A crisis in osteoporosis treatment exists; the majority of those who sustain fracture do not receive treatment to reduce future fracture risk. This crisis presents an opportunity to focus the field from osteoporosis to fracture, the outcome of consequence. Proposed here is a change in focus suggesting that 1) attempts to define the level of trauma leading to fracture are counterproductive and that all fractures in older adults merit consideration of evaluation and 2) bone loss is not the entire problem but rather part of a broader syndrome including osteoporosis, sarcopenia, and other factors leading to fracture. With this approach, all fractures in older adults should be evaluated for potential lifestyle, non-pharmacological, and pharmacological interventions that could be implemented to reduce the risk of fracture recurrence. © 2017 American Society for Bone and Mineral Research.