A message from the ASOP Board President and CEO
Why We Urgently Need Standards of Care in Osteoporosis and Bone Health
Jared Torkelson, PA-C, President
Dudley Phipps, PA-C, CEO/Executive Director
Osteoporosis and bone health (OBH) affect over 35 million Americans—roughly 10% of the population—with an estimated $95 billion in annual costs by 2025. It ranks among the top 10 chronic diseases in the U.S. for both impact and expense. Yet, despite its prevalence, OBH care remains fragmented, inconsistent, and often overlooked. Why? Because we lack true standards of care.
The Problem: A Fragmented System
OBH care is delivered by a diverse group of providers—MDs, DOs, NPs, and PAs—across specialties like primary care, internal medicine, endocrinology, orthopedics, nephrology, and women’s health, to name a few. This variety enriches the field but complicates consistency. About 60% of OBH care in the U.S. comes from PAs and NPs, who often serve as frontline providers. Some focus narrowly, such as on post-menopausal osteoporosis, while others tackle the full spectrum of OBH conditions, from rare bone diseases to fracture prevention.
This diversity, while valuable, creates a patchwork of care. The OBH ecosystem is flooded with over 10 guidelines from various societies, each offering divergent recommendations. Insurance companies add their own suggestions, further muddying the waters. Providers rarely adhere to these guidelines strictly, leaving patients with inconsistent treatments that vary by provider, specialty, or region. Without clear standards, healthcare professionals (HCPs) struggle to deliver evidence-based care, leading to missed opportunities for prevention, suboptimal plans, and avoidable fractures.
The Education Gap
The challenge is compounded by inadequate training. On average, OBH providers receive just 2-4 hours of education on this complex disease during their base training—far too little for the scope of care required, whether managing post-menopausal osteoporosis or comprehensive bone health. Continuing medical education (CME) programs exist, but they’re designed to build on foundational knowledge that most providers lack. Existing certificate courses focused on osteoporosis often lack depth, fail to foster ongoing learning, and don’t establish standards of care.
This forces providers—whether endocrinologists or NPs—to “reinvent the wheel,” piecing together knowledge through trial and error. The result? Wide disparities in expertise lead to uneven patient care. We can’t expect a diverse provider base to manage a top 10 chronic disease effectively with such a shaky foundation.
Why Standards Matter
Standards of care are more than protocols—they’re a blueprint for transforming OBH management. They provide:
Clarity: Clear, evidence-based protocols for screening, treatment initiation, and progress monitoring, tailored to diverse providers and specialties, reducing guesswork.
Consistency: Uniform care pathways that ensure every patient—whether seen by a PA in primary care or an orthopedist—receives high-quality treatment.
Accountability: A framework that aligns all HCPs with proven practices, minimizing errors and enhancing outcomes across the board.
Standards are especially critical given the range of providers involved. A primary care NP managing post-menopausal osteoporosis needs the same reliable framework as an endocrinologist addressing complex bone disorders. Beyond patient care, standards address enterprise-level concerns. Without them, healthcare organizations face medical and legal risks due to inconsistent practices. They also struggle to recruit and retain qualified staff for OBH service lines, discouraging investment in this critical area. Standardized training and certification could change that, making OBH a priority rather than a liability.
A Path Forward
To create standards of care, we need three things:
Ownership: A dedicated body, like the American Society for Osteoporosis Professionals (ASOP), to champion OBH and drive change.
Robust Education: Rigorous, specialty-specific certification programs that equip all HCPs—MDs, PAs, NPs, and beyond—with comprehensive knowledge, not just certificates for attendance.
Unified Guidelines: Evidence-based standards that harmonize existing recommendations into a single, actionable framework accessible to every specialty.
Imagine a future where HCPs nationwide, from women’s health to nephrology, deliver consistent, proactive care focused on reducing all fracture risks—not just preventing the next one. Where patients enter a streamlined system, whether through screening, post-fracture care, or pre-operative optimization, and leave with optimized bone health. This is the vision ASOP’s Bone Health and Osteoporosis Platform (BHOP) aims to realize.
The Time to Act Is Now
Osteoporosis isn’t just a medical issue—it’s a public health crisis costing billions and affecting millions. With 60% of care delivered by PAs and NPs and a wide range of specialties involved, the need for standards has never been clearer. We can’t afford to let fragmented care and inadequate training hold us back. By establishing standards of care, we can elevate OBH management, reduce fractures, improve lives, and lower costs.
Let’s start a conversation: How can we rally providers, organizations, and policymakers to make OBH standards a reality? Share your thoughts below—We’d love to hear your ideas.