Diane Altkorn

Screening for osteoporosis.

of the Clinical Problem Theprevalenceofosteoporosis inpersonsolder than50years in the United States is estimated to be 16% of women (about 8.6 million individuals) and 4% of men (about 1.6 million individuals).1 In the United States, more than 1.5 million fractures per year are related toosteoporosis, includinganestimated300 000hipand700 000 vertebral fractures.2 Many patients who develop fractures experience a decrease in functional status, with up to one-third of patients enteringnursing facilitieswithin 1 year after ahip fracture; the mortality rate after hip fracture may exceed 20% in the first year.3 Low bone density is the primary risk factor for osteoporotic fractures, and treatmentof patientswith lowbonedensity canprevent fractures.3

Handbook of Clinical Skills: A Practical Manual

There is growing acknowledgement of the importance of interpersonal and communication skills in the training of future physicians. Effective diagnostic and clinical management skills require competency in observing, listening, communicating, problem-solving and negotiating. In addition, the physician needs human relationship skills. It is apparent that a systematic curriculum is needed to teach these clinical skills to medical students and trainees and this handbook provides a practical guide.