Proactive, Preventive and Personalized Orthopedic Care

Healthcare in the United States suffers from reactivity. Outside of routine primary care and annual checkups, most patients only seek care when an issue has already occurred. One of the most unsettling stats in cardiology is that the first symptom of heart disease is death for 40% of people. While people typically strive to make good lifestyle choices, a lack of education and access to preventative care has exacerbated the ongoing public health crisis in America.

This sick-care model also impedes providers. When clinicians are disconnected from patients’ daily lives, it limits their ability to gain a full picture of the patient’s health — and provide more personalized care accordingly. Despite the fact that 83% of patients depend on their providers for their well-being, providers are often limited to offering generic advice that is often far less impactful on a patient’s lifestyle and habits. 

For orthopedic surgeons, the issue is even more pressing. Orthopedic care has long been considered a reactive discipline, as most patients seek an orthopedic provider as a result of MSK or joint pain. However, many of the factors that contribute to such pain are lifestyle factors that need to be addressed outside of the office. These factors include:

• Obesity 
• Exercise and physical activity 
• Nutrition
• Stress
• Smoking

Often times, surgery isn’t the answer — or at least, not the only answer. 79% of orthopedic patients don’t receive surgery within 18 months of the initial visit. But most of the time the treatment is just that, a reactive treatment to an existing problem. Orthopedic providers should look toward proactive, lifestyle health approaches to influence better outcomes, move the needle on population health, and gain deeper relationships with patients. 

Better Outcomes = Happier Patients

The fact is that no one wants to be in pain. But many patients do not understand the correlation between their lifestyle choices and their health. In the case of MSK and joint pain, the connection between lifestyle factors and pain is undeniable. One of the most important indicators of the need for lifestyle intervention is obesity. Obesity negatively impacts the body in multiple ways that contribute to orthopedic pain. It places a greater physical burden on supporting joints, but it can also increase pain-inducing inflammation throughout the body. 

• The odds of sustaining an MSK injury are 15% greater if overweight and 48% greater for Class III obesity 
• Weight loss is a top recommendation by the American Academy of Orthopedic Surgeons for mitigating osteoarthritis in knee patients with BMI greater than, or equal to, 25
• Every 1 lb. of excess weight causes an additional 4 lbs. of pressure on the knee joint, and 10 lbs. of pressure on the lower back
• A patient with obesity is more likely to experience complications such as infection, poor wound healing, difficulty breathing, blood clots and pulmonary embolism after surgery 

Simple lifestyle changes aimed at reducing weight and creating positive habits in other areas can reduce chronic MSK and joint pain, and the risk of developing it. And teaching patients how to reduce their weight and maintain that healthier lifestyle can help them not only achieve better orthopedic outcomes, but a better life as well. Simple lifestyle health improvements have been proven to:

• Prevent up to 80% of premature heart disease, stroke and Type 2 Diabetes cases 
• Prevent up to 40% of cancer diagnoses
• Reduce the risk of Alzheimer’s by 60%

Proactively reaching patients with that kind of intervention before surgery can make a significant difference in the surgical experience and outcomes. Numerous studies have proven that weight loss ahead of surgery (when needed) helps reduce surgical and post-surgical complications. According to a 2023 study, helping patients “prehabilitate” by implementing a healthier diet in the weeks or months ahead of surgery can positively impact patient readiness and fitness, and therefore influence better surgical outcomes, as well as patient recovery and long-term health.

But the key word above is proactive. Most patients are not equipped to make and maintain significant lifestyle changes on their own. Even if a patient understands the concept of why they need to reduce their weight or make other lifestyle changes, they may not have adequate education or resources to do so on their own. According to the much-cited Freedhoff 2016 study, 95% of diets fail. And many patients have little knowledge about exercise, or worse, a poor or traumatic relationship with the concept of it.

Orthopedic providers can help by providing a clear roadmap and hands-on support to help patients navigate their individual journeys, filling the wide gap that currently exists between patients and long-term lifestyle health.

How to Start Being Proactive 

When you’re already a busy orthopedic provider, how do you begin integrating lifestyle health coaching services into your practice? One answer is Remote Patient Monitoring (RPM) technology and other full-service virtual care programs like Prescribe FIT.

According to Accenture, 62% of patients would choose a virtual option for their health and wellness advisories. In another study by Sony, 88% of respondents reported that a “specialized remote health monitoring device” would help them manage their health. And in perhaps the most telling statistic, more than 50% of patients say they would consider switching doctors if their current physician didn’t offer remote monitoring services. 

This paints a clear picture of what today’s patient wants:

• More proactive care from their providers
• Care that is personalized to their unique body and challenges
• Closer communication between the patient and their providers 

Orthopedic practices have adopted digital solutions at a slower rate than some other disciplines because of the pervasive idea that orthopedic care has to happen in an operating room or office. But when you start to incorporate holistic lifestyle elements into the care mix, the door suddenly opens wide for RPM solutions that enable the proactivity and personalization your patients seek.

Prescribe FIT is a virtual lifestyle health program tailored specifically to orthopedic care. In our work with orthopedic practices across the nation, we see proof of the positive effects of lifestyle health education every single day. Facilitated by our certified health coaches, and monitored by our partner physicians, our program is designed to help address long-term lifestyle health issues. 

“I was looking for a natural, healthy way to lose weight and feel better without medications when my orthopedic physician reached out about this at-home lifestyle coaching program called Prescribe FIT,” said Rachel Jennings. “It’s been amazing! I’ve lost 89lbs in my first 129 days. That’s 29% of my body weight! And my BMI has gone from 49.6 to 35.2. I feel better, am happier, and am living my best life again all because my orthopedic physician cared about more than my shoulder – he cares about my overall health. And the best part is, it’s covered by insurance!”

Over the last few years through our partnerships with orthopedic practices around the country, we have identified a few keys for implementing proactive, preventative and personalized orthopedic care: 

1. Lean on technology: You may be surprised how many patients are willing and ready to incorporate technology into their care routine. Safety constraints during the pandemic meant that telehealth boomed in popularity. We utilize a mobile app and digital scale to help connect patients and providers outside of the office, gathering data that allows us to customize an individual’s health program in real time based on the guidance of their surgeon.
2. Address root causes: Surgery is an important part of healing but it doesn’t typically address the root cause of pain. Proactively working with your patients to identify those root causes and establish a plan to rectify them results in happier, healthier patients. Our program works directly with surgeons to craft those plans and then support patients through their goals. 
3. Connected care interventions are critical: It is very hard for people to break habits and form new ones — and harder yet to do it alone. Part of providing proactive, personalized care means being there to encourage, educate and course-correct when necessary. Our program establishes this support network through our certified Health Coaches, who are assigned on a one-on-one basis to the patients they work with. 
4. Take the time to educate patients: We make a point to educate patients about the “why” behind their surgeon’s guidance, including how to get there. Whether the goal is weight loss, smoking cessation, better post-surgery recovery or otherwise, we have seen more lasting and impactful results when patients understand how their actions will affect their outcomes. 
5. Think different: To make the shift from reactive to proactive, surgeons must be as bought in as their patients. But committing to this kind of care is worth it for your patients and the overall health of our society. Orthopods have always been on the cutting-edge of technology and thought of as innovators in health care. Once again, orthopedics can lead the charge and accomplish something other specialities and primary care has failed to embrace.

Healthcare is slowly but surely trending toward more proactive value-based care, supported by virtual care options. As patient drivers continue to evolve, orthopedic practices must take steps to ensure that they can offer the kind of proactive, personalized care patients need. 

Be Proactive. Go Virtual.

If you’re ready to discuss how your practice can make the leap from reactive to proactive, we’re ready to help you get there. Contact us today to learn more.