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Why Proactive Patient Outreach and Education is Necessary Today in Orthopedics from Dr. Howard Luks

Dr. Howard Luks

Howard J. Luks, MD is a leading orthopedic surgeon and sports medicine specialist. Dr. Luks is an expert in shoulder, knee, and other sports injuries, and author of Longevity… Simplified: Living A Longer, Healthier Life Shouldn’t Be Complicated.

TL;DR:

  • There is a direct connection between obesity and orthopedic issues
  • Metabolic health improvements also improve surgery outcomes
  • Patients don’t understand how their lifestyle affects their musculoskeletal system
  • Patients want proactive, preventative care and depend on their healthcare providers – no matter their specialty – for their overall health
  • As healthcare becomes increasingly value-based, proactive patient outreach and health education programs are essential to improve population health

 

The landscape of orthopedic surgery is evolving regarding technological advancements, surgical techniques, and the approach to patient care. The rise in obesity and its associated health (and surgical) complications has brought to the forefront the need for a more proactive stance in patient outreach and education, especially concerning metabolic health. This article explores why initiatives like Prescribe FIT’s Fast Track to HealthTM program are beneficial and necessary in today’s healthcare environment.

Acknowledging the Connection Between Obesity & Orthopedics

Our bodies are highly complex and interrelated. It is now clear that metabolic disease associated osteoarthritis is rapidly increasing in prevalence. We are seeing more patients with a significant chronic inflammatory burden due to the downstream consequences of type 2 diabetes, insulin resistance, fatty liver, and more.  This manifests as having more pain and inflammation despite more mild disease radiographically. This also manifests itself with an increased incidence of prosthetic joint infections (PJI), stiffness, and other post-operative complications.

The Centers for Medicare & Medicaid Services (CMS) is updating its patient risk scoring system in 2024, underscoring the growing importance of these risk-based models. This makes it even more important to focus on improving the health of our patients preoperatively as these models start to scale. Implementing outreach programs like Prescribe FIT’s Fast Track to Health will better align the practice with risk-based model objectives and improve the practice’s capital preservation strategy.

The Impact of Metabolic Health on Pain

Metabolic health significantly influences the severity of pain experienced by patients with conditions like osteoarthritis. Whether the increase in pain is due to the presence of inflammatory cytokines or macrophage polarization, the result is a painful swelling that impedes functional capacity. Educating patients about the relationship between excess weight, inflammation, and joint pain can be a powerful motivator. Understanding that weight loss and lifestyle changes can substantially improve pain levels and quality of life can encourage patients to embrace healthier habits.

Surgery Complications and Weight

The risks associated with surgery, particularly complications like prosthetic joint infection, increase with elevated weight and A1c levels. These complications are not just detrimental to patient health but also to the provider’s performance metrics. Patients generally wish to avoid such outcomes, and when informed about the risks and how their metabolic health plays a role, they are more likely to take preemptive action. Surgeons want to be able to concentrate on primary joint replacements.  Minimizing the need for single or two-stage exchanges or surgery to improve range of motion will enhance the practice’s ability to focus on maximizing their primary joint surgical volume.

Outcomes from a Surgeon’s Perspective

For surgeons, operating on patients who have improved their metabolic health and reduced excess weight can lead to more straightforward procedures, fewer complications, fewer revisions, and better outcomes. This benefits the patient and enhances the surgeon’s ability to deliver high-quality care and focus on their primary joint replacement volume.

 

Framing the Conversation with Unhealthy Patients

Recognizing the difficulty of initiating conversations about weight and metabolic health with orthopedic patients is essential. These discussions are sensitive, often fraught with emotional and psychological undertones. Even though most patients will engage if the conversation is framed properly, many physicians hesitate to broach these topics, fearing negative reactions or damaging the patient-provider relationship. However, avoiding these conversations is a disservice to patient care, especially considering the direct correlation between metabolic health and orthopedic outcomes.

The key to receptivity lies in how the conversation is framed. When approached with empathy, understanding, and a clear explanation of the health implications, most patients are receptive and appreciative of the concern for their overall well-being. It’s about shifting the narrative from blame to empowerment, where patients are partners in their health journey. When specifically addressing how their overall health affects the amount of pain they’re experiencing, the complications they face after surgery, and the dire consequences of PJIs, many patients are ready to engage.

Contrary to some beliefs, many patients are acutely aware of their weight issues and their impact on their health. They may not vocalize it, often due to shame or fear of judgment, but internally, they recognize the problem. This internal acknowledgment is a critical engagement point for healthcare providers to initiate supportive and constructive dialogue.

Many overweight individuals are eager for change but may lack the guidance, resources, or motivation to take the necessary steps. Here lies an opportunity for orthopedic practices to be more than just a place for surgical consultation but a source of comprehensive health improvement strategies.

The Role of Proactive Outreach & Patient Education

Proactive patient outreach, such as that offered by Prescribe FIT’s Fast Track to Health education & enrollment program, is pivotal in bridging the gap between recognizing the need for lifestyle changes and taking action. Such programs provide patients with the knowledge, resources, and support necessary to embark on a health improvement journey. For patients, the benefits of engaging in a virtual health and fitness program are manifold, from enhancing daily functional abilities to ensuring a smoother surgical recovery with a lower incidence of postoperative complications. Furthermore, this occurs with little intervention from the surgeon or the rest of the practice’s care team.  Yet, it reflects positively on the practice because of the value of a more patient-centric approach.

The highly trained outreach team at Prescribe FIT is well-positioned to serve the needs of a busy orthopedic practice in this regard.  Their team has successfully performed these outreach services for orthopedic practices of various types and sizes from coast to coast. Contrary to popular belief, patients respond favorably to outreach programs deemed caring, personalized, beneficial, and worthy of their time.  When the outreach is performed in the proper context by appropriately trained staff, the benefits to the practice accrue even further. Patients generally respond favorably to these personalized touches in an otherwise transactional, sterile, fast-paced healthcare environment.

Diminishing Risk and Rewarding Overall Health

In a healthcare environment increasingly focused on outcomes and value-based care, reducing the risk of complications is paramount. Proactive health initiatives improve patient outcomes and protect providers against the penalties associated with poor performance metrics. Surgeons can better focus on their primary joint replacement volume by minimizing complications. Patients educated and supported in making lifestyle changes fare better in orthopedic treatments and surgeries and contribute to a healthcare model that rewards health improvement and maintenance.

 

The necessity for proactive patient outreach and education in orthopedics cannot be overstated. In the face of rising obesity rates and associated health issues, engaging patients in conversations about metabolic health and encouraging them towards lifestyle changes is crucial. Programs like Prescribe FIT represent a forward-thinking approach to patient care that prioritizes holistic well-being, reduces surgical risks, and aligns with the goals of modern healthcare delivery. By embracing these initiatives, orthopedic practices can play a critical role in reversing the declining health trend and improving countless individuals’ lives.

Published on March 7, 2024