I am currently in Las Vegas, NV attending the AAGL 41st Global Congress on Minimally Invasive Gynecology and would have loved using yesterday’s prompt to do a News-Style post to talk about the exciting ways pain and physical therapy are being explained, but…time is short at these things and I had to take a pass. Equally apropos, however, given that I am in the immediate company of 1600+ gynecological surgeons from around the world, is today’s prompt to “Redesign a doctor’s office or hospital room.”
I have lots of ideas, but here is one of my favorites:
A fully-scaled physical therapy clinic attached to the office of a urogynecology practice. A urogynecologist is an obstetrician/gynecologist specializing in the care of women with pelvic floor disorders (PFDs), including loss of bowel or bladder control, pelvic organ prolapse, and pelvic or bladder pain. Physical therapists trained in management of PFDs (non-surgical, non-pharmacological) work regularly and increasingly with urogynecologists to provide comprehensive care for these sensitive women’s health issues. Some physical therapists are already practicing in urogynecology offices, a situation that allows for increased collaboration among care providers and may simplify access to care for the patient. I have been in such an arrangement in the past and while both of those benefits were wonderfully present, I performed all my care in the confines of one examination room. As a result, I felt limited.
My redesign calls for a “full” PT clinic space – with open gym area, a treadmill and other exercise equipment, access to modalities (ice, for example), and several private treatment rooms. I want to practice pelvic floor PT with the privacy needed to address sensitive issues, but able to utilize a full complement of equipment, space and skills to yield the best outcomes.
The pelvic floor itself – a collection of connective tissue, muscles and nerves – does not exist or function in isolation from the rest of the body. Comprehensive rehabilitation for pelvic floor disorders requires an understanding of the pelvic floor’s vital relationships with other structures, functions and systems. A facility in which care can be carried out as an expression of this understanding is extremely valuable. Certainly, many amazing and creative PTs have achieved great outcomes in less-than-conventional settings: they will keep doing so and I will encourage them the whole way!! But my initial “redesign” calls for “normal” PT facility to be structurally integrated with the “normal” urogynecology office. Such a collaboration could have adjacent entrances or share an entrance and waiting area (potential overhead cost savings?), manage the patient care in separate spaces, but be united on the back end in shared common space, a meeting room and staff offices. This would allow for all of the benefits first mentioned, but also preserve the ability of the PT to practice with the greatest latitude and for patients coming for only medical visits or only PT visits to be cared for in clearly separate spaces (a logistical benefit!). I could keep dreaming and redesigning, largely through addition of other important services crucial to female pelvic health: Ob/gyn, midwifery, colorectal, mental health, massage, yoga, and personal fitness services would all contribute greatly to a redesigned female pelvic health practice!
Let me know if anyone wants to try it out!
Thanks to We Go Health for putting down the challenge of 30 in 30 for National Health Blog Post month!