In the past, when orthopedic surgeons saw 60-70 year-old patients with arthritis or other conditions affecting their knees or shoulders, they would focus on conservative treatment that ensured the joints were at least functional. Orthopedic surgeons today know that simply functional joints aren't enough for baby boomers: They want to remain active. An increasing number of older adult patients and weekend warriors want to return to their normal level of function after an injury, which often means undergoing surgery. Here, industry experts discuss this trend and provide seven tips for orthopedic surgeons wishing to cater their practice toward the older patient generation.
1. Focus on your patient population. Look at your community demographics and decide whether it would be profitable to exclusively market your practice towards the baby boomer population, says Lee H. Igel, PhD, clinical assistant professor at New York University. "If you want to go for this population, consider how they fit in with what you are already doing and decide whether you need to do something different to focus on them," he says. This change in tactic could mean focusing only on baby boomers and turning away younger patients who seek treatment. Turning away one population of patients gives the physicians and practice staff time and energy to focus on the target population. "It helps to figure out who to say 'no' to so you can refer those patients to another physician," says Dr. Igel. "You can build a network by saying 'no' to people and gain a reputation among other physicians that way."
2. Devise treatment on a case-by-case basis. Many older patients assume that once an injury occurs, they won't be able to participate in activities again. However, with recent innovations in custom design uni- and bicomparmental implants, bone-sparing knee surgery, orthopedic surgeons are often able to restore older patients' joints back to normal function. "I get a lot of patients from other physicians who say they are 60-years-old and don't need their ACL anymore. We can reconstruct the patient's anatomy with uni- and bicomparmental custom knees and return them to their regular activities just as we can do with younger patients," says Gary S. Levengood, MD, founder of Sports Medicine South in Atlanta. "We save as much of the bone and soft tissue as possible so the knee rotates like a normal knee and does everything a normal knee does. The patient's brain doesn't have to register how to use their knee again."
However, there is also a point when surgical intervention is unreasonable, says James N. Gladstone, MD, co-chief of sports medicine at Mount Sinai Medical Center in New York City, and surgeons must be realistic with their patients. "Rather than categorizing people by age, we look at each case and each individual on a case-by-case basis and try to tailor the treatment for the problem," he says.
The patients should also understand their role in the recovery process. Older patients may have less time for rehabilitation, says Dr. Levengood, but they need to maintain a healthy lifestyle and complete rehabilitation exercises. "Set the expectations," he says. "Tell them the outcomes are available but they have to work for them."
3. Understand the patient's goals before treatment. Even though all older patients may not get back to the same level of activity as they were before the injury, surgeons should recognize what the patient's goals are and form a treatment plan around them. "Listen to the patient and find out what the patient wants to do and then based on what you have, you should be able to get them to that point," says Dr. Levengood. "The key is to get a good idea of where the patients are and what they want to do. If patients are able to ski before their injuries, why can't they do that again? As a sports medicine physician, I take the same attitude toward weekend warriors as I do with younger athletes who expect to get back to the same level of play."
4. Network through younger patients. Many sports medicine physicians serve as team physicians for local youth, high school or college sports teams. Use these connections with the younger players to promote your practice to their older relatives who might need orthopedic care in the future. "You can get those athletes, but you can also get their parents and grandparents because you are demonstrating your expertise," says Dr. Levengood. "The thing is to position yourself so you're not just a hammer and everything is a nail. You have to be able to do the 14-year-old's ACL and the 60-year-old's ACL."
5. Direct marketing efforts toward older adults. Place articles or advertisements in magazines with an older audience, such as AARP or Vim and Vigor, says Dr. Levengood. He has published patient profiles about the work he's done with older patients in such publications, which attracts the publication's readership to his office. "People read the profiles about patients coming in not being able to do things and then we get them back to their lives," says Dr. Levengood. "The readers say, 'Hey, that's me. I'm not ready to pack it in yet, I'm ready to keep going.'"
6. Give public lectures at sports clubs or gyms. Collaborate with a local sports club or gym to give a presentation on the best practices for nursing injuries, staying healthy and keeping a nutritious lifestyle. "Typically, the population that attends these sorts of events are the middle and older age group," says Dr. Gladstone. "I often find that people come in and their knees hurt because they are overweight. They want to lose the weight but can't run. We can be helpful in offering alternatives based on the patient's specific ability." Some of these alternatives include dieting, walking, swimming and bicycling. Dr. Gladstone also emphasizes stretching among his older patients, especially if they only occasionally engage in sporting activities. While the information isn't necessarily sports-related, the surgeon is still building a reputation among a potential patient-base.
7. Use the Internet to reach patients at home. Many baby boomers regularly use the Internet and orthopedic surgeons can use this space to their advantage. Thomas Vangsness, MD, chief of sports medicine at the Keck School of Medicine at USC and the LAC/USC Medical Center, has created YouTube videos of different shoulder and posturing exercises and uploaded them onto his website for patients to use at home. "I tell my patients to go to my website and follow the different exercises for knee and shoulder issues," he says. "For many patients, the videos are a lot better than giving them little sheets of paper with exercise descriptions and pictures. They can actually see how to do their exercises."
Read other coverage on success in sports medicine practices:
- 7 Proven Tactics to Position Your Sports Medicine Practice as an Industry Leader
- 5 Best Practices for Physicians to Develop a Successful Sports Medicine Practice
- 4 Best Practices for Negotiating Payor Contracts for Your Sports Medicine Practice
Treating the patients
1. Focus on your patient population. Look at your community demographics and decide whether it would be profitable to exclusively market your practice towards the baby boomer population, says Lee H. Igel, PhD, clinical assistant professor at New York University. "If you want to go for this population, consider how they fit in with what you are already doing and decide whether you need to do something different to focus on them," he says. This change in tactic could mean focusing only on baby boomers and turning away younger patients who seek treatment. Turning away one population of patients gives the physicians and practice staff time and energy to focus on the target population. "It helps to figure out who to say 'no' to so you can refer those patients to another physician," says Dr. Igel. "You can build a network by saying 'no' to people and gain a reputation among other physicians that way."
2. Devise treatment on a case-by-case basis. Many older patients assume that once an injury occurs, they won't be able to participate in activities again. However, with recent innovations in custom design uni- and bicomparmental implants, bone-sparing knee surgery, orthopedic surgeons are often able to restore older patients' joints back to normal function. "I get a lot of patients from other physicians who say they are 60-years-old and don't need their ACL anymore. We can reconstruct the patient's anatomy with uni- and bicomparmental custom knees and return them to their regular activities just as we can do with younger patients," says Gary S. Levengood, MD, founder of Sports Medicine South in Atlanta. "We save as much of the bone and soft tissue as possible so the knee rotates like a normal knee and does everything a normal knee does. The patient's brain doesn't have to register how to use their knee again."
However, there is also a point when surgical intervention is unreasonable, says James N. Gladstone, MD, co-chief of sports medicine at Mount Sinai Medical Center in New York City, and surgeons must be realistic with their patients. "Rather than categorizing people by age, we look at each case and each individual on a case-by-case basis and try to tailor the treatment for the problem," he says.
The patients should also understand their role in the recovery process. Older patients may have less time for rehabilitation, says Dr. Levengood, but they need to maintain a healthy lifestyle and complete rehabilitation exercises. "Set the expectations," he says. "Tell them the outcomes are available but they have to work for them."
3. Understand the patient's goals before treatment. Even though all older patients may not get back to the same level of activity as they were before the injury, surgeons should recognize what the patient's goals are and form a treatment plan around them. "Listen to the patient and find out what the patient wants to do and then based on what you have, you should be able to get them to that point," says Dr. Levengood. "The key is to get a good idea of where the patients are and what they want to do. If patients are able to ski before their injuries, why can't they do that again? As a sports medicine physician, I take the same attitude toward weekend warriors as I do with younger athletes who expect to get back to the same level of play."
Marketing to baby boomers
4. Network through younger patients. Many sports medicine physicians serve as team physicians for local youth, high school or college sports teams. Use these connections with the younger players to promote your practice to their older relatives who might need orthopedic care in the future. "You can get those athletes, but you can also get their parents and grandparents because you are demonstrating your expertise," says Dr. Levengood. "The thing is to position yourself so you're not just a hammer and everything is a nail. You have to be able to do the 14-year-old's ACL and the 60-year-old's ACL."
5. Direct marketing efforts toward older adults. Place articles or advertisements in magazines with an older audience, such as AARP or Vim and Vigor, says Dr. Levengood. He has published patient profiles about the work he's done with older patients in such publications, which attracts the publication's readership to his office. "People read the profiles about patients coming in not being able to do things and then we get them back to their lives," says Dr. Levengood. "The readers say, 'Hey, that's me. I'm not ready to pack it in yet, I'm ready to keep going.'"
6. Give public lectures at sports clubs or gyms. Collaborate with a local sports club or gym to give a presentation on the best practices for nursing injuries, staying healthy and keeping a nutritious lifestyle. "Typically, the population that attends these sorts of events are the middle and older age group," says Dr. Gladstone. "I often find that people come in and their knees hurt because they are overweight. They want to lose the weight but can't run. We can be helpful in offering alternatives based on the patient's specific ability." Some of these alternatives include dieting, walking, swimming and bicycling. Dr. Gladstone also emphasizes stretching among his older patients, especially if they only occasionally engage in sporting activities. While the information isn't necessarily sports-related, the surgeon is still building a reputation among a potential patient-base.
7. Use the Internet to reach patients at home. Many baby boomers regularly use the Internet and orthopedic surgeons can use this space to their advantage. Thomas Vangsness, MD, chief of sports medicine at the Keck School of Medicine at USC and the LAC/USC Medical Center, has created YouTube videos of different shoulder and posturing exercises and uploaded them onto his website for patients to use at home. "I tell my patients to go to my website and follow the different exercises for knee and shoulder issues," he says. "For many patients, the videos are a lot better than giving them little sheets of paper with exercise descriptions and pictures. They can actually see how to do their exercises."
Read other coverage on success in sports medicine practices:
- 7 Proven Tactics to Position Your Sports Medicine Practice as an Industry Leader
- 5 Best Practices for Physicians to Develop a Successful Sports Medicine Practice
- 4 Best Practices for Negotiating Payor Contracts for Your Sports Medicine Practice