It was David E. Kelley's suggestion to make the character of Alfred Molina British, not only because it would be easier for the actor to act on his natural accent, but also because emphasized the distance between Hooten and his staff, making this distance even more apparent, more clear.
David E. Kelley offered the role of Dr. Harding Hooten to Anthony Heald, but the actor had a stage commitment and besides thought the character was too similar to his previous work with Kelley, on Boston Public (2000). After turning down the offer and explaining the reason, the creator wrote the smaller role of Mitch Tompkins for the actor.
The title is a play on Morbidity and Mortality conferences (M&M) where poor outcomes are discussed to improve the processes. The M&M conferences were a central scene in each episode that occurred Monday mornings in the show.