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Physician mocks Microsoft cancer-cure plan


Computer hard drive.

Roy Poses, M.D., who runs the Health Care Renewal Web site, denounces what he sees as the arrogance of Microsoft for claiming it  can cure cancer.

He writes that the company sees cancer as “just a software platform problem: Microsoft will ‘solve’ cancer within 10 years by ‘reprogramming’ diseased cells.

“Hand a computer scientist a computer and some genetic data, and the world then becomes a deterministic, binary place.”

“We are only scratching the surface in genomics, and to state it is merely a ‘computational problem’ as if biology worked like a deterministic, binary digital computer is, in my mind, wishful thinking.’

“It would be great if genetics were just one big Intel Core I7 that one could program in binary assembly language after decoding its instruction set, but I have doubts it’s that simple. ”

To read Dr. Poses’s post, please hit this link.

Dr. Poses goes after Steward Health Care


Roy Poses,  M.D., in his Health Care Renewal blog,  denounces Steward Health Care, a private-equity creature that will sell off its hospitals but continue to operate all of them.

His comments stem from a Sept. 26 Boston Globe article leading off with:

“Steward Health Care System said  that it lined up $1.25 billion from a real estate investment firm that will help the Boston-based company finance a national expansion, pay off debt, and return money to the private equity firm that bought it almost six years ago.

“Steward said Medical Properties Trust Inc. would buy all of its hospital properties for $1.2 billion and pay $50 million for a 5 percent equity stake in the company. Steward will lease the properties from MPT, based in Birmingham, Ala.”

Dr. Poses writes:

“Steward Health Care, as run by Cerberus {a private-equity firm}, was one of the earlier leaders in hiring corporate physicians, whom it pressured to avoid ‘leakage’ of patients to other hospitals and doctors, even if some might question whether the care provided elsewhere might be better for those patients. The multimillion dollar a year CEO of Steward suggested the health care had become a commodity, objectionable to those who thought that health care should be a mission-based calling.

“After Steward consolidated, operational misadventures began.  In 2013, it closed the pediatric unit at Morton Hospital {in Attleboro, Mass.}  In 2014, it closed Quincy Hospital, despite promises that it would expand health care services, and specifically not close that hospital so quickly.   Starting in 2014, Steward stonewalled state requests to disclose financial data as required by state regulations after the private equity takeover.   In 2016, Steward continued to withhold financial data  and closed the short-lived family medicine residency program at Carney Hospital,  amidst complaints by the residents about poor organization, and inadequate numbers of faculty.”

To read Dr. Poses’s entry, please hit this link.

To read The Globe’s story, please his this link.



Poses: No pain for execs in Tenet scandal


Roy M. Poses, M.D., writing in his Health Care Renewal site, complains that despite Tenet Healthcare’s $514 million fine by the Feds for its kickbacks and other bad behavior, that no Tenet executive is being punished. Health Care Renewal focuses on what Dr. Poses sees as increasing and severe corruption in American healthcare, mostly driven by greed.

The  Tenet settlement is meant to resolve a lengthy criminal investigation and lawsuits.

Dr. Poses writes:
“As is typical of such settlements, no individual who might have authorized, directed or implemented the kickbacks suffered any consequences.  While top managers of Tenet might have gotten even bigger bonuses because of the additional revenues supplied by the sorts of behavior discussed above, they  would suffer no financial penalties as a result of this settlement.  In fact, in 2015, the current Tenet CEO,  Mr. Trevor Fetter, who was an officer of the company in 2013, the last year kickbacks covered by the settlement ocurred, received total compensation of $15,354,283according to the company’s 2016 proxy statement.”

To read Dr. Poses’s posting, please hit this link.


‘Immersing’ ignorant hospital board in healthcare for a day


In his usually provocative Web site Health Care Renewal, Roy M. Poses, M.D., writes, in his often mordant style:

“Last week, the New England Journal of Medicine published an article by Bock and Paulus describing an innovative program at Mission Health in Asheville, N.C., to expose health system board members to the real world of healthcare.  The article was nice, but begged an important question: why was such a program {called ‘Immersion Day’} necessary?”

“The article asserted:

‘The U.S. healthcare industry has long been beset by seemingly intractable problems: incomplete and unequal access to care; perverse payment incentives; fragmented, uncoordinated care that threatens patient safety and wastes money; and much more.’

“So the hypothesis on which the program was based was:

‘These challenges are particularly vexing to the people who oversee or set policy for healthcare organizations. The disconnect between health care in its intimate, real-world setting and the distilled information delivered in the boardroom or policy discussions is a key barrier to responsive governance and policymaking. Sometimes seeing with new eyes can l’ead to transformational understanding.’

“So Doctors Bock and Paulus came up with the idea of providing basically provided a one-day clinical immersion program to members of the hospital system’s board of directors.

‘we created ‘Immersion Day,’ when board members and thought leaders could spend 9 to 12 hours in scrubs, behind the scenes, immersed in the nuances of care delivery.’

“But the article begged the questions of why this is news? The article stated that there is a big ‘disconnect’ between what is discussed in hospital board rooms, and the health care that goes on in hospitals day by day.  Furthermore, it stated that many hospital board members had no direct experience with health care.  Instead, the article described the non-physician board members, who were by far in the majority, as ‘educators, attorneys, manufacturers, investors, and bankers.’ It did not say why the majority of people responsible for the governance of a healthcare organization had no direct familiarity with healthcare.  That does not seem to make sense.  So why did it take so long to try to give them such familiarity, and why would a program to do so be newsworthy?”

“Hospital boards whose members are unfamiliar with health care may reflect hospital management that is similarly unfamiliar with health care. In fact, most hospitals and hospital systems, like most U.S. healthcare organizations, are not led by healthcare professionals.  Instead, they are led by generic managers, following the dogmas of managerialism.”

The rise of ‘generic managers,’ redux


Roy Poses, M.D., who runs the Health Care Renewal site, complains that  more than 60 percent of the chief executives of America’s “Great Health Systems” have no educational background in healthcare but instead are those whom Dr. Poses calls “generic managers.”

He bases his remarks on Becker’s Hospital Review’s list.

And he says that there are now 10 healthcare managers for every U.S. physician.

Physicians shut up to please Big Pharm


Roy Poses, M.D., writes in his Healthcare Renewal blog about the “Anechoic Effect,” with the example of the American Society of Clinical Oncology (ASCO) fearing to offend Big Pharm and complain about its very high prices and other rapacious practices.

Anechoic in this context means the deadening of discussion.

He writes: “So because pharma gives ASCO a lot of money, at best, only the most distinguished ASCO members can gently question pharma, but cannot criticize, much less ‘trash’ the source of their mammon.”

Taking the EHR utopians down a few notches


Roy Poses, M.D., in  his Healthcare Renewal site, discusses how the federal government is backing down on some requirements for digital health records after claims of an EHR utopia have been proven false.

He writes:
“In recent months, the hyper-enthusiasts and their government allies have had to eat significant dirt, and scale back their grandiose but risible — to those who actually have the expertise and competence to understand the true challenges of computerization in medicine, and think critically — plans.

“(At this point I’ll give them the benefit of the doubt and not call the utopians and hyper-enthusiasts corrupt, just stupid.)”

Where to find if they’re paid off

Roy Poses, M.D.’s latest edition of Healthcare Renewal has recommendations on where to go to find if physicians, hospitals, clinics, healthcare think tanks and so on have financial conflicts of interest.

Rich UPMC chief dreams of ‘doctor-less future’


Jeffrey Romoff, $6.6 million CEO of giant UPMC, in Pittsburgh, dreams of a “doctor-less future,” reports Roy Poses, M.D., of Healthcare Renewal.

Nonprofit hospital CEOs’ rich profits


Roy Poses, M.D., in his Healthcare Renewal site, complains again about richly paid hospital chief executives laying off healthcare professionals and being sanctioned for offenses and yet collecting millions of dollars in severance payments.

In this case he’s writing about Cape Cod Hospital.

Dr. Poses continues on the warpath of discussing the “marked contrasts between how well top hired managers of non-profit hospitals were doing, and how their institutions were doing.”

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