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Hello 2012, Goodbye Better Health

Dear Better Health Friends & Contributors,

2012 will mark Better Health’s 4th year anniversary of group medical blogging. I began Better Health with the hope of organizing “voices of reason” in the health blogosphere so that our ideas would enjoy greater circulation and be more influential. We were the early adopters of social media – some of the first physicians, nurses, patient advocates, and scientists to join together to provide trustworthy content to our readers via blogs. We grew to represent over 130 bloggers and, over the years, were joined by such prestigious organizations as the American College of Physicians, Harvard Health Publications, Diario Médico, and the Centers For Disease Control And Prevention. I am proud of our excellent writing, and I know that we touched many lives through our blogging.

Many of our contributors have enjoyed such success in blogging that they are regular features of several publishing platforms. Others have gone on to careers in social media education and are now sought-after speakers across the U.S. and beyond. Today’s blog audiences often receive their health information via personalized “filters” on Facebook and Twitter, rather than specific websites. And so for these reasons, Better Health has achieved its purpose to promote medical bloggers. I will discontinue future publication of blog posts at the getbetterhealth.com website as of today. Better Health, LLC will continue on as my personal consulting company.

I want to thank you all for contributing content to Better Health – I have personally enjoyed reading your work and I wish you success in your future writing endeavors. As I look forward to the next chapter of my life I hope to remain in touch with you all via email, Facebook (/drvaljones) or Twitter (@drval).

Please note that Grand Rounds will continue as usual, and that the getbetterhealth.com website will remain in archive format indefinitely.

With all my best for 2012,

Val

P.S. I will continue to promote medical blogging via Grand Rounds, and I will be hosting it at USA Today in the near future (date TBD). Please stay tuned for submission information. The Grand Rounds calendar will remain updated at the top of the Better Health home page indefinitely.


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4 Responses to “Hello 2012, Goodbye Better Health”

  1. Mike Sevilla, MD says:

    Thanks Dr Val for all you’ve done for medbloggers! Good luck on your next step for Better Health, LLC!

  2. Jessie Gruman says:

    Thank you, Val, for your vision, your energy and your generosity in starting and running Better Health. Your commitment to sound, responsible medicine, your willingness tackle / publish pieces on tough issues and your level-headed but innovative approach to social media are only some of the characteristics that make you an important leader.

    Through Better Health you cultivated a group of clinicians, researchers, and advocates and patients who have found here a much-needed place to voice their ideas and concerns. It’s great that people will still be able to find them as Grand Rounds continues in a different form.

    Best wishes for success in the next iteration of this important work.

  3. Pranab says:

    This is sad. Anyways. Wish you the best Dr. Val you have indeed been one of the leading lights of the medical blogging community. As always it is sad to see a pioneer blogger go.

  4. Dena says:

    Even though the website is no longer being updated I’m glad the site is remaining. It is a great resource for achieving better health.

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Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

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Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

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As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

***

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