Closing the Gap: Advancing Osteoporosis Care Across Practice Settings
Becker’s Healthcare Podcast
Release Date: March 30, 2026
Host: Kristen Buessman (Amgen)
Guests: Christina Yazdani (UT Physicians Orthopedics), Dr. Gregory Mines (Florida Orthopedic Institute)
Episode Overview
This episode focuses on optimizing post-fracture care for osteoporosis patients across various orthopedic practice settings. Host Kristen Buessman leads a discussion with Christina Yazdani and Dr. Gregory Mines, exploring their approaches to establishing and expanding bone health clinics, overcoming operational challenges, bridging gaps across healthcare systems, and practical advice for building successful post-fracture care programs. The episode highlights both the opportunities and obstacles faced in efforts to close care gaps for osteoporosis patients, especially those with fragility fractures.
Key Discussion Points and Insights
1. The Need for Dedicated Post-Fracture Care
[02:16 – 05:37]
- Lack of Follow-Up: Both guests observed significant numbers of osteoporotic fracture patients getting lost to follow-up post-hospitalization, leading to a cycle of additional repeat fractures.
- "We saw a bunch of repeat customers...we just decided to kind of tackle it head on." — Christina Yazdani [02:58]
- "No one really truly take control of the underlying osteoporosis...patients were falling through the gaps until we generated this post fracture clinic." — Dr. Mines [05:23]
- System Priority: UT Physicians prioritized establishing a bone health clinic after recognizing the deficit in coordinated care for trauma-induced fragility fractures. Florida Orthopedic Institute began its program due to similar recognition, especially within older, high-risk populations.
2. Program Growth and Expansion
[06:15 – 11:03]
- UT Physicians (Houston, TX)
- Originated in 2015 with a half-day weekly clinic targeting hip fragility fractures and quickly expanded.
- "By about 2019 we had two full time apps and one dedicated medical assistant and we were seeing patients out of six different clinic locations across Houston." — Christina Yazdani [07:31]
- COVID-19 prompted some contraction, but now the program operates across four locations, with seven full-day clinics and two telemedicine half-days weekly.
- Florida Orthopedic Institute (St. Petersburg, FL)
- Started as an internal referral-only clinic for fracture patients and expanded to a broader, more inclusive patient base, including external referrals and patients identified via EMR risk factors.
- "We kind of went from this post fracture recovery to prevention on the side of people that didn't have fractures yet." — Dr. Mines [10:27]
- Now sees 6–10 new patients weekly with ongoing growth.
3. Barriers and Challenges in Post-Fracture/Osteoporosis Care
[11:28 – 15:19]
- Data and Workflow Integration: UT Physicians faces significant obstacles in sharing patient data across systems, with different EMRs between physician group and hospital.
- "We're not even in the same EMR...bridging the gap between those two systems." — Christina Yazdani [11:35]
- Multi-party involvement requires ongoing administrative and clinical coordination.
- Sustaining Staffing and Capacity: Florida Orthopedic Institute grapples with the need to add qualified clinicians due to overwhelming demand as the program grows.
- "The response for this bone health clinic has been overwhelmingly great...we need to find someone dedicated and who could be that champion alongside of me." — Dr. Mines [15:10]
- Transition From Post-Fracture to Preventive Care: Both clinics highlighted that their initial focus was on treating patients after a fracture, but the future is in prevention and early intervention.
4. Practical Advice for Establishing Bone Health/Fracture Liaison Clinics
[16:04 – 20:20]
- Team Passion & Education: Both guests emphasize that passion, dedication, and patient education are crucial to success.
- "Education is power...by educating our patients, they take control of their health...requires time in the clinic set aside to discuss osteoporosis." — Dr. Mines [16:37]
- Solid Workflow Structure: Building seamless processes from intake to clinical decision-making and insurance authorization ensures success and minimizes access barriers.
- "It's very important to have a very solid workflow starting all the way from the front desk through your authorizations department." — Dr. Mines [17:29]
- Entrepreneurial Effort: Establishing a bone health clinic is likened to starting a new business—requires self-marketing, ongoing reengagement with internal and external partners, and persistence.
- "I always kind of compare it to starting your own business...you're marketing yourself to the other providers...to the nurse navigators, to the medical assistants..." — Christina Yazdani [18:16]
- Ongoing outreach to other specialties and service lines is essential, as is learning the logistics of therapy delivery (e.g., partnerships with infusion centers).
Notable Quotes & Memorable Moments
-
On the broken cycle of care:
"We saw a bunch of repeat customers...lots of people that would have a hip fracture and then six months or a year later they're back for the other side."
— Christina Yazdani, [02:51] -
On why post-fracture clinics are needed:
"It became clear that there was a deeper issue at play here in terms of systemic disease beyond the fracture initially...And so the bigger problem was osteoporosis."
— Dr. Gregory Mines, [04:46] -
On building momentum:
"That half a day clinic quickly expanded...we were really full steam ahead, doing well."
— Christina Yazdani, [07:14] -
On challenges with fragmented systems:
"What seems like an easy referral just has never panned out that way…we're not even in the same EMR."
— Christina Yazdani, [11:32] -
On workforce needs:
"We need to find someone dedicated and who could be that champion alongside of me."
— Dr. Mines, [15:16] -
On the entrepreneurial nature of founding a clinic:
"I always kind of compare it to starting your own business…you're marketing yourself to the other providers, to the nurse navigators, to the medical assistants..."
— Christina Yazdani, [18:16] -
On the importance of patient education:
"Education is power, and by educating our patients, they take control of their health as well, which can lead to optimal goals for everybody."
— Dr. Mines, [16:31]
Timestamps for Important Segments
- [02:16] — Christina Yazdani on setting post-fracture care as a system priority
- [03:58] — Dr. Greg Mines’ overview of Florida Orthopedic Institute’s approach
- [06:15] — UT Physicians’ clinic growth and scaling story
- [09:11] — Florida Orthopedic Institute’s strategies for expansion and prevention
- [11:28] — Major challenges: system fragmentation and staffing
- [16:04] — Dr. Mines’ advice for others: passion, workflow, and education
- [18:07] — Yazdani’s advice: entrepreneurial mindset and community partnerships
Takeaways for Listeners
- Bridging care gaps for osteoporosis patients after fractures is essential to prevent recurrence and reduce systemic health burdens.
- Interdisciplinary coalition-building and staffing are central to the success of new clinics.
- Investing time in relationship-building, both internally and externally, ensures sustainability and continued growth.
- The long-term goal is shifting from reactive post-fracture care to proactive prevention and risk management.
- A “start-up” mentality is required—plan for nonclinical workload and ongoing marketing efforts.
- Education—both for patients and providers—is the cornerstone for lasting outcomes improvement.
For further resources or to learn more, the guests recommend visiting fracturecaregap.com for tools and information about osteoporosis population health management.