Page 4 - Rochester Medicine | 2019 Volume 1 | University of Rochester Medical Center

A specialty that started small—as a division
Top photo, Kostantinos Vasalos guides a
participant through a video-capture fitness
assessment. Center photo: Vasalos, Gregg
Nicandri, MD, and David Mitten, MD, review
the patient’s results.
1 ROCHESTER MEDICINE | 2019 – V1
At Risk: Growing Numbers of
of surgery with just a handful of providers— Aging, Inactive Patients
is now a vast and diverse enterprise, with “Like our colleagues across the country, UR
approximately 60 clinical faculty and 600 Orthopaedics is caring for patients facing
staff. Together they cover 240,000 annual multiple, complex medical challenges,” adds
visits for patients from Rochester, the Paul T. Rubery, MD (Flw ’94), Marjorie
Western New York region, and the Northeast. Strong Wehle Professor in Orthopaedics and
A look at the Clinton Crossings outpatient chair of the Department of Orthopaedics.
facility may render the keenest snapshot “America’s population is aging, obesity is at
of the Orthopaedic department’s pace and epidemic levels, and youths and adults are
personality. Physically expansive at more experiencing higher levels of anxiety and
than 100,000 square feet, it is as robust depression. We are seeing the impact of this
and multifaceted in its clinical offerings, throughout the Medical Center, particularly in
with space for each of the department’s our orthopaedics patients.”
14 divisions. At any hour of the workday, The numbers back that up. The Population
every clinic room is full, but staff and care Reference Bureau reports that the number
providers help patients move smoothly of Americans over age 65 is expected
through their visits at a speed of nearly 17,000 to double from roughly 50 million today to
a month. nearly 100 million by 2060. According to the
Running at this intensity, it would be Centers for Disease Control (CDC), only
hard to see how Orthopaedics could get any 1 in 5 Americans meets the baseline for
bigger or move any faster. But it will, because recommended physical activity, and nearly
slowing down isn’t an option. 40 percent of American adults—about 94
It’s not just the growing number of patients million—are obese. It’s an epidemic that
and rising demand for specialized services brings with it chronic health conditions in
that are pushing URMC Orthopaedics adults and children.
forward. And it’s not just the onward “Understandably, much of the focus
trajectory of a department that prides has been on how these lifestyle factors
itself on its entrepreneurial spirit and contribute to heart disease and cancer, but
competitive fire. they also have a profoundly negative impact
“The urgency comes from socioeconomic on musculoskeletal health,” Rubery says.
and health trends that are already in force, “Obesity places tremendous mechanical
building speed, and poised to impact millions force on knees and hips, so patients are
of Americans now and in the decades ahead,” having joint problems earlier in life. We are
says Mark Taubman, MD, CEO of the even seeing obesity affecting bone health in
University of Rochester Medical Center and children. Inactivity is a factor in lower bone
dean of the School of Medicine and Dentistry. density as people age, so we’re seeing more
“Like its counterparts across the country, adult patients requiring arthritis care, joint
the Department of Orthopaedics is seeing replacement, and treatment for osteoporosis
musculoskeletal issues in patients of all ages and fragility fractures.”
that prior generations of providers never Pointing out that many of these conditions
encountered,” Taubman adds. “Baby Boomers could be mitigated or even prevented with
living into their 90s who need arthritis care proactive care, Rubery argues that as the
and joint replacements—that’s just one population ages, the need for orthopaedic
source of our explosive volume growth. The care will rise. He says health systems will
entire Orthopaedics enterprise is focused on be called upon to deliver well-designed
meeting patients’ needs now and building for treatment facilities, well-trained providers
the changes coming its way, so it can help and care teams, and “breakthrough
future generations live longer, healthier, more research that leads to innovative treatment
active lives.” approaches.”