Clinical Benefit of Telehealth

Welcome to Pelby biz podcast. I'm Dr. Kelly Alhui. I have grown and established brick and mortar practice in Northern Virginia called Ortho Pelvic Physical Therapy and also founded Pelvibiz, which is an online business consulting company that helps healthcare providers make more money and be healthy while doing it, especially in the pelvic health realm. Let's get into today's episode. Today we're going to talk about what I have found with doing telehealth. And I know the word telehealth, teletherapy makes people very anxious, makes people nervous. But I promise you, you will surprise yourself with telehealth or teletherapy if you're able to do it well and you have the correct tools. And I'm going to tell you guys a little story about certain cases I've seen with telehealth. It's just really interesting that I found actually telehealth to be more beneficial. So the first case is where I got online and I was on a zoom call or whatever, and this lady was really wanting to. She had back pain only when she picked up her dog. Well, at the office I can kind of mimic that, but I can't really unless she has her dog, you know, with her. Well, at home she had her dog with her. And so I'm like, great, this is perfect. So show me all the different ways that you have to pick up your dog. Now this dog has a diaper on it and it has, it really is like a smaller dog. And so, like, for me to be able to see her set up, how she feeds him, how she carries him, how she lifts him, all those things was the reason why in one session I was literally able to not have her leak with picking up her dog compared to if she was in clinic, I was guessing, and we didn't really know if it was going to work or not. Does that make sense? So that's just one example. Another example is, let's just say I'm treating male patients for ed. Okay? So I'm treating male patients with ed, and in clinic, I tend to find that a lot of times they're very shy, very reserved. Sometimes they don't like to be touched because they're fearful of touch because they may have an erection. Then sometimes maybe there's a trauma or abuse. And so you really have to be mindful of that. And so when you have a computer screen between you and the patient, sometimes it's easier for them to open up and talk. From my experience, that's what I've seen. That being said, it also challenges you as the therapist to try to come up with questions and do kind of like motivational interviewing, coaching, more so than just using your hands. And the beauty of that is you may actually find your answer in that, more so than just doing the normal routine of manual lengthening, lifting, that kind of thing. So by asking deeper questions, because the computer screen is kind of forcing you to ask those questions and dive deeper, you may really actually find the answer that you're looking for to help solve this patient's problem. So, like when I'm working with male patients with ed, what I find a lot of times is mentally it's a big factor. Whether or not they're super stressed out or whether or not they are, they're super stressed, so they can't have any enjoyment. Just like for females as well, you know, or maybe they don't have some kind of fantasy that they're thinking of so they can't have an erection because they don't have that fantasy yet in place. Males are very, or can be, not always, but can be, can be a very mental game to have an erection. Now, yes, it could be a blood, blood flow issue as well, but a lot of times, mentally, there's something there that's blocking them. Okay. And so to get to that, you have to be able a, to ask, you know, you have to be able to make uncomfortable questions comfortable and you have to be able to dive deeper and understand it's okay to ask those, to ask different questions of like. Well, tell me, so why do you believe you can't have an erection? Well, I don't know. My prostate's enlarged, I have a blood flow issue potentially. I'm trying to connect with my wife and then I get nervous, then I get stressed out. Oh, yeah, wait. And my work is so stressful. Okay, so then you just say timeout. Let me break this down a little bit. So tell me more about your work. Okay, so you work from 6:00am to 6:00 clock at night? Yes. Do you have any breaks? No. Okay, so right there we are not getting any blood flow to the pelvic floor. Okay, so is there any way, because you're in charge of some meetings, is there any way that we can cut meetings short by like five, ten minutes? Yeah, I think so. Okay, great. Let's add in a small walk around your house then. Great. I integrate already into their environment. They love that because I'm not adding anything extra because these people don't have time for anything. Extra great. Can your wife, throughout the day do, you know, kind of inappropriate grabs? If this person's working from home. Okay. Not at the office, can they do inappropriate grabs to be able to kind of get your brain prepped on, hey, this may happen tonight. This is great. Is there ways that we can get more blood flow throughout the day? If you're on zoom calls all day long, can you get the hypervolt and put that on your inner thigh and try to do that while you're on a meeting, not talking to the people and just listening. That's one thing. Is there something that you can do at night to help decompress at night? Oh, there's a TV show like the Kardashians you love. Okay, great. Let's go ahead and watch the Kardashians and let's decompress. That's probably going to take you about 30 minutes to come down from your stressful day and be able to fall asleep. So cool. I'm glad we found that. Like, so do you guys see how I'm working through this? And this is all part of. This is all part of ed. Like, this is it. And if you're not asking those questions, school's not going to teach you this stuff. Okay. But if you're not asking the right questions and digging, you're not going to solve the person's problem just by using their hands. Just, I can lengthen the crap out of their tissue. But if mentally, I can't get my ED patients to chill out mentally, it's not happening. It's literally not happening. I can recommend a penis pump with them as well. Right. Or a ring that. It's like a cock ring that holds the blood flow into the penis. I recommend all that stuff. But a lot of times the issue is. And it's not their fault, it's mentally. If I can get to them mentally here, then I know I can help solve their problem. On top of it doesn't hurt to have an increase in blood flow in all the manuals. Sure. But I can also teach them that over the, you know, the screen here. Okay. That they can do on themselves. So it's just really interesting that there is, I would say, a big need for this. And I do believe that a lot of times you can help people more than we all think. Even though it's scary, scary, it's new. So people are scared of it. But I actually believe it gives you a different angle or different perspective when you can't use your hands because you got to think outside the Box more. And I think in medicine, that's what a lot of us need, is more outside the box thinking. I'll give you another example. I have another patient, male patient, and they're having trouble sitting because they have pelvic pain, right? And Ed and we did telehealth, and we looked all around his house with different chairs, couches, chairs, wherever he's sitting on, and all the chairs that he was sitting in. It just basically pointed out why he had back pain. And there was one chair that I was like, hey, I really want you to focus on this chair, and let's sit in it. And that helped alleviate all of his back pain, and that actually helped lengthen his pelvic floor muscles because they weren't in such a retracted position the entire day for eight hours. And so just that alone, by me being able to see his setup, he felt confident. Okay? I gave him confidence through that session that he was good to sit in that chair and that wouldn't cause him back pain. And overall, because it was doing that for eight hours, we just changed that up, and there goes the back pain. So just be mindful of that. They don't have to give them 20 exercises that you could literally just look at their environment. I promise you, their environment tells you everything. It's why they have a problem to begin with. Whether or not that's physically, whether or not that's mentally their environment, whether or not that's, you know, their setup, whether or not that's their routine. Like, you just gotta ask. Show me. That's what I say. Don't tell me. Show me. Show me what you do every single day. I need you to walk me through it. I need you to bring this camera, this computer with you. And it really does tell me a lot. So I know it's, like, scary at first. You're like, oh, my God. Well, I gave them all my stretches, and I don't know what other stretches to do. Well, ask questions. That's why you got to dig deeper. So I really believe we can get better at just even in person by doing teletherapy, because we'll be able to ask the right questions more so and be able to get more answers or even get the patient to recognize potentially what their problem is more so, because we are asking the right questions. So I think that's huge when it comes to teletherapy and telehealth. So, yeah, I mean, I would say, like, those are just brief stories of what I found with teletherapy that I think are really fascinating of why it's a positive. The negative is if someone really did need lengthening, maybe they're confused on how to do it, then potentially it could be harder for them to do that on themselves. What's another negative? The other negative could be they have to put in more of the work. If that is a negative. I don't know if that's a negative or a positive, but that could be a negative. Other than that, I really see lots of positives to it and I think it's going to be done more and more. We see the stats on it already coming out. I think we put something on Instagram that was like by 2025, I think another like 20% of people will be doing telehealth teletherapy. So I think there's just gonna be more of it and I think there's gonna be combos. I think there's gonna be group therapy, I think there's gonna be group wellness. I think there's gonna be lots of different things coming down the pipe. So the faster you can get comfortable doing this, the more that you're gonna be ahead. So can't wait for you guys to join us. We have a telehealth. What do you call it? A telehealth. What is it called? What is it? We're doing a presentation. Telehealth presentation. Let me get the date for you guys. It's going to be August 15th. We're doing a webinar on August 15th at 7:00pm August 15th, 7:00pm, we will do a webinar on teletherapy for pelvic health providers. So please make sure you tune in for that. It is free. You're not going to want to miss it, I promise. You guys haven't seen the stuff that I will be presenting on. It's going to be epic. So if you guys want, go ahead and click the link below and sign up for the telehealth webinar. So hopefully we'll see you guys there. Bye, guys. Thank you guys so much for listening to the podcast. This podcast is sponsored by Jane. They are the people that are going to have amazing scheduling system for your patients. They're going to provide you with a super bill. They're going to make templates for you. They're going to provide you with the best customer service. And because of that, they allowed us to have a code for one free month for those that are wanting to try Jane for their scheduling, checking out super bills, telehealth all the different options. That code is Pelvi Biz1mo we'll put in the show notes, but PelviBiz1mo that is the code for Jane. And thank you so much Jane for sponsoring this podcast. If you guys want more information and want to learn how that you can keep bettering yourselves, go ahead, click the link down below and make sure that you book a call. And we love to provide any clarity questions on any follow ups. Bye guys.