A Closer Look

‘Your work is not your worth’ even for doctors

Cardiologist David Mokotoff, who has been working for almost 50 years, contemplates what comes next.

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This column began in 2008 when I left the Orlando Sentinel as a senior reporter and entered the health-care profession as a licensed massage therapist. This week, the column ends as I begin a new chapter of my career and enter nursing school.

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‘Your work is not your worth’ even for doctors

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 I was 16. Yet this is a self-imposed deadline. The contract with my medical practice ends then and I have stated my intention to retire on that date.

I probably could renegotiate a contract with them; however, in less than a year, they will likely start searching for my replacement. So the question is, “Do I really want to retire?”

Friends and patients ask me continually, “What will you do if you retire?” And my answer is always the same, “Fish, read, write, cook, garden, visit the grandkids, and travel.” My financial advisor says I should be able to afford it.

Yet, the work ethic is so deeply engrained within me, that the mere thought of not drawing a regular paycheck gives me pause to reflect.  It is in these moments that I recall a line from Viktor E.Frankl's book, Man’s Search for Meaning, “Your work is not your worth.”

Or another famous quote, whose author escapes me, “ No man dies wishing he had spent more time at work rather than with his family.”

Devoted and long-term patients grow increasingly anxious and ask me about the date. I half-jokingly tell them, “It depends upon who wins the election.”

But this too is a dodge. No matter who wins, Medicine will never be the same.

Change of course in life and nature is inevitable. But all change is not necessarily better. Some changes in the practice of medicine seem to be an improvement, such as electronic records, and point of contact lab testing.

Others seem worse for doctor and patients, like pre-authorizations, guidelines, effective comparisons, bundled payments, and HMO’s, to mention only a few.

The reality is that in order to gain satisfaction from practicing medicine today, doctors must come to grips with the cold reality of diminishing autonomy over decision-making roles. As a breed of fiercely independent individuals, we are loath to do this.

At least for me, this sense of powerlessness, or someone always looking over my shoulder, is in essence the biggest hindrance to job satisfaction. Mitigating that is the occasional compliment by a patient or family for a job well done.

I may keep a foot, or toe, in medicine after June 30, 2014. However, as that date creeps ever closer, it is a good time to reflect on a life of service, and how it has affected the lives of others, and not just me.

--David M. Mokotoff, M.D.
St. Petersburg cardiologist
Author: The Moose’s Children: A Memoir of Betrayal, Death and Survival

 

Resources

We’ve collected a list of resources for you, including federal and state agencies and private associations. This is a free listing, without paid advertisers.

Healthcare practitioner license search

People can look up a health-care professional to see whether they have any disciplinary history or pending complaints.

Nurse practitioner degree programs

This site, a personal project of Joyce McKay, lists schools across the country currently offering nurse practitioner degree programs.

Medicare Rights Center launches MRU

Medicare Rights University is a subscription-based online service that features courses on key Medicare topics and provides subscribers with information.

What is Medicare and what does it cover?

Here is an online guide that explains the four parts of Medicare.

Medicare Extra Help program

Medicare recipients now have access to the Medicare Extra Help Subsidy Program, which allows Medicare recipients to receive discounted prescription drugs. A family member, trusted counselor or caregiver can apply at www.socialsecurity.gov or call 786-469-4600. 

American Lung Association of Florida

Florida Center for Public Health Preparedness

Florida Government e-Rulemaking Site

Provides notices of proposed rules and rule changes, public meetings, etc.

Continuation Coverage

Centers for Medicare & Medicaid Services' site and helpline where unemployed workers may request review of a denial of eligibility for COBRA premium assistance.

Robert Wood Johnson Foundation

Agency for Healthcare Research and Quality-Consumer Guide

Falls-prevention DVD available to health professionals

The Florida departments of Elder Affairs and Health are offering a DVD on falls prevention to health professionals. For a copy, e-mail DEMO_InjuryPrevention
@doh.state.fl.us
.

New fed site gives health information in Spanish

Federal officials have unveiled a Spanish-language version of its tool to help people navigate the increased coverage resulting from the health-care overhaul. Click here to visit.

Group offers free ‘living will,’ other forms

Free, downloadable end-of-life forms (to designate a health-care surrogate, for example) are available at a web site sponsored by the Hemlock Society. 

Government site outlines new health-care law

A new government site, aimed at individuals, Medicare recipients and small employers, explains how the new health-care law works for the consumer as well as for seniors on Medicare. Click here to visit.

FDA site lets public find drug safety info

The Food and Drug Administration launched a website where patients and health-care professionals can find safety information about recently approved drugs and vaccines. Click here to access.

Florida sets up oil spill info line

 Florida has set up a toll-free telephone line to provide residents and visitors with information about the Gulf of Mexico oil spill. When you call 888-337-3569, operators will answer questions about the state's response activities, volunteer opportunities and health, safety and protective tips.

Complaints against licensees now online

Public administrative complaints filed against licensed health-care practitioners are now available on The Florida Department of Health Web site. Consumers can see if a public complaint exists for any health-care professional licensed by DOH at this site. 

Consumer Reports looks at reform

Consumer Reports has a guide to health reform, with videos, Q&As, viewpoints and in-depth papers. Access it here.

Online resources for information on health reform

The Washington Post has compiled a handy list of guides to the new rules. Access it here.

Summary of new health-reform law

Here is a summary of the provisions of the Patient Protection and Affordable Care Act (adjusted by the reconciliation act that followed.

And here is the timeline for implementation.

Updated Medicare primer

The Kaiser Family Foundation has updated its Medicare primer that explains key elements of the program. It describes characteristics of the Medicare population and how much people pay out-of-pocket. The updated 2010 Medicare primer is at www.kff.org/medicare/7615.cfm.

Mesothelioma cancer risks in FL

A national group that seeks to inform the public about this type of cancer lists environmental risk factors in Florida.

Consumer health information

The FDA has created a partnership with Everyday Health to deliver FDA's consumer health information to the 30 million users who visit EverydayHealth.com each month. EverydayHealth.com/FDA will offer health information from FDA on food and medical product safety as well as prevention and wellness topics.

What you need to know about anti-viral drugs

Not everyone needs antiviral drugs when they get sick. This CDC fact sheet explains who should take them.

State offers flu hotline

The Florida Department of Health has launched a toll-free hotline, 877-352-3581, to provide public health information and updates on the H1N1 "swine" flu.
It is open from 8 a.m. to 8 p.m. daily. Information is available in English, Spanish and Creole.

Information can also be found at the department's website, doh.state.fl.us.

New consumer guides

Spanish-language consumer guides are now available from the Department of Health & Human Services's Agency for Healthcare Research and Quality for consumers and clinicians. To access the guides in Spanish as well as English, go to effectivehealthcare.ahrq.gov. Audio versions of many guides also are available.

Suspect insurance fraud?

Call Florida's Fraud Fighters Hotline at 800-378-0445. It's operated by the Insurance Fraud Division of the state Department of Financial Services. 

Helpful hint

Did you know the state offers a Web site where you can quickly find the best price in your local area for the drugs you take? The Drug Finder can save you money.

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