Episode Focus

This season-opening episode examines whether bone health is approaching a “Big Bang” moment similar to diabetes 15 years ago—and, critically, how to ensure that the scaling of bone health care does not repeat the moral and practical mistakes that accompanied diabetes’ transformation.

The episode is anchored by a conversation with Victor Montori, MD, Professor of Medicine and endocrinologist the Mayo Clinic, author of Why We Revolt, and founder of the Patient Revolution, followed by a panel discussion with bone health clinicians.

Why This Conversation Matters Now

Diabetes care transformed rapidly once previously fragmented forces—screening, therapeutics, reimbursement, and technology—converged. That transformation improved outcomes, but it also introduced new burdens: over-reliance on metrics, protocol-driven care, administrative overload, and erosion of patient and clinician agency.

Bone health today shows many of the same pre-transformation conditions:

• A large, mostly undiagnosed at-risk population
• Fragmented ownership of care
• Reliance on single metrics (e.g., T-scores) to make complex decisions
• Growing technological capability without fully formed care models
• Increasing economic pressure from preventable fractures

This episode explores whether bone health is on the verge of a similar inflection point—and what lessons from diabetes must guide its evolution.

Core Conceptual Comparisons

• HbA1c <> T-score: Both are population-level summary metrics that became over-empowered as individual care decision-makers.
• CGM <> bone health monitoring: Diabetes advanced not by finding a better number, but by capturing lived, dynamic risk. Bone health has not yet had an equivalent “continuous risk” moment.
• Fragmented care ownership: Just as diabetes once belonged to “everyone and no one,” bone health risk today lacks clear longitudinal accountability.
• Undiagnosed disease burden: In both conditions, risk is widespread, silent, and often only recognized after harm occurs.

The Patient Revolution Lens

Dr. Montori’s work frames healthcare reform as a moral project, not merely a technical one. Key principles guiding the episode include:

• Care must fit into patients’ lives, not the reverse
• Metrics should inform conversation, not replace it
• Scale without humility risks industrializing fragility
• Clinician and patient burden are ethical concerns, not side effects

These principles serve as a safeguard as bone health care begins to scale.

Panelists:

Bryan Huber, MD, Orthopedic Surgeon

Dudley Phipps, PA-C, CEO/Executive Director, American Society of Osteoporosis Providers

Peter T. Bianco, MBA, Moderator, The Bone Health Basement Tapes

Season 3 Trailer: Bone Health’s Big Bang?

Bone health has never lacked importance. Fragility fractures are predictable, costly, and life-altering—and clinicians have long known how much better outcomes could be with earlier intervention.

So why does prevention still feel so hard to sustain?

In Season 3 of Bone Health Basement Tapes, we explore a possibility—one we’re not yet sure we believe.

What if bone health is approaching its own Big Bang?

Not a sudden breakthrough. Not a guaranteed transformation. But a moment where long-standing forces—clinical capability, workforce expertise, practice leadership, technology, and system design—may finally be starting to align.

Across the season, we dig into the realities providers and practice leaders live with every day.

We explore why fragility risk is often visible long before a fracture—but acting on that risk can still be inconsistent and difficult. Why bone health programs can succeed locally yet struggle to survive or scale. Why effective therapies and digital tools exist, yet operational, staffing, and financial friction remain. And why prevention so often depends on individual effort rather than durable systems.

We also examine the evolving role of technology in bone health—advanced imaging, analytics, workflow tools, and digital platforms that increasingly make risk visible and care more measurable. Not as silver bullets, but as catalysts that raise an important question: If we can see more, measure more, and know more—why is it still so hard to act consistently?

Along the way, we look at how bone health fits into the broader healthcare ecosystem—how it intersects with surgery, post-acute care, employers, and families—and why the value of prevention is widely felt, but unevenly captured.

We draw careful comparisons to other disease areas, like diabetes, where meaningful change only happened once technology, accountability, workforce development, and investment caught up with clinical knowledge. Not as a promise—but as a lens for asking better questions.

Season 3 also turns its attention to the people doing the work: the growing importance of specialized training, clearer roles, and deeper expertise—and why workforce development may be one of the most underappreciated foundations of sustainable bone health care.

This is not a technology showcase. And it’s not an investor pitch.

It’s a grounded, practice-first conversation about how bone health actually works today—and what would need to change for prevention and optimization to become easier to deliver, not harder.

We’re not declaring a transformation. We’re exploring whether the conditions for one might finally be emerging.

Welcome to Season 3 of Bone Health Basement Tapes: Bone Health’s Big Bang?

This episode goes inside ASOP’s Provider Certification pilot—the first step toward a scalable, provider-focused training and credentialing path for bone health.

We unpack why the curriculum was built, how the pilot was structured, and what the early results suggest about standardizing care pathways to meet rising demand.

You’ll hear what worked, what needs refinement, and how certification can translate into practice-ready workflows that improve identification, treatment initiation, and follow-up—without adding friction to busy clinics.

Our guest, Alexandra Rocco, PA-C (Utah Orthopaedics), brings a frontline view from the pilot: how the coursework shaped team roles, documentation, imaging, and treatment protocols; what barriers remain; and where certification can accelerate access before a first fracture. If you’re a clinician, practice leader, or payer, this conversation outlines how certifying providers can turn overlooked fracture risk into proactive, reimbursable care at scale.