This is the second part of a three-part series discussing the impact of baby boomers on orthopedics. You may also be interested in viewing the first part where experts are asked: What Do Baby Boomers Mean for Orthopedics Today and Tomorrow? 10 Responses
Christopher Browne, MD, Orthopedic Surgeon, Eastern Oklahoma Orthopedic Center, Tulsa: Patients want to continue to be active and productive because they are working more years than previous generations. They also want to continue living an active lifestyle by running, biking, gardening and traveling. Patients are also becoming more informed about procedures and physicians due to the amount of information online.
Our practice upgraded our patient information and education within the last 12 months. We send out e-newsletters to give patients the latest news in the field of orthopedics and sports medicine, and provide procedure animations on our website so they can fully understand the different treatment techniques. Additionally, our physicians are very good at spending the necessary time with each patient to answer all of their questions.
Terrence Crowder, MD, Orthopedic Surgeon, Sonoran Spine Center, Phoenix: To accommodate this generation of people who will need our care in the future, our practice is adding more and more ancillary staff. The baby boomer population requires a lot more attention than their parents did 20 years ago. They want to know more about their appointment and they bring in articles from the internet about their condition. We’ve had to hire more people to fulfill the clerical needs because baby boomers are calling with a list of questions about their appointment or future surgery. We are finding that it costs a lot more to than we expected to meet their needs.
Insurance companies are also reducing the reimbursement for physicians and as this generation becomes closer to qualifying as Medicare patients, we will receive less for seeing them in our clinic. These patients require more time, which is reasonable, but physicians aren’t being paid more. A lot of physicians are hiring midlevel providers to maximize their time.
Guillem Gonzalez-Lomas, MD, Orthopedic Surgeon, New Jersey Medical School, New Brunswick: In the same way that sports medicine patients can be culled from covering high school or college sports, physicians can cover masters events or provide “Masters” clinics at local gyms to attract more patients. Baby boomers also are avid devourers of web-based services. Practices need to have a presence on the web and make sure they specifically cater to active boomers. Testimonials from patients are always illustrative. Question and answer sections about common questions baby boomers might have (such as: Will I be able to run after my total knee replacement?) may reassure them that your practice understands their needs.
Along these lines, patients often get information or ‘half-information’ from blogs or chat groups that may over-emphasize a particular complication or treatment. Addressing these common misconceptions or rare complications with evidence-based information can help put them in perspective and be reassuring to patients.
Kent Lerner, MD, Orthopedic Surgeon, Metropolitan Orthopaedics, North Arlington, N.J.: From being in practice as long as I’ve been, it really starts with getting to know the patient a little bit. You need to listen to what they are telling you; it doesn’t take long to figure out if someone is retired with a hurt shoulder and wants to play golf again or if there is something more serious going on. If this patient has a rotator cuff tear and it is repairable, it should be repaired. Up until the past 10 years, the standard of care was open or mini-open repair, but now it has transitioned to arthroscopic repair. The advantage of arthroscopic procedures isn’t that they heal faster, but the patient can rehab and recover faster. You want to do things where there is as little inconvenience and pain to the patient as possible.
If another patient is running six miles per day and develops a knee problem, the treatment will depend on what you see in the X-ray exam. If the patient is developing arthritis, they may not be able to keep up with the same amount of running. They might want to keep running until the knee runs out — but they need to be informed. Know the individual, personality, health and medical condition and then educate them about what their options are and expectations should be.
Steve Neufeld, MD, Orthopedic Surgeon, The Orthopedic Foot & Ankle Center, Washington, D.C.: Baby boomer generation patients often come armed with a lot of knowledge from the internet, which can be a source of both reliable and unreliable health information. I spend a lot of time redirecting them and dealing with their misconceptions and potentially erroneous (and sometimes potentially dangerous) “medical” information. To help patients find credible sources of information, a practice might consider gathering the list of common questions and creating a section of the practice’s website that house patient education sheets or website links to valid, credible research sites to try to answer these questions in advance. At our practice’s website we named that section, the “Medical Library” and our patients say they use it regularly for reliable information.
Also, help baby boomer patients remain active longer with interesting ideas for low-impact exercise, non-invasive treatments and if surgery is the last option, make a commitment to find ways to help them recover more quickly after surgery. With baby boomers, excellent communications skills and written reference materials, studies are a key to a long term relationship.
At our practice, we have formed a new retail company that sells comfortable, supportive orthopedic shoes, orthotics and braces. If people want to stay active, it’s important to have the right footwear and instead of sending them to a random store, we can provide them with the footwear they need. When patients need surgery, they don’t want to have downtime in a cast, so we are involved in research to find ways that will speed up the recovery process and make it easier. I developed a special plate that allows patients to bear weight almost immediately after surgery. They can begin walking sooner and start the rehabilitation process more quickly postoperatively. There are also new techniques for fixing a ruptured Achilles tendon that allow patients to start therapy just a week after surgery.
Patti O’Brien, Administrator, St. Vincent Medical Center’s Joint Replacement Institute, Los Angeles: We have built a practice website and we always refer our patients there for further learning. There are animated videos on the website for patients to watch that teaches them about the hip or knee procedures our surgeons perform. There are also patient testimonials on our website. Baby boomers are always looking for information about the research and development our physicians are doing, so our physicians are continuously publishing articles on their work and we share those on our website as well.
Sometimes, we connect former patients with potential patients to talk about their experiences with a particular surgeon. This helps potential patients to help them feel more at ease when making treatment decisions. Baby boomers have a lot of questions and our staff has been trained with basic knowledge of the procedures and diagnoses so they can impart that knowledge to the patients. We teach our staff members exactly what the patients go through in surgery and what the postoperative course is like so they really understand what each patient is going through.
Timothy Payne, MD, Orthopedic Surgeon, M and M Orthopedics, Lemont, Ill.: When you are talking about treating people today, the life expectancy is longer than it was 15-20 years ago, so the object of treatment for a lot of people is to preserve the joint as long as possible with conservative techniques. We also work on educating our patients about how they can preserve their knee and optimize function. I think part of the problem is communicating with the patients because the healthcare language has always been different from everyday language. I need to talk to my patients in terms they can understand so they know what I’m saying and can follow my instructions.
The big thing is developing a basis by which we can communicate and use simplified terms our patients can understand. For example, when a patient has arthritis I use the example of potholes in the road. To a certain extent, visual images help create that common language that people can grasp, and from there the discussion becomes logical. If you do something that causes pain, you don’t keep doing it. You need to adjust your activity. Another alternative solution I use for patients with arthritis is the BioniCare Knee System by VQ OrthoCare, a non-invasive and non-pharmaceutical treatment for osteoarthritis of the knee.
Baby boomers often feel compelled to do a task, such as an exercise program for their cardiac problems, even if it hurts the joints. We try to give them alternative exercises so their joints will stop bothering them. There is no guarantee that these adjustments will help, but when you develop a program where you are doing cross training and multiple exercises, you are more likely to keep from aggravating the joint.
Related Articles for Orthopedic Practices:
7 Ways Orthopedic Sports Medicine Practices Can Cater to Baby Boomers
5 Tips for Orthopedic Surgeons to Connect Better With Patients
4 Ways Sports Medicine Physicians Can Stay Ahead in 2011
