Osteoporosis: Breaking Bones Is Not Inevitable

  • Richard M. Dell


When I finished my orthopedic surgery training at USC in 1987, I was faced with the choices of private practice, academics, or the Kaiser system. I chose Kaiser because of its integrated model of care and its commitment to using information technology to manage patients. Within Kaiser, I have never had to worry about variable reimbursement and conflicting financial priorities getting in the way of my providing necessary care and working with my colleagues to develop our osteoporosis fracture prevention program. Fracture prevention makes sense in Kaiser because it is considerably less expensive to prevent a hip fracture than to manage it, simple as that.


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  1. 1.
    Prevalence report. National Osteoporosis Foundation. Accessed 20 April 2011.
  2. 2.
    Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res. 2007;22:465–75.PubMedCrossRefGoogle Scholar
  3. 3.
    Dawson-Hughes B on behalf of the National Osteoporosis Foundation Guide Committee. FRAX bone treatment algorithm: a revised clinician’s guide to the prevention and treatment of osteoporosis – commentary. J Clin Endocrinol Metab. 2008;93:2463–5. Accessed 20 April 2011.
  4. 4.
    Dell R, Greene D, Schelkun SR, Williams K. Osteoporosis disease management: the role of the orthopedic surgeon. J Bone Joint Surg (Am). 2008;90:188–94.CrossRefGoogle Scholar
  5. 5.
    Newman E. A schema for effective osteoporosis management: outcomes of the Geisinger Health System Osteoporosis Program. Dis Manage Health Outcomes. 2003;11:611–6.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of OrthopedicsKaiser PermanenteDowneyUSA

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