Telehealth: How It Helps You and Your Patients

Hi, welcome to the Pelby Biz Podcast. Are you a pelvic health PT or ot struggling to start your own practice? This podcast helps pelvic health PTs and OTs get out of debt, gain the.

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Welcome guys to Pelli Biz Podcast. I'm your host, Kelli Elhue. Today we're going to talk about how to crush virtual physical therapy sessions, AKA telehealth sessions. I think the biggest thing is, number one, prep the patient ahead of time. I think this is so huge and many of us miss this and it's a very easy, easy thing to do. So let's just say we have a patient for an initial evaluation that comes in to our clinic. They come into our clinic, okay? When I'm telling them about the plan of care at orthopelvic, we do 12 sessions, okay? We believe in 12 sessions based on how long it takes someone to actually strengthen a muscle, which it takes three months, okay? So that's why we do 12 sessions. That being said, when we state that this is the plan of care and this is what we believe how this is going to work, we prep the patient and say, just so you know, at least two of these sessions will be telehealth. Oh, what's telehealth? Telehealth is where we use video physical therapy to then be able to use your environment. That's selling point number one. Okay. We use your environment to be able to get you the outcomes that you desire. Selling point number two is that it saves you time. You don't have to come into the office. So you know we're going to use this. If you don't have time to come into the office or if you get Covid or if your child's sick or whatever may come down. It's called life. When Life happens. We really love to do telehealth. And we're actually going to make two of these sessions out of the 12. So something that you're going to do at home because we want to see in your own environment how you're going to actually succeed and get to your goal. So that's really, really important because in our PT space, in our PT clinic, the environment is set up kind of in a fake reality of what truly is the reality. Are they a mom that has three kids that are running around all the time and they're trying to get them, you know, get dinner, bathe them, make sure they're not coloring on the wall, like, whatever it may be, like that's the reality. Okay, great. If that's the reality, then let's go ahead and make things around that reality. I personally believe that. Well, I didn't believe this at first. When I first did the pt, I did all the PT things that they taught us in school. We'll do sideline hip abduction and lift your leg up and down and do all lower level core exercises pretty much. And that's your rehab today. I completely think differently because I realized that people really don't change. They want to do the same thing. And it's very hard to create changing, lasting habits for them. So why am I going to fight that? Instead, if I really analyze what their actual routine is already and what their environment is set up to be already, and then I incorporate different things that are just a little add on. So for instance, let me give you an example. If they are, you know, having to walk down the hallway to put their kid to bed. Okay. When you're walking down the hallway, can you try to pull in your belly three times and relax your belly? Like, that's the exercise, no joke. When you're walking down the hallway, can you actually sidestep down the hallway instead of forward walking? Okay, so then that's the exercise. So this is how you get people to do a task that you want them to do, but it's not overwhelming for them because you're not now trying to create a whole new habit. If I were to tell this person, hey, just so you know, it's going to be an extra 30 minutes of all these exercises a night and good luck. I'm just going to keep adding these things on every single time you come in. That's just going to overwhelm the crap out of them. And then they're confused about what exercises do I do? Do I do these? Do I not do like, oh, I forgot what that one was again. She needs to remind me. Like, it really is so, so confusing. So anyways, that being said, you've got to prep the patient ahead of time. That there is reasons why we really, really, really want to use their home environment. Okay? And even some of you may be thinking, well, Kelly, like, what about pain with intercourse? Like, why does that environment matter? Well, it matters a lot because wherever they're having intercourse at, like, whether or not it's on their bed or their bedroom or whatever else, you want them to feel comfortable in that space. So being able to coach them in that space, I think is super, super valuable. Okay? And maybe they have, like, this cool pillow that we want to incorporate, or maybe they have the angle of the bed is a certain way and we want to incorporate that or the height of the bed, like we need to look at. Or, you know, maybe there's a wall that they're using or whatever it may be that we can incorporate in based on positions. Be able to position them better based on their own environment. That's huge. Okay. Even someone like chronic pelvic pain, if they're always have chronic pelvic pain, a lot of times, I know a lot of you guys are thinking, kelly, well, I really need to put my hands on them. Well, that's my second point is head over hands. Head over hands, okay? Use your brain more than your hands. In PT school, OT school, we're taught, look, use your hands. Hands solve the problem. No, they don't. It's your brain that solves the problem. So someone with chronic pelvic pain, and we're trying to help them out. A lot of times if they're in clinic, we're doing tons of visceral stuff. We're doing tons of manual manipulation, okay? For chronic pelvic pain patients. So you're probably thinking, well, there's a virtual session. Then what good am I doing to that patient if I can't put my hands on them? The reality of that is you can see their whole house set up. You know, if they allow you. Right. You can see where they mainly hang out and where they're doubled over. And what things do they have? Do they have a microwave next to them to where they could use a heating pad and get to that? Maybe they can't. Do they have a wedge that's on their bed that they can lie on their back and lift their hips to alleviate some of that pelvic pain? Maybe, maybe not. If not, then can we show them how to use their own pillows? On their bed to then create their own wedge, to then give them some relief there. Okay? These are just little examples. There's so many examples that I have that how you can really crush a telehealth and the fact of you can really talk people through the solution that they are looking for and especially use their own environment. But I think the biggest thing is, is getting over the hurdle, number one of setting it up when they first come in and telling them. And look, even if they don't come in for an evaluation, you know, in person, then tell them that over the phone. Most of these then are going to be telehealth sessions because we love to use your environment. Instead of putting you, you know, in a fake environment here, we're going to use your environment so that you can have all the success whether or not you're traveling, whether or not you're sick, whether or not your kids are sick, whatever happens, that we can continue to make progress weekly. And that way this doesn't have to stop. That's how I position it. Okay? Because we all know we have so much knowledge, and you don't need to take 20,000 other courses. We have so much knowledge that we can help them with. And I'm going to get into that in a second, okay? Of everything we can do besides the physical hand touch, which we all have been trained, that that is the biggest asset for us, and that's truly not the biggest asset. Okay? Number three, I think the biggest thing is get down to their deeper. Why? Their deeper why? So if you truly don't understand their problem, it's going to be harder for you to do a virtual session if you just know superficially what their problem is. Like, let's say their abs. Okay, let's just say they want to get their abs back. Okay? Their deeper. Why is that? They are embarrassed that they can't wear a tight shirt. That's their deeper. Why? Not that their abs are separated with Dra, Okay? They want to get back to feeling like themselves, to be able to wear that shirt that they've been wanting to wear, that outfit that they've wanting to wear, like, that's their deeper. Why? So if you know that, and let's go with Dra, like at this example, okay? If you know that they want to get back into their clothes and fit back into their clothes, then what's another solution besides you giving them exercises to work their abdominals that are going to help them get back into their clothes? What is it? Number one, what do we know that's the most important thing about health, Sleep. Sleep helps with hormones. Doesn't hormones make people, you know, lose weight? Yes, it does. So is there a chart that we can coach Sally over here? I always use Sally as my examples, by the way. So is there a chart that we can coach Sally over here to track her sleep? Is there a device that we can give her to track her sleep? Like a watch or like a mattress that tracks her sleep or a ring that you wear on your finger? Like, there's so many different devices right now on the market that track your sleep. Even your iPhone tracks your sleep. Okay, so is there that. Can we show her how to analyze that and maybe even give her tips on Sally? I need you to go to bed by 10 o'. Clock. I need you not to touch her phone after 8. I need you to not drink, you know, water past this time. Like, there's so many different tips. You see where I'm going with this? And then we start coaching her on better sleep, and overall, that's going to help with her weight loss. And no, we're not sleep experts, but we can actually provide basic health coaching that will make the overall outcome so much better. On top of that, can't we provide a little bit of nutrition advice? I think so. Can't we say, hey, drink a glass of water immediately when you wake up in the morning. That's gonna help the metabolism start going, guys, that's gonna make Sally start feeling better. Can't we all recommend that we don't have to be certified nutritionist? We can all recommend that. Okay, why don't you, Sally, just take a walk every morning? Let's get you on a routine of that. But remember, we're not gonna force habits on someone because creating a new habit is going to be very challenging for them. So instead, you know, drinking a glass of water with your vitamins that you already take, because I listened to her and I listened to her whole routine. She's like, yeah, I take my vitamins in the morning. And then I. Okay, when you take your vitamins, then I need you to attach a habit of attaching a drink of water to that. If you can attach a habit that they already have to another habit, it's going to make them way more compliant. So that's what we're doing here. Okay? So that's what I want you to kind of coach on, is what overall habits they have. You got to figure out their routine. You got to figure out their deeper why. So I really have someone go through their entire routine. Okay. I Wake up at this time, I typically then have to go rush and get the kids out of bed. Okay, then when do you eat? What do you drink? When do you get in the car? Do you get in the car like, what is it? And I literally walk them through when we talk it out their whole entire day, especially on initial evaluation and maybe even follow up visits after that. And then that way I can start problem solving through their bigger why not just through the muscular skeletal system, but all the other systems and tasks and everything else that they have to do. So I'm pulling health coaching into physical therapy, into kind of life coaching and, and being a mentor slash accountability partner for them. And that is what's going to actually drive the patient to make a change to then us get the results. Guys. It's not our one hour of manual therapy that we would do in clinic that actually gets the results. It's how committed can the patient become no matter what environment that they're in. And we are teaching them through video physical therapy that we can diversify that instead of it being looking so cookie cutter in the mold of just like this is what strictly PT is. This is old school, guys. It's really old school. And if you are not thinking outside the box and you're just thinking of like what I learned in PT or OT school, you are literally missing the boat. And you've got to treat the person as a whole because many providers are not doing that. And if you can dynamically do that, you win. You literally win. And the patient will, you know, comply with what you're doing. So in virtual session, just so you guys know, how we structure them is it's the same price as a normal session in person, it's the same price. We're providing the same amount of value, if not more, because we're actually saving them time as well. Okay, so we structure it. It's only our in person is 60 minutes, our telehealth is 60 minutes. But this is how I break it down. We do 30 minutes to 45 minutes of us talking and conversing on the video online. Okay? The rest of the time, whether or not it's 30 minutes to 15 minutes is spent truly making a written plan and then giving it to the patient. So often than not, don't we, as I know, at least as USPTs, we tend to be like, okay, so you come in for one session, here's three exercises, okay, come in for another, here's three more exercises. You come in for another, here's 3 more. And then we Just add on the exercises that overwhelms the crap out of the patients. So because that's so overwhelming for them, we don't have time to then sit back and really truly hear them out and make a true plan. So I believe that virtual physical therapy sessions really can create an impactful punch to create a whole game plan fully written out in an email. Step A, you need to do this. Step B, you need to do this. Step C, you need to do this. And it's very clearly laid out. I feel like it's harder to lay that out in clinic and it's a lot easier to do on telehealth because you don't have your hands and you truly have to listen to the patient and you have to understand their needs and then develop a program. So the bonus again about doing a virtual session is that you actually get a very clear plan written out for you on what needs to be done step by step on your daily activity. And we're creating that for them. Everyone needs that. Everyone needs accountability. That's accountability. And everyone needs a clear path on what they need to do for the day. And I went through her whole routine and now she has the exact plan of what she needs to be doing. And that's going to create clarity for her to then be able for her to feel better about herself and to then I'm going to go back to the DRA example to then say, hey, I'm taking steps to be able to improve my self confidence so that I can fit back in my jeans again. And you know, that's literally it. That's literally it. So if you are not offering telehealth slash video physical therapy sessions at your clinic, it is a must. You have to not only does it help with numbers because if they, you know, have Covid, you can still do sessions. But in the reality of this is we can really still help them in so many different aspects. And I want you guys to see that. Okay? So I think it's really, really important to incorporate and most of these softwares now these days have something where it's very easily. They can send them a link you get on, it's HIPAA compliant and you guys can talk on the video and it's, you know, secure and everything's good. So. And they can do it anywhere if they're travelers. If you're traveling like you can do it anywhere. So hopefully guys, this helped decrease your fear about video physical therapy slash telehealth and be able to treat and everyone through a video physical therapy conference and do the thing and get after it and keep helping people progress towards their goals. Bye, guys.

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