Todd Rice, MD, MBA
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Latest articles
Physician voices
When I matched into anesthesiology residency in 2002, I assumed that the entire four years of training were guaranteed to me, barring any gross failure on my part. A package deal, essentially. I hadn't heard of anyone not finishing. For…
When I matched into anesthesiology residency in 2002, I assumed that the entire four years of training were guaranteed to me, barring any gross failure on my part. A package deal, essentially. I hadn’t heard of anyone not finishing.
For me, residency was exhaustingly tolerable, yet gratefully formative – interspersed with warm camaraderie, the occasional difficult patient or frustrating attending, satisfying progress, and finite episodes of survivable misery. I had a …
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Understand your resident contract: What you don’t know may hurt you
Physician voices
I recently wrote about my new type 1 diabetes diagnosis, the quest for affordable meds and supplies, and the subsequent financial savings found through transparent pricing outside of my insurance plan. I summarized that health care "coverage" is very expensive,…
I recently wrote about my new type 1 diabetes diagnosis, the quest for affordable meds and supplies, and the subsequent financial savings found through transparent pricing outside of my insurance plan. I summarized that health care “coverage” is very expensive, whereas medical services may be found much more affordably.
My next step was to establish an ongoing primary care physician relationship.
I contacted one of the large medical …
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Why direct primary care is the future
Health policy
I'm a healthy 48-year old, ASA physical class I anesthesiologist. At least I was healthy until an unintentional 20-pound weight loss over the summer, accompanied by an unquenchable thirst, insatiable appetite, blurry vision, and the bathroom frequency of an elderly…
I’m a healthy 48-year old, ASA physical class I anesthesiologist. At least I was healthy until an unintentional 20-pound weight loss over the summer, accompanied by an unquenchable thirst, insatiable appetite, blurry vision, and the bathroom frequency of an elderly prostatic.
My lab workup would reveal a fasting blood sugar of 310 mg/dL, an A1C >14, positive urine ketones, low C-peptide, and glutamic acid decarboxylase antibody (GAD-65) level that was off …
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Health coverage really isn’t covering much
Medical education
I recently received a call from a physician resident in the Northeast U.S. who had been notified that she would be terminated from her residency program for a “weak knowledge base.” There would be no contract offered to her for…
I recently received a call from a physician resident in the Northeast U.S. who had been notified that she would be terminated from her residency program for a “weak knowledge base.” There would be no contract offered to her for the coming academic year. She reports that her scores are no worse than several of her colleagues and that her accredited program has a history of arbitrarily dismissing residents. She …
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Medical residents and academic due process: Know your rights
Physician voices
“Don’t get tired! Don’t f*cking move! Don’t you f*cking move, or I’ll f*cking die!” That’s an excerpt from an OR in St. Louis on March 12th. This is just one of the outbursts that was reported from a single, multi-hour…
“Don’t get tired! Don’t f*cking move! Don’t you f*cking move, or I’ll f*cking die!”
That’s an excerpt from an OR in St. Louis on March 12th. This is just one of the outbursts that was reported from a single, multi-hour surgery — an attending’s toxic mandate to her resident, who was poised in a precarious situation under the drapes. The rest of the OR staff caught plenty of its own abusive …
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Push back on toxic behaviors from other doctors
Medical education
Performance appraisals are an integral part of an organization's assessment of employee and trainee standing. Management and human resource literature is full of analysis and debate regarding how to best rate subordinates. Regardless of evaluation system utilized, some of the…
Performance appraisals are an integral part of an organization’s assessment of employee and trainee standing. Management and human resource literature is full of analysis and debate regarding how to best rate subordinates. Regardless of evaluation system utilized, some of the common goals of individual appraisals are to monitor progress, identify areas for growth, set goals, guide development, provide and elicit feedback through open communication, and document issues that may require …
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Influencing your resident evaluations for success
Physician voices
Physician training is an extremely high stakes business, not only for the patients that will be under the care of the eventual independent, fully-trained, board-certified doctor, but for the trainee herself. The financial and time costs of the entire training…
Physician training is an extremely high stakes business, not only for the patients that will be under the care of the eventual independent, fully-trained, board-certified doctor, but for the trainee herself. The financial and time costs of the entire training process are enormous. To become derailed from the board certification path can have significant and permanent career consequences. With so much at stake, what does a resident do when she …
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It’s important to proactively manage your resident progress. Here’s how.
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