Can An Orthopedic Bone Health Clinic Add Value To Your Practice?

You would think the rate of osteoporosis and vitamin D insufficiency would be relatively low due to our 100-degree summers and scorching sunny skies in Arizona. However, the inverse is probably true. Our patients here typically have low vitamin D and calcium levels, and this is because our patient population is seasonal at best.

Recently, I had the opportunity to utilize a new bone harvesting tool, the Avitus Bone Harvester (Avitus Orthopaedics), to obtain 25 cc of autogenous proximal tibia corticocancellous bone for a tibiotalocalcaneal joint fusion. This product is innovative and has the potential to reduce the complications of these problematic surgeries all of us perform from time to time.

In general, foot and ankle surgery has a high rate of complications, including non-union, inherent to the value we provide. Our patients are high-risk (at best) and may provide renal, endocrine and/or vascular nightmares when it comes to treatment.

At the CORE Institute, we have underscored the importance of bone healing and fragility fracture management by providing our patients the opportunity to be seen in the Bone Health Clinic (https://www.thecoreinstitute.com/about-us/bone-health-program.html ). The clinic is comprised of several bone health physicians and a team of physician assistants and nurse practitioners in the Phoenix valley. This allows our practice to work as a team to ensure practical management of osteoporosis, non-unions and fragility fractures.

What spurred our practice to form a bone clinic? Well, we are in the bone business and the government recognizes that through upcoming Merit-based Incentive Payment System (MIPS) quality requirements, it can ensure participation in certain metrics and ensure that practices meet priority benchmarks. One small piece of the puzzle, pertinent to foot and ankle surgery, is osteoporosis management in post-menopausal women. The requirement states that physicians are to document if a Caucasian female aged 50 to 85 who sustained a foot or ankle fracture either had a dual energy X-ray absorptiometry (DEXA) scan, or currently uses pharmacologic osteoporosis agents. (https://mdinteractive.com/2017_MIPS_Orthopedic_Surgery )

The team of clinicians in the bone health clinic assists our foot and ankle team in optimizing outcomes, reducing our non-union rates and creating plans of attack for non-healing fragility fractures. The team will also administer osteoporosis medications, draw appropriate labs to assess bone health and thoroughly review the medical history for potential issues.

I do believe a focus on bone health is paramount to optimizing outcomes and we as a team are providing proactive and preventative care, which will ultimately result in a large cost savings for our patient population.