Building stronger bones in southeast Edmonton
For people who have tried multiple medications for osteoporosis, experienced repeated fractures or simply can’t shake their fears about treatment, the osteoporosis clinic at the Covenant Community Health Centre is a lifeline to support and resources. With education at its core, the clinic helps people understand what's happening inside their bones and what they can do to address it.
When standard treatment isn't enough
The clinic exists for patients whose bone health challenges go beyond what a family doctor can manage alone.
"Our patients are typically individuals who maybe have been on several osteoporosis treatments and get side effects, or have been on osteoporosis treatments and continue to fracture or have already had 25 fragility fractures and need to know where to go from here," says Shelly Hagen, a registered dietitian and Menopause Society Certified Practitioner (MSCP) who has worked with the clinic since it launched in 1999.
Among this group of patients who are very fragile and compromised, there are roughly 10 percent of referrals whom Shelly calls "the worried well."
"There's lots of horror stories out there that osteoporosis medications have so many side effects and cause all these problems, and they’re sort of aware that they could benefit, but they’re so fearful," Shelly says. "Family doctors will often refer them on for a specialist lens to reassure them and help them move forward."
A three-and-a-half-hour class that wins people over
Education is the foundation of the clinic, says Shelly. Once patients are referred by their family doctor, they are encouraged to attend an education session before their appointment with one of the clinic’s physicians. Shelly teaches the class, covering everything from the basics of osteoporosis to medication options and nutrition. A physical therapist joins her during the session to discuss exercise and safe movement.
Delivered over Zoom, the session runs for three and a half hours — from 1 to 4:30 p.m. — a length that makes some patients hesitate, says Shelly.
"They're looking for a million reasons not to come. They're just horrified. They say, 'Oh, it's going to be too much.’ But at the end of it, you wouldn't believe how many of them say, 'I'm so glad I did this. I learned so much. I thought I wouldn't learn anything.' They're just ready to jump through the phone and embrace you."
Phone calls instead of waiting rooms
Unlike most clinics that returned to in-person visits after the COVID-19 pandemic, the osteoporosis clinic stayed virtual. If a patient really wants to be seen in person, they can, but otherwise the clinic is 100 per cent virtual, says Shelly.
The physicians do their assessments by phone, then flag patients who might benefit from a follow-up call with Shelly to talk through lifestyle changes or get answers to lingering questions. The approach works, although the connection feels different, Shelly says.
"You still get wonderful feedback over the phone like, 'I appreciate that you spent this time with me and you called me back,' but it's not the same as face-to-face contact."
Wait times cut nearly in half
The clinic operates with a small but dedicated team. For years, Dr. Brian Wirzba was the only physician, seeing patients on Tuesday mornings two to three times a month. About two or three years ago, Dr. Chai Gandhi, an endocrinologist, joined the team.
The impact on wait times of adding a second physician has been significant, says Shelly. While patients used to have to wait 18 to 24 months for an appointment with the clinic, they are now waiting about six to eight months.
“The physicians have been really plowing through and working hard to try to address this,” says Shelly.
Regardless of the wait times, urgent cases are prioritized. If a referral is triaged as a high priority, the clinic aims to book an appointment for the patient within three months.
Part of an integrated healthcare centre
The osteoporosis clinic is one of several outpatient services at the Covenant Community Health Centre that previously operated out of the nearby Grey Nuns Community Hospital. Having these clinics under one roof alongside a pharmacy, laboratory and other healthcare services makes it easier for patients to get the care they need. For people dealing with bone health challenges, the clinic offers specialist expertise, practical education and ongoing support in a community setting.
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