Charla Fischer, MD: Orthopedic Patients Going Forward

With an aging population, who already experiences back pain at a high rate, orthopedic surgeons and specialists across the nation are having to manage an influx of patients with advances in medical technology.

In an interview with MD Magazine®, Charla Fischer, MD, associate professor of orthopedic surgery at NYU Langone Spine Center, discussed dealing with an aging population, how demand's of patients have changed, and where she gets most of her patients.

MD Mag: As the population ages, does back pain become a greater concern?

Fischer: As our population ages, it's just a sign that people are staying more active for more years of their life which is great, it's fantastic, it's a good problem to have but it just brings in a challenge to my end of talking to patients about staying healthy longer as well as on the surgical side age is no longer really as big of a concern about undergoing surgery as it used to be it's more looking at the patient as a whole and looking at their medical comorbidities. So, talking to an 80 year old about a spine surgery isn't as daunting as it used to be so that's one thing that a lot of patients are concerned about is their age and it's really you’re as young as you feel so I've seen a lot of older patients who are very active, very healthy, and feel great except for they have back pain and those patients would do really well with surgery.

How has your average patient changed in recent years?

Fischer: The average patient that I have seen over the years has changed in terms of expectations and what they're doing. So, that you know the body age is at a certain predetermined sort of schedule and everyone's genetics determines that but most of the time you start to get these wear and tear and arthritic problems. If you start to see these wear and tear and arthritic problems in patients around 50, 60, 70s and maybe a few years ago a 70 year old patient would not be doing very much. Just maybe going for a walk and hanging out with grandkids. Now, I see 70 year old patients who are wanting to play pickleball, tennis, all kinds of activities, which is really exciting for me to see patients staying healthy so long. So, just sort of what they're doing with their lives has changed and so that sets up a higher bar for me as a surgeon and just sort of reminds me that you know people stay active as long as they can so I really enjoy being able get them back to their activities.

Are most of your patients obtained through referrals from primary care physicians or directly?

Fischer: Well I do see a fair amount of patients that have been to their primary care doctor or have seen a physiatrist or a pain management specialist and then through the NYU MyChart portal a lot of patients just make appointments with me directly, which is great because I'm happy to talk to anyone who will listen about back health and so those patients that are a little more app or technology savvy or used to just sort of making appointments that way are younger usually, healthier usually, it's their first time seeing someone about their back pain. I see a lot of patients who are in that just after college timeframe and they're making the transition from college life to worker bee life the daily commute carrying a bag sitting at a desk so a lot of that can tweak your back and so I talked to them about good work ergonomics and things like that and I really respect the fact that they are taking the time to invest in their back health now to try and prevent problems in the future.