Roy M. Poses, M.D.

Seminar TopicUnderstanding and Addressing External Threats to Ethical and Evidence-Based Practice.
The health care "crisis" has now been going on for more than 20 years, with ever worsening access, increasing costs, stagnant quality, and now increasingly demoralized health care professionals.  Most attempts to understand and address this permanent crisis have come to nought.  Discussions with health care professionals suggested that they feel their ability to practice ethically and rationally is under increasing threat, even though the nature of these threats is rarely publicly discussed.  Health care is increasingly dominated by ever larger organizations.  Governance of health care organizations is increasingly unrepresentative of key constituencies, unaccountable, opaque, and independent of ethical standards.  Leadership of health care organizations is increasingly ill-informed, incompetent, self-interested, and corrupt.  Poor governance and poor leadership are manifest in tactics involving on one hand, deception, disinformation, and delusion, and on the other, intimidation, coercion, conflicts of interest, and perverse incentives.  This seminar will discuss these politically incorrect topics, and begin to suggest how they could be addressed.