David Mokotoff, MD

David Mokotoff is a cardiologist who blogs at his self-titled site, David Mokotoff. He is the author of The Moose’s Children: A Memoir of Betrayal, Death, and Survival.

A cautionary tale of employing doctors

David Mokotoff, MD

Policy

June 21, 2013

For all of those out there anticipating the 2014 official roll out of Obamacare, officially known as Affordable Care Act (ACA), here is a cautionary tale.

Many years ago, as I was growing my cardiology practice, it became evident that diagnostic services for my specialty, like stress tests and echocardiograms, were done less efficiently and cost more at the local hospital, than in the office. This stimulated many groups in the …

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A cautionary tale of employing doctors

User friendly recording of data often seems like an EHR afterthought

David Mokotoff, MD

Tech

June 4, 2013

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As I began logging on to my third different hospital EHR (electronic health record) recently, I contemplated how much more of this I could take. Being less than a year from planned retirement, the nuances of learning a new EHR and CPOE (computerized physician order entry) system is not fun. Furthermore, every hour I spend learning a new and unique system is …

Copy and paste medicine is not new

David Mokotoff, MD

Physician

April 28, 2013

As a second year medical student in 1971, I still remember an article in the prestigious New England Journal of Medicine, describing a new phenomenon, The Emperor’s New Clothes Syndrome. It was based upon the famous Danish author, Hans Christian Anderson’s fairly tale from the 1800’s.

A vain emperor, who cares for nothing except wearing and displaying clothes hires two swindlers who promise him the finest, best suit of clothes from …

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Copy and paste medicine is not new

Why I’m skeptical of the growing number of disability beneficiaries

David Mokotoff, MD

Physician

March 29, 2013

My office consultation for the 50 year-old woman was her complaint of chest pain. I could not help but glance at her insurance and it was for Medicare. I have always been fascinated with what types of disability people have which qualifies them for Medicare and SSD, (Social Security Disability), before the usual age of 65. To say that I have observed bizarre and inequitable awards would be a gross …

Cookbook medicine can make doctors clinically lazy

David Mokotoff, MD

Physician

March 7, 2013

Juan Gonzales, (not his real name), is a somewhat demented elderly Hispanic male, who I met last week in an intensive care unit. He spoke little English, and I spoke limited Spanish. His devoted family was at the bedside, and fortunately his daughter was able to provide some history. He was admitted with palpitations and dizziness and atrial fibrillation with a rapid response.

His family had just moved him from Miami, …

How the physician replaced the medical secretary

David Mokotoff, MD

Tech

February 15, 2013

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I recently sat in a small room, in the bowels of a local hospital, training for the impending implementation of CPOE. For those not familiar with current health care acronyms, this stand for Computerized Physician Order Entry.

Nearing the end of my medical career, I could not help but admire the timing of this phenomenon. “They’ve finally done it,” I mused silently. They …

Should doctors be required to ask patients about guns?

David Mokotoff, MD

Physician

February 1, 2013

Recently both President Obama and the AMA have called for physicians to talk with their patients about gun ownership, especially if they sense mental health issues. This request sounds innocuous enough, but let’s explore the implications and the reality here.

First I need to issue a disclaimer. I am neither a member of the NRA nor do I necessarily feel that more gun laws and bans will reduce the recent tragedies …

ObamaCare: All roads lead to single payer

David Mokotoff, MD

Policy

January 3, 2013

When the marketing of ObamaCare began in 2009, I always believed that the end game was for a federal single payer system. Since the present Affordable Care Act, (ACA), was passed in 2010, there has been nothing to convince me otherwise. The only reason single-payer wasn’t passed two years ago was because it was hard enough to arm-twist and bribe even …

The unintended consequences of boilerplate guidelines

David Mokotoff, MD

Physician

December 9, 2012

I recently saw a 90-year old patient in my cardiology office practice. She was demented, but cooperative with the exam. A devoted daughter, with whom she lives, accompanied her to the appointment. Her dementia was severe enough to make a cogent history from the patient impossible. However, the daughter had something on her mind, and it had nothing to do with her mother’s heart condition.

“My mother’s primary care doctor wants …

A doctor reflects on the cusp of retirement

David Mokotoff, MD

Physician

November 25, 2012

June 30, 2014. I don’t need to have this date circled on my calendar, or on my phone calendar reminder app. It is now etched in my brain. That is the date of my anticipated retirement from private practice. It is hard enough for me to grasp that next summer I can enroll in Medicare, let alone quit working––something I have done with only one brief 3 month break, since …

Why health insurance is the problem and not the solution

David Mokotoff, MD

Policy

October 6, 2012

Recently a neighbor backed into my car while I was leaving a food store. The damage was minimal, but she offered to have her insurance company pay for the repair. After contacting the company, I was offered several body shops, and chose the one closest to my home. The work was completed in only two days, and while it was in the shop, I decided to also have some dents …

Preserving the doctor-patient encounter in the face of technology

David Mokotoff, MD

Physician

September 25, 2012

I recently was on vacation in Rocky Mountain National Park. Suspended on an overlook of astonishing beauty at 11,000 feet above sea level, I stared out at the tundra and bits of August snow that still clung to the highest peaks. Suddenly my attention was snapped from the massive boulders and landscapes to the ringing of my cell phone. It was a referring doctor asking me about a mutual patient …

David Mokotoff, MD

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