Granny Smith has been a delightful patient last 2 years. You enjoyed operating and rehabbing her distal radius fracture 2 years ago. She was so cheerful and hard working getting the use of her shoulder back after her proximal humerus fracture last year. Now it is discouraging to see her so down after her intertroch hip fracture this year. Somehow she never got going with Calcium Citrate or Vitamin D or a DXA or a lateral spine view of her kyphosis or any medication for her Osteoporosis.
You had hoped that her primary care provider would take care of the Osteoporosis although you never did send a note specifically giving the diagnosis and your expectation of help. Unfortunately her diabetes and blood pressure and worsening GERD and her shortness of breath (from her kyphosis) all took precedence. There just is not time in a 15 or even 20 minute visit to cover everything.
Some individual has to take responsibility for dealing with the Osteoporosis. Who that is must be clearly spelled out within the team of practitioners taking care of Granny Smith. If you have no individual lined up, stop by the “Own the Bone” booth in the exhibit hall. They can help you. Go to www.OwnTheBone.org.
Experience has shown that Osteoporosis is best cared for when it is the sole subject of the medical visit. Often a PA-C or ARNP has the time to spend when a busy MD or DO does not.
Some larger orthopedic groups have an endocrinologist or rheumatologist or rehab specialist supervising the osteoporosis program within the orthopedic group. If you do not treat osteoporosis within your group, you need to have someone outside the group to take that specific referral.
Jay Ginther, MD, FAAOS
Categorised in: Healthcare Professionals