Center for Osteoporosis and Bone Health: An Overview
Speaker: Marcy Bolster - Rheumatology & Immunology
Marcy Bolster: My name is Marcy Bolster. I’m a professor of Medicine at the Medical University of South Carolina. I specialize in rheumatology. I’m Medical Director for the Musculoskeletal Institute. I’m also Medical Director for the Center for Osteoporosis and Bone Health. I’d like to talk, for a few minutes, about the Center for Osteoporosis and Bone Health.
This isn’t a new building on campus at MUSC. It’s a virtual center. The center consists of four different sites where patients can be seen. We have nine physicians seeing patients at four different sites. The nine physicians include five specialists in Endocrinology and four specialists in Rheumatology. The office sites for patients to be seen include Rutledge Tower, which is downtown, West Ashley, the north area specialty clinic, and the Mount Pleasant office. One of the main advantages of having such a center is that we have nine physicians who are very committed to an interest in osteoporosis and bone health. We also collaborate with Radiology, Physical Therapy, Orthopedic Surgery, Neurosurgery, and Physical Medicine and Rehabilitation.
We offer DXA scans for screening for osteoporosis at Rutledge Tower, in Mount Pleasant, and at the West Ashley office. We have a collaborative effort between the Center for Osteoporosis physicians and the Department of Radiology, such that all of the DXA scans that are performed at any of our three sites are interpreted by both a radiologist and an osteoporosis center physician. This allows us to provide a clinical interpretation of the bone density report, to provide more clinical information for the referring physician and the patient, and to make recommendations for management options.
Another important part of the management for a patient’s bone health includes exercise. We have a close collaboration with Physical Therapy, where patients can be seen to help them with strengthening exercises with balance, with minimizing their risk for falling, and for initiating an exercise program that they may do at home.
There’s a special area of focus within the Center for Osteoporosis and Bone Health for those patients who have a vertebral compression fracture. A vertebral compression fracture is a fracture of one of the bones in the spine. It’s also called a vertebral fragility fracture. We have the ability to take care of patients who’ve had a vertebral compression fracture by having a group of specialists evaluate the patient. The patient can be seen initially by physiatry, which is also called a physical medicine and rehabilitation doctor. This doctor can perform the evaluation and help determine if specific pain medicines are needed, if the patient needs to wear a brace, and if any further imaging or x-ray studies are needed.
If the patient needs further x-ray studies, those studies can be performed the same day of the visit to the physical medicine and rehabilitation physician visit. After obtaining any further x-ray studies, the physical medicine and rehabilitation physician has a consultation with an interventionalist. This interventionalist could be a spine surgeon, a neurosurgeon, or an interventional radiologist. This consultation is helpful because the two doctors can make a decision about whether or not to recommend an intervention for a procedure to help with the patient’s pain from the vertebral insufficiency fracture. Following this consultation, the patient is also seen, on the same day, by a rheumatologist, who is an expert in osteoporosis and bone health. The rheumatologist can make any recommendations for management of the underlying disease, which is the osteoporosis. The rheumatologist can also make recommendations for any further testing that might be needed to evaluate the patient’s bone health.
Another program within the Center for Osteoporosis and Bone Health includes the Geriatric Fracture Program. This is a program that was developed to take care of patients who have had a hip fracture, which is a hip insufficiency fracture. A patient with a hip fracture that comes in through the emergency department is admitted to the hospital to undergo surgery for the hip fracture. The patient receives care from both an orthopedic surgeon and a hospitalist. The hospitalist is a physician who specializes in in-patient medical care. The patient gets the benefit of seeing both the orthopedic surgeon and the hospitalist throughout the hospital stay. These two physicians work closely together to help prepare the patient for the upcoming surgery and to help with the perioperative management, or the management of the patient around and after the time of surgery. The patient is seen by Dr. Faye Hant who is a rheumatologist and has expertise in osteoporosis and bone health. The patient will typically see Dr. Hant the same day as their appointment with the physical medicine and rehabilitation physician.
Following the hospitalization and surgical repair of the hip fracture, the patient is then referred to see one of the physicians at the Center for Osteoporosis and Bone Health to receive a consultation to help with the management of the patient’s underlying problem, which is osteoporosis.
The Center for Osteoporosis and Bone Health has a nurse navigator. Her name is Sheryl Naugle. She is able to help with the coordination of patient care. She helps with the scheduling of patients to the appropriate physician and clinic, and she’s available to answer questions as they arise in terms of preauthorization for medications, further testing, and scheduling of testing, and return appointments. In order to get an appointment, patients may self-refer or they may be referred by their physician. The scheduling number is (843) 876-2663 (876-BONE.)
Thank you for listening to the information about the Center for Osteoporosis and Bone Health at the Medical University of South Carolina. I hope this information is helpful to you.