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Roy Poses

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Massive ransomware seen as more proof of perilous over-reliance on IT


The Web site of Roy Poses, M.D., sees the worldwide ransomware attack underway, including against hospitals and other healthcare institutions, as yet another ominous sign of our extreme over-reliance on computer systems.

Dr. Poses writes:

“InformaticsMD reviewed the recent global ransomware attack in the health care context, focused on the hacking of British NHS  {National Health Service} hospitals.  As seems usual in health care information technology debacles, hospital managers were quick to soft-pedal what aspects of it they could (the NHS was not the ‘target’ of the attack?  There was no evidence that “patient data was accessed”?)  Preliminary reports indicated that the NHS was using an outdated version of Windows which had not been updated.  Once again, advocates for commercial health information technology have been exaggerating (if not fabricating) its benefits, while pooh-pooling its harms for a long time.  The use of technologies whose benefits and harms have never been properly assessed by clinical research studies continues to pose dangers for patients.  Insiders in the health IT industry seem to be collaborating with government bureaucrats to promote this unproven technology.  True health care reform would require rigorous assessment of all new medical/ health care technology, regardless of who might be offended if such assessments provide negative results.”

To read more, please hit this link.

Healthcare swims in a sea of conflicts of interests

conflict Painting by  Elihu Vedder (1836–1923). Photographed in 2007 by Carol Highsmith. 
Roy Poses, M.D., in his Healthcare Renewal site comments:
“The theme continues.  A recent prominent Health Affairs blog post on {physician} burnout omitted discussion of underlying causes, much less promote resistance to them.  Now it turns out that the lead author was not only the well-paid CEO of a very prominent non-profit health system, but had just been offered a board position at giant pharma company Merck.  A recent prominent National Academy of Medicine report on health care reform again omitted discussion of any underlying causes of health care dysfunction that might disturb the powers that be.  Many of its authors were also members of the boards of directors of health care corporations.  Now it turns out that one of them had long been on the board of Amgen, and may have had other complex relationships with the pharma industry.   Who, other than Health Care Renewal readers,  knew conflicts of interest in health care were so complicated …. ) ? These newly noted conflicts of interest underlined how current discussions of health care reform are influenced, if not dominated by people with strong ties to organizations, particularly large health care corporations, that benefit from the status quo.  What kind of reform would they produce?  True health care reform minimally requires discussions lead by health care professionals, unbiased policy experts, patients and the public at large.  Contributions – oral, written, or monetary – from those who personally are profiting from the status quo should be met with requisite skepticism.”
To read Dr. Poses’s site, please hit this link.
To read the Health Affairs piece on physician burnout, please hit this link.

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.

Roy Poses, M.D.: Self-dealing insiders take over hospitals


”Avarice,” by Jesus Solana.
Roy Poses, M.D., in his Health Care Renewal site, writes at the end of a recent article there:
“The compensation given top executives of health care organizations gets ever more floridly exaggerated.  More and more this compensation seems to denote how these organizations have been taken over by insiders who make it a priority to benefit themselves….”
“{C}urrent trends in executive compensation in health care could cause declining morale of other employees, increasing isolation of top executives, poor organizational performance, income equality and a declining economy, and ultimately social unrest.”
“Although the transition of executives into a new aristocracy is a society wide, if not a global problem, we in health care cannot be complacent that someone else will solve it.  True health care reform would enable accountable leadership that puts the health care mission and patients’ and the public’s health ahead of personal gain.”
To read Dr. Poses’s essay, please hit this link.

Tangled in conflicts of interest





Roy Poses, M.D., who runs the Health Care Renewal site linked here, asserts:

“The important conflicts of interest generated when academic healthcare leaders also serve on the boards of directors of for-profit healthcare corporations is suddenly less anechoic, thanks to some intrepid researchers and the British Journal of Medicine.”
Dr. Poses says:  “As we have said again and again, the web of conflicts of interest that is pervasive in medicine and healthcare is now threatening to strangle medicine and health care.  Furthermore, this web is now strong enough to have effectively transformed U.S. healthcare into an oligarchy or plutocracy.  Health care is effectively run by a relatively small group of people, mainly professional managers plus a few (lapsed?) healthcare professionals, who simultaneously run or influence multiple corporations and organizations.”
And:”For patients and the public to trust healthcare professionals and healthcare organizations, they need to know that these individuals and organizations are putting patients’ and the public’s health ahead of private gain. Healthcare professionals who care for patients, those who teach about medicine and health care, clinical researchers, and those who make medical and healthcare policy should do so free from conflicts of interest that might inhibit their abilities to put patients and the public’s health first.”



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.)”

The narcissism of ‘generic managers’


Roy Poses, M.D., discussing what he calls “generic management,” says hospital chief information officers say patient engagement is all about  — chief information officers.

“So why would CIOs claim to ‘own’ patient engagement?  Maybe they are simply clueless about what patient engagement really involves.  CIOs rarely interact with patients.  Most CIOs have no direct healthcare experience, and are not trained as doctors or nurses.  For example, a recent list of “100 Hospital and Health System CIOs to Know” included only 10 with health professional degrees (seven M.D.’s, three R.N.’s).

”Why then, not simply admit that the issue is out of their area of expertise, rather than claiming ‘ownership.’ My best guess is this is the bravado, or arrogance of generic managers.”

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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