used to have several rounds of rehearsals of all the presentations the members of the department used to make at various national and international conferences. However, most Indian doctors do not follow these basic norms at national or regional conferences. I wonder why? Is it laziness? Do they not feel the need to rehearse and time themselves? Is it disrespect for the other speakers? I know of people who are arrogantly convinced that what they have to say is more important than what the next speaker may have to say and the audience should be grateful to them for deigning to speak for longer than the allotted time.
2. The transplant community in the US seems very large in proportion to the volume of work they do. Even if we factor in the basic research component, the bloat seems enormous. Are they all busy? Are they all doing important research? So much of the research has degenerated into alphabet soup, research for the sake of doing research instead of a genuine effort to find solutions to problems. The whole thing looks very inefficient.
3. There is a definite stagnation in the field of transplantation. Nothing important has happened in the field of immunosuppression in the last 25 years. Technical innovations and improvements are increasingly emerging from Japan, China, Korea.
4. I think tolerogenic immunosuppression inevitably needs to develop in the setting of living donor liver transplantation where pre-transplant intervention is going to be an integral part of inducing tolerance. Perhaps an East-West collaboration is the way to move forward.