Study Design: A single-center prospective nonrandomized controlled trial with blinded (allocation-concealed) ascertainment of outcomes comparing the proposed physician-intervention to usual care controls. We define usual care as notification of the patients' physician of chest radiograph results. Allocation will be on the basis of an alternate-week time series design, with the proposed intervention "on" for all patients for one week, followed by the intervention being "off" (i.e., usual care) the next week. After 3 months, controls will be offered the physician-intervention plus patient-activation, with outcomes recollected 3 months later. Eligible patients will be >60 years of age who present to the Emergency Department: (1) with a chest radiograph reporting the presence of a vertebral fracture, (2) are not taking prescription osteoporosis treatment, and (3) are discharged home. The primary outcome is the proportion of patients starting prescription osteoporosis treatment within 3 months of fracture recognition; secondary outcomes include BMD testing and diagnosis of osteoporosis. The intervention is expected to increase the primary outcome by at least 20% (absolute) over usual care rates of 10%. With alpha=0.05, beta=0.80, 20% losses-to-followup, and additional power to address secondary outcomes and effects of patient-activation, the required sample size is 240 patients.