Is Bone Density testing still viable for the physicians practice?

Complete Medical Services – lots of questions today about bone density. Osteoporosis isn’t going away simply because Medicare reimbursements are $50 per study. Osteoporosis negatively effects 50% of all women over the age of 50. These are staggering statistics.

A medical practitioner is in business to make money – this is true. However, the medical practitioner is also in business to treat patients.

An average of 60% of all patients referred out of their primary care doctor for routine tests such as bone density – never have the test done. This make it very difficult for a doctor to properly manage their patients and help that patient prevent a future fracture. Most people view osteoporosis as something that happens when you are old – and it won’t impact them directly. This simply isn’t true. Everyone will reach that age. The fact is that many people are walking around today with osteoporosis in a high risk category for fractures and don’t know it.

By ignoring the reality of the true impact of osteoporosis on a person is ignoring the pain, suffering and potential death that they will face after a fracture.

Educating a patient about the importance of having a bone density scan should be done at every primary care physician office. By offering bone density testing in the office a doctor can help guarantee a patients compliance moving that number from 40% closer to 100%.

Beyond the diagnostics a focus must be Fracture Prevention. This includes the initial diagnosis of osteoporosis; the verification of a patients propensity to fracture risk; and finally treatment. However, there is another step in working with a patient to mange fracture prevention – that has been overlooked.

This overlooked step is – helping a patient that has been diagnosed with osteoporosis and is in a high risk category for fracture – to avoid falling. It is well known that a person with brittle bones due to osteoporosis normally falls due to their hip breaking. However, a person with osteoporosis can also break their hip after falling. It is simply imperative to help this patient prevent falls.

An all encompassing Fracture prevention program should then include:

The bone density- a diagnostic tool to help diagnose osteoporosis and assess a patients risk of a future fracture due to osteoporosis. A bone density, such as a Lunar Prodigy or Hologic Discovery would have included features such as- FRAX- the 10 year fracture risk assessment, essential for treatment protocol for patients who are found to have osteopenia. LVA (Lunar Prodigy) or IVA (Hologic Discovery) which is the vertebral fracture assessment or the 5 year fracture risk assessment.

The treatment- This would include everything from calcium supplements to FDA approved pharmaceuticals for osteoprosis.

Balance Test- this is a direct test helping patients who complain about sudden loss of balance. Why is this a critical part of Fracture Prevention? It is imperative to help a patient with osteoporosis avoid falling. Vestibular issues impact a very large percentage of people. This is an inner ear issue that can quite easily be diagnosed and treated with simple exercise therapy. However, a patient left untreated will suffer a fall, and that patient with osteoporosis will potentially fall with a fracture.

Fractures must be prevented at all cost. This is life altering. Although hip replacements are quite common, not all patients return to a normal life after a fracture and hip replacement as a direct cause of osteoporosis. Some patients do not survive the fracture. This is life changing.

The bottom line – is that bone density testing is critical. Diagnosing osteoporosis is critical. Having DEXA readily available is critical. Having a physician who can help guarantee compliance by his patients to have the DEXA done, because, that doctor offers bone density in his office is imperative.


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