Optimizing Your Front Desk for Pelvic Rehab

Although awareness of pelvic rehabilitation is growing, patients who are referred for pelvic rehabilitation usually have more questions than the average patient about attending therapy. This can mean that you as a provider are burdened with a lot of phone calls or emails that go something like this: can I come to the clinic if I’m on my period? what are you going to do? are you familiar with my condition? how long will it take to get better? Consider how often these questions occur with patients who have knee pain, or headaches, and you may find that pelvic rehab is perceived by patients as quite unique from other types of rehab. How can you avoid trying to find time in your busy clinical schedule to tackle these additional communications? You can start by educating your front desk to handle patient care questions related to pelvic rehab, such as the following frequently asked questions:

• Do I need a referral from a doctor?
• What will we do on my first visit?
• What is biofeedback?
• What is ____________ (proctalgia fugax, interstitial cystitis), etc?
• I have my period, should I reschedule?
• Do you do internal work?
• Will my insurance cover this?

It is likely that the patient will ask to speak directly with the therapist, so you can first encourage your support personnel to politely inquire if there is something he or she could help in answering. Create a list of conditions along with a brief description of its definition, and a few examples of skills that a pelvic rehab provider has to offer. Your support staff can also offer to mail a brochure or flyer that you create which answers some of the frequently asked questions. Providing an “FAQ” section on your website that can be referred to may also decrease some of the stress of trying to play phone tag. Make no mistake that if you DO have the time to follow-up with a patient who has a question, you may create a connection that is really important for that patient in regards to scheduling an appointment. On the other hand, if you don’t have time set aside in your day for such calls or emails, you risk having the patient not get her questions answered. A form (on your site or as a written resource) might have some of the commonly asked questions written out, and you could use the ones below as an example to get you started.

Do I need a referral from a doctor?

Most patients can attend a physical therapy visit without having a prescription or written referral from a doctor or other referring provider. Insurance companies, however, may insist that you have a referral in order for you or your therapist to receive payment. Even if you do not need a referral from a medical provider, your therapist may require that you have seen a medical provider for your condition. Many conditions involving the pelvis can be medical in nature and require checking for more serious conditions before coming to the clinic. It is also helpful to have a medical provider with whom your therapist can coordinate care and discuss your health as a team.

What will we do on my first visit?

First, we will talk about what concerns or symptoms you have. Your therapist will also look over any forms you filled out to learn more about your history. The exam will be discussed with you so that you can have any questions answered. Your therapy exam may include general movement like bending forward and backward, seeing how you move your body, and specific tests of your joints, muscles, and nerves. For pelvic rehabilitation, an assessment of your pelvic muscles internally (through the rectum or vaginal canal) may be valuable.

Will we use biofeedback? (What is biofeedback?)

Your therapist may use surface EMG (electromyography), a form of biofeedback. This may involve placing some sticky sensors on your body so you and your therapist can get a better idea of how you are coordinating muscle activity in the abdomen or pelvis. Biofeedback means that you will be able to get information about how your muscles are working, and in therapy this is often displayed as graphs or bars on a screen. An internal sensor for the vaginal or rectal canal may also be used.

(For those menstruating) Should I reschedule if I have my period?

It is usually not necessary to reschedule if you are on your cycle, so you are welcome to keep your appointment.