In this presentation, Kelly Alhooie argues that the core issue in physical therapy is not the exercises themselves but the failure to integrate treatment into the patient’s everyday environment. She explains that prescribing generic home‑exercise routines without considering the patient’s real‑world context leads to overwhelm, non‑adherence, and wasted appointments. By shifting to teletherapy, clinicians can observe patients in their own spaces, ask more precise questions, and foster active participation. Alhooie highlights that teletherapy works for any diagnosis, especially pelvic‑floor therapy, and that its value exceeds in‑person care because it saves travel time and fits into patients’ lives. She recommends charging the same rate as in‑person visits ($250) despite shorter (45‑minute) on‑camera sessions, followed by 15 minutes of documentation that is sent to the patient. The workflow is streamlined using the HIPAA‑compliant platform Jane, and sessions can be conducted on a laptop or iPhone. Overall, the talk provides a practical roadmap for clinicians to adopt teletherapy, emphasizing environmental integration, communication, pricing parity, and efficient technology use.
Chapters
Number 1, you get to do it in the patient's environment. Hear me out on it, guys. I'm sorry to say this, but if you give someone leg lifts, if you give someone 30 leg lifts, they are not going to do that. So all of a sudden, think about this, someone walks into the clinic or you treat them online and you write out this amazing 20-minute exercise routine for them. This person, by the way, has never exercised in their life. This is probably why they have back pain, okay? And you're like, hey, I need you to do this every single day. That's what most of us say, or every other day. This person is like, I don't even know how to do one of these exercises, let alone— she wants me to do 20 minutes of this? I'm gonna use that excuse that I just put on the screen. I haven't done my exercises, so I'm not gonna come in. It's not worth my time. Now you just overwhelmed the patient, and you didn't teach the patient on how to integrate and how to integrate into effectively into their actual environment. And so now they have to go home. I mean, think about this, guys. I mean, they really have taught us all wrong in school. I'm not kidding. They got to go home, they got to figure out where they're going to lay to do the exercise. Their dog's going to get them, the baby's going to get them. They got to figure out what things that they need to do the exercise with that we had specifically at the clinic. They may not have it. I mean, they gotta figure out when they're gonna do it in the time period that they don't have. So why are we not integrating into their environment? I mean, literally, it's like, it's like, duh, we should so just integrate what they're already doing. We're gonna save them time. We're gonna have— be able to communicate with them more. Guys, I can't tell you enough how many clients that I have had in person and then also online, the same clients, by the way. It is, it's crazy the difference, and I'm not even trying to do this. When I'm in person, I realize we tend to use our hands as a crutch because you can just work on the client and talk about like the weather and whatever, right? When I'm specifically on teletherapy, I have to ask very specific, direct questions to them because I can't use my hands. So it makes me think more, and it makes me have to communicate with them more to get them to answer what I'm trying to figure out for them. So it actually is very effective with communication, but you've got to learn how to communicate, and that's what I teach through the method. Also, it promotes patients to actively participate. They are more active in their plan of care when it's through teletherapy because again We can't just like put them down on the table and say, "Hey, I'm just gonna work on your back," and they just kind of zone out. They actually have to be actively participating. So there is a benefit to it. They can still make progress in different environments. They can go on vacation. We still do teletherapy on vacation all the time. They could be sick. Guess what? We're still doing teletherapy as long as they can like breathe, you know. If they can't find childcare, we are still doing teletherapy with them, okay? So you're probably thinking, who the heck's a good candidate for pelvic floor therapy? Guess what? Everyone. Every single person is a great candidate no matter what diagnoses. I've treated everyone, I promise you, and I've coached many people to treat all different diagnoses through teletherapy. So per session teletherapy, I wanna know, I'm curious to know in the chat, Okay, who charges a different price for teletherapy if they're already doing it, or do you charge the same price? Just curious. So we actually charge the same price. The value, guys, is actually higher for teletherapy. Okay, good. I'm seeing same. Good job, guys. Yes. Okay. Okay, what's up, Mel? Um, all right. So, same price, perfect. The value is actually higher because you're saving them time. Remember, they do not have to drive to a physical location. So remember I was talking about that weight loss at the beginning of this presentation? If you could have weight loss over a week or weight loss over a day, which one would you pick? Weight loss over a day. Same thing here. The value goes up because you're condensing their time and they can do other things. So please do not discount your services and make it the same. So we charge $250 a visit in person, and guess what we charge on telehealth? $250 a session. Now, our telehealth sessions, they're 45 minutes. They're not an hour. Our in-person sessions are an actual hour long. So again, they are condensed. Now, the reason why we do this, and I want you guys to think about this too as you're planning the teletherapy, is we have 45 minutes of actual communication with them on the camera. Then we leave 15 minutes to write out their plan, and then we will send it to them. Because I know that most of us therapists do not have time, so I don't want to create extra work. So I, I basically say we can get— by 45 minutes of communicating back and forth, you get so much information that there's enough to make a full plan. And then 15 minutes, then you can send them that plan. And by the way, we never ever I can 100% say this, I've never had pushback on the 45 minutes, by the way. Never. Okay, the software that we use, Jane, for those that have been in my world for a while, I love Jane, absolutely love Jane. It's HIPAA compliant. It's so easy just to switch from someone in person to teletherapy. Super, super easy. It's just a button. And so we use it all the time. Basically, this is what the emails look like that go out. If you are trying to book a teletherapy. So it's very, very organized. They have consent forms there, and then basically, hey, your provider's right here, she'll be ready to go at this date and this time, go ahead and sign in. So what devices do we use? We use our laptops, or we tell them to use their iPhone, one or the other. You need something that can be mobile, by the way. So make sure that you're setting up your patients for success when it comes to teletherapy
