In this presentation, Kelly Alhooie outlines a teletherapy‑focused approach for assessing and treating pelvic floor dysfunction without any internal examinations. She begins by describing a four‑step client interaction framework: (1) uncover the client’s true why, (2) clearly identify the problem using a scorecard or questionnaire, (3) provide hope by mapping a pathway from current state to desired outcome, and (4) deliver a quick‑win tip that yields an immediate result (e.g., a foam mat for hip pain). She then demonstrates three remote assessment techniques for a hypertonic pelvic floor: external fingertip observation while side‑lying, a bathtub‑mirror “pelvic clock” exercise to watch the floor during sneezing, coughing or laughing, and coaching the client to use a makeup mirror to view labial movement during those actions. Alhooie stresses that coaching—not hands—is the core of effective teletherapy and that true musculoskeletal change requires about three months of treatment, not a few brief visits. She positions the therapist as the “hero” who guides the client to the finish line. Finally, she makes a business case for teletherapy, explaining how it eliminates cancellations, expands lead generation to a statewide market of 40 million potential patients, and improves cash flow by reducing payroll‑draining no‑shows. The talk blends clinical tactics, client‑engagement strategy, and practice‑growth arguments to show that pelvic floor issues can be accurately assessed and successfully treated without any hands‑on exam.
Chapters
So here's the general format. Number 1, again, you gotta get to the true why. It's very important for that. Number 2, you must point out that they have a problem. You can do this through a scorecard that I have over here for like an app screen, or you can specifically ask them questions with like a questionnaire, but it's gotta point out that they have a problem and that you have the solution. Number 3, you must provide hope. You gotta show them a pathway on where they're at and where they're going to go, and that you actually have the unique solution for them, because that is going to give them hope that they know that you know your stuff and that they're gonna get the benefit. Next, you're gonna provide one tip that's going to get them that quick result. So I always do like a quick win. So let me give you an example. Someone that has hip pain, If they're coming to me because they're like, Kelly, I'm— I sit and I have this hip pain right here in my hip crease. Okay, great, Sally, we're gonna put this, um, we're gonna put this foam mat in your car and you're gonna sit on that. Yes, we have to lower your car seat down, but you're gonna sit on that and you're gonna drive. And they're like, oh my God, I don't have any hip pain today. It's like, yes, that's the quick win we're looking for. So that way you can show them immediately that you have the solution. So here's what I want to kind of wrap things up with. So ways to diagnose a hypertonic pelvic floor without your hands. I asked you guys this question at the beginning of the presentation. So how are we going to do it? Here's, here's number 1. Number 1, you're gonna be lying on your side. You're gonna take your finger and you're gonna place it— I said on your butthole. Yes, I said butthole. Butthole or your anus, okay? You can place your finger externally, not internally, and you're going to place it there and you're going to breathe. And as I breathe, I'm going to see, does the pelvic floor move? And the client is going to tell me if their finger is moving dynamically or not. That's a way for me to truly understand what is their pelvic floor doing without me physically being in front of them. Number 2, I go tell them to say, hey, bring me to your bathtub. And I put them in the bathtub like this, and we're— here's a lovely pelvic clock too, okay? Put them in bathtub like this, put a mirror out in front of them as you can see here, and I'm like, hey, I want you to take a look down there. What's happening when you sneeze, cough, laugh? Is anything kind of popping down there? Okay, and they can do that. They don't have to do this, by the way, while I'm on the call, just so you know. Okay, they're not showing me their parts on the call, just, just so we're clear. Um, the next thing I like to do is I'll coach them on how to sneeze, cough, and laugh, and I will take a makeup mirror. Where's my makeup mirror? I'll take a makeup mirror and I will put it below them, and they will sneeze, cough, and laugh, and they will look. They just spread their labias and they will look to see what's going on down there. That's how you can see what's, what's happening. So let's do a recap. Here's a big recap. Number 1: stop presenting teletherapy as an afterthought. Hopefully I'm very clear on that. Do not present it as an afterthought. You gotta present it beforehand. You gotta learn how to coach people and not just use your hands. Coaching is key. You gotta get people to the end result no matter what so that you are the actual hero. What I mean by that, guys, is If you let a patient go after 3 visits— I know we all think we're magical, and I'm sure most you guys on this call are so magical, but 3 visits is not truly going to get a musculoskeletal change. It just isn't. We know that from the research. Takes 3 months to truly get a musculoskeletal change. So if we don't know how to coach someone and we start to feel uncomfortable, we're like, up, I gotta let you go. I'm not gonna book out because I, I don't know what to do with you now. I, I don't know. And so I guess you're, you're hopeless, and you let them go, and now they go to other— all these other providers don't get their problem solved and think that they're, they're unfixable. We don't want that. We want to be the heroes. We want to give them the result because we know we have the solution for them. So get them to the finish line. That's key, and it's our job to do that. Now we want to really integrate teletherapy because it solves 3 significant problems. This is major, 3 significant problems. Number 1, and this is what the pelvi— the, the teletherapy method that I've come up with really helps solve. Number 1, it helps solve the cancellation. If you preference it ahead of time, it will help literally make the cancellations go bye-bye or very minimal. Because you just switch it over to teletherapy. No problem. Number 2, it really helps with leads. So if you guys are like, look, I've hit everyone in my area, I don't know where else to go. Guess what? You can hit the whole frickin state. You can hit the whole state. You will. I promise you, you won't run out of leads. There's 40 million people that need our help. 40 million. There's less than 10K of us. That's a massive market. So we must be, we must be doing this. And number 3, cash flow. If you guys are struggling with cash flow and you need more cash flow coming to your clinic, because you guys saw, you guys saw when I broke it down, it was gonna cost me, if I had 2 providers on, it was gonna cost me $10K a month because of cancellations. $10K a month, that's payroll right there.
