Archive for the ‘Healthcare Professionals’ Category
Orthopedic Surgeons treat fractures. Now Orthopods are joining the fight to Prevent Fractures.
At the National Osteoporosis Foundation (NOF) 2015 meeting, Orthopedic Surgeons were the most numerous specialty among docs (MD and DO) . This is huge! In 2007 we were above 1% for the first time. Now we are 17%. What has happened?
Orthopods can easily identify persons with bone health issues, because a fracture is the clearest clue that there may be a bone health problem. Often patients see orthopedics for a fracture and do not see their regular primary care doc until their next annual check-up.
The idea that bone health (including osteoporosis) could and should be identified and treated in an orthopedic office was very unusual when I started in 2007. It is still not common, but it is spreading rapidly. We have directly helped a dozen other offices start treating bone health.
The latest trend is for Nurse Practitioners (NPs) and Physician Assistants (PAs) to do most of the bone health assessment and treatment within an orthopedic, or other, office. That was evident at the meeting. Over 1/3 of the attendees were NPs or PAs – many of them working in orthopedic offices.
Family Medicine docs, NPs, and PAs also attended in record numbers. This is a growing trend. Proactively addressing bone health, before a fracture, is taking its rightful place in primary care.
Orthopedic, Family Medicine, and Geriatric practices are increasingly offering bone health evaluation and treatment.
Take Control of Your Bone Health. Get a Complete Bone Health Evaluation.
Jay Ginther, MD
Every patient visit is teaching Bone Health. Proper nutrition with Calcium, Vitamin D3, Protein, Multiple Vitamins& Minerals. Balance, Exercises, and Fall Prevention. Not just the patient, but the whole family.
We also teach other medical providers. Often we host Nurse Practitioner students from Allen College. Katie Bries, ARNP, taught the Bone Health section at the Allen College NP Residency Program last week. Earlier, I taught the Podiatry residents and staff at their morning conference.
We teach the public too. Kate, our nurse, presents to community groups. We are participating in the Scheels Health Fair on Thursday.
Teaching patients and others how to Prevent Fractures and Prevent Osteoporosis is our favorite. Treating Osteoporosis is important, but less fun for all concerned. Learn how to Prevent Fractures and Prevent Osteoporosis.
Call us to schedule a presentation to your organization.
Jay Ginther, MD
Usually we operate on a Hip Fracture. We do that in order to: preserve Independent Living; or preserve independent ambulation in Assisted Living; or preserve assisted ambulation in a Care Facility; and always to preserve quality of life. But what if none of those goals are possible?
At the St Paul Geriatric Fracture Conference this month, it was proposed that alternative care to surgery is sometimes more humane and less costly to society – both laudable goals. The ideal care for a patient with a fractured hip is to thoroughly discuss all alternatives before proceeding to surgery.
Family and other caregivers should all join the patient for a relaxed discussion of the future, weighing quality of life issues radically changed by the usual loss of function / independence imposed by the fracture. Only after concensus is reached, should surgery proceed – if that is the chosen path.
Unfortunately, the clock is ticking. The likelihood of death, medical complications of the fracture, medical complications of surgery, and permanent disabilities begin to increase only 12 hours after fracture. Gathering all interested parties and making informed life-changing decisions within that time limit is very challenging.
Ideally the patient, family, care-givers and primary physician have discussed the possibility of fracture and come to tentative decisions about what sorts of care are desired. This is especially true for patients who already cannot ambulate, are becoming demented, or have a limited quality of life.
Involve the patient in the decision while he/she can still express his/her desires. Written Advanced Directives are ideally on file with physician and hospital. Allow the patient to Take Control of his/her Future.
My wife and I have discussed our desires with our children. We have advanced directives on file. You should too.
Jay Ginther, MD
Wrong Question! What you should be managing is Fracture Risk. If you only look at Bone Mineral Density (BMD), you miss the chance to decrease Fracture Risk in the overwhelming majority of people.
85% of the women who Fracture have a DXA score of “osteopenia” or even “normal”. Keeping their bone density at “only osteopenia” does them no favor. So how can you manage Fracture Risk?