Roy M. Poses Clinical Associate Professor of Medicine

Dr Poses went to Brown University as an undergraduate, and got his medical degree from the same university. He did an internship and residency in internal medicine at University Hospital in Boston, and a fellowship in general internal medicine at the University of Pennsylvania.
Dr Poses became an enthusiastic proponent of evidence-based medicine, the idea that physicians should practice medicine in the best interests of their patients based not only on their knowledge of biology and traditional medicine, but also on combining the findings obtained by critical review of the best available clinical research with consideration of the individual patients' values and needs. His research focused on how physicians make judgments and decisions, and why they often do not make them according to the precepts of evidence-based medicine. He also did original clinical and health outcomes research.
In the late 1990s, Dr Poses performed a qualitative study involving interviews of health care professionals about what they thought had gone wrong with health care. The results were that physicians felt that their core values were under external threat, and were able to identify examples of threats, most deriving from concentration and abuse of power in health care. He was able to find numerous cases that embodied such threats by searching the news media, but found that the issues they raised were rarely discussed in the national media, and were mostly ignored by scholarly health care and medical publications. Therefore, he and colleagues launched a blog to discuss these issues, entitled Health Care Renewal, http://hcrenewal.blogspot.com/. Dr Poses is now also President of FIRM - the Foundation for Integrity and Responsibility in Medicine, a not-for-profit organization (NGO) designed to raise awareness of external threats to the core values in health care as the first step toward addressing them.

Brown Affiliations

scholarly work

Wu WC, Smith TS, Henderson WG, Eaton CB, Poses RM, Uttley G, Mor V, Sharma SC, Vezeridis M, Khuri SF, Friedmann PD. Operative blood loss, blood transfusion, and 30-day mortality in older patients after major non-cardiac surgery. Ann Surg 2010; 252: 11-17.

Brehaut J, Poses R, Shojania K, Lott A, Man-Son-Hing M, Grimshaw J, Bassin E. Do physician judgment biases predict inappropriate use of treatments? Implementation Science 2007: 2: 18-29.

Wu WC, Schifftner TL, Henderson WG, Eaton CB, Poses RM, Uttley G, Sharma SC, Vezeridis M, Khuri SF, Friedmann PD. Levels of preoperative hematocrit predict postoperative cardiovascular and fatal outcomes in elderly patients undergoing major non-cardiac surgery. JAMA 2007; 297: 2481-2488.

Lawrence VA, Hilsenbeck SG, Noveck H, Poses RM, Carson JL. Medical complications and outcomes after hip fracture repair. Arch Intern Med 2002; 162: 2053-2057.

Poses RM, Krueger J, Sloman S, Elstein A. Physicians' judgments of survival after medical management and mortality risk reduction due to revascularization procedures for patients with coronary artery disease. Chest 2002;122:122-133.

Smith WR, Poses RM, McClish DK, Huber EC, Clemo FLW, Schmitt BP et al. Prognostic judgments and triage decisions for patients with acute congestive heart failure. Chest 2002;121:1610-1617.

Poses RM, McClish DK, Smith WR, Huber EC, Clemo FLW, Schmitt BP et al. Results of report cards for patients with congestive heart failure depend on the method used to adjust for severity. Ann Intern Med 2000;133:10-20.

Poses RM, Berlin JA, Noveck H, Lawrence VA, Huber EC, O' Hara DA, Spence RK, Duff, A, Strom BL, Carson JL. How you look determines what you find: Severity of illness and variation in blood transfusion for hip fractures. Am J Med 1998;105:198-206.

Poses RM, Chaput de Saintonge DM, McClish DK, Smith WR, Huber EC, Clemo FLW, Schmitt BP, Alexander-Forti D, Racht EM, Colenda CC, Centor RM. An international comparison of physicians' judgments of outcome rates of cardiac procedures and attitudes toward risk, uncertainty, justifiability, and regret. Med Decis Making 1998;18:131-140.

Carson JL, Duff A, Berlin JA, Lawrence VA, Poses RM, Huber EC, O' Hara DA, Noveck H, Strom BL. Influence of peri-operative blood transfusion on postoperative mortality. JAMA 1998;279:199-205.

Poses RM, McClish DK, Smith WR, Chaput de Saintonge DM, Huber EC, Clemo FLW, Schmitt BP, Alexander-Forti D, Racht EM, Colenda CC, Centor RM. Physicians' judgments of the risks of cardiac procedures: differences between cardiologists and other internists. Med Care 1997;35:603-617.

Poses, RM, Smith WR, McClish DK, Huber EC, Clemo FLW, Schmitt BP, Alexander-Forti D, Racht EM, Colenda CC, Centor RM. Physicians' survival predictions for patients with acute congestive heart failure. Arch Int Med 1997;157:1001-1007.

Carson JL, Duff A, Poses RM, Spence RK, Berlin JA, Trout R, Noveck H, Winslow W, Strom BL. Effect of anemia and cardiovascular disease on surgical mortality and morbidity. Lancet 1996;348:1055-1060.

Colenda CC, Rapp SR, Leist JC, Poses RM. Clinical variables influence treatment decisions for agitated dementia patients: survey of physician judgments. J Am Ger Soc 1996;44:1375-1379.

Poses RM, McClish DK, Smith WR, Bekes C, Scott WE. Admission co-morbidity predicts survival of critically ill patients. J Clin Epidemiol 1996;49:743-47.

Poses RM, Smith WR, McClish DK, Anthony, M. Controlling for confounding by indication for treatment: is administrative data equivalent to clinical data? Med Care 1995;33:AS36-AS-46.

Poses RM, Cebul RD, Wigton RS. You can lead a horse to water - improving physicians' knowledge of probabilities may not affect their decisions. Medical Decis Making 1995;15:65-76.

Poses RM, Wigton RS, Cebul RD, Centor RM, Collins M, Fleischli GJ. Practice variation for patients with pharyngitis: the importance of variability in patients' clinical characteristics and in physicians' responses to them. Med Decis Making 1993;13:293-301.

Poses RM, Cebul RD, Wigton RS, Centor RM, Collins M, Fleischli G. Controlled trial using computerized feedback to improve physicians' diagnostic judgments. Acad Med 1992; 67: 345-347.

Poses RM, McClish DK, Bekes C, Scott WE, Morley JN. Ego bias, reverse ego bias, and physicians' prognostic judgments for critically ill patients. Crit Care Med 1991; 19: 1533-1539.

Poses RM, Anthony M. Availability, wishful thinking, and physicians' diagnostic judgments for patients with suspected bacteremia. Med Decis Making 1991; 11: 159-168.

Johnson BA, Poses RM, Fortner CA, Meier FA, Dalton HP. Derivation and validation of a clinical diagnostic model for chlamydial cervical infection in university women. JAMA 1990; 264: 3161-3165.

Poses RM, Bekes C, Winkler RL, Scott WE, Copare FJ. Are two (inexperienced) heads better than one (experienced) head? - averaging house officers' prognostic judgments for critically ill patients. Arch Intern Med 1990; 150: 1874-1878.

Poses RM, Bekes C, Copare F, Scott WE. What difference do two days make? - the inertia of physicians' prognostic judgments for critically ill patients. Medical Decision Making 1990; 10: 6-14.

Poses RM, Bekes C, Copare F, Scott WE. The answer to "what are my chances, doctor?" depends on whom is asked: prognostic disagreement and inaccuracy for critically ill patients. Crit Care Med 1989; 17: 827-833.

Carson JL, Poses RM, Spence RK, Bonavita G. The relationship between severity of anemia and survival in surgical patients. Lancet 1988; 1: 727-729.

Cebul RD, Poses RM. Cost-effectiveness of statistical decision rules and experienced physicians in the management of pharyngitis. JAMA 1986; 256:3353-3357.

Poses RM, Cebul RD, Collins M, Fager SS. The importance of disease prevalence in transporting clinical prediction rules: the case of streptococcal pharyngitis. Ann Int Med 1986;105:586-591.

Poses RM, Cebul RD, Collins M, Fager SS. The accuracy of experienced physicians' probability estimates for patients with sore throats. JAMA 1985; 254:925-929.