In this monologue, Kelly Alhooie argues that clinicians and coaches should move beyond narrow, discipline‑specific techniques when treating erectile dysfunction (ED) and instead adopt a holistic, coaching‑based framework that integrates physical, mental, relational, lifestyle, and referral dimensions. She illustrates how various professionals—physical therapists, occupational therapists, chiropractors, MDs/DOs, cardiologists, and tele‑coaches—often focus on a single presumed cause (e.g., muscle length, back alignment, testosterone, or Viagra) and thereby mask the underlying issue. Alhooie emphasizes the importance of asking broader questions about stress, relationship dynamics, work habits, and daily posture, especially for populations like sedentary engineers. She describes how coaching can identify mental blocks, lifestyle contributors, and cardiovascular risks, and how teletherapy can deliver targeted mental‑behavioral interventions while coordinating referrals to appropriate specialists. The overarching claim is that a coach’s role is to synthesize all pieces of the patient’s puzzle, refer when needed, and thereby achieve better outcomes than siloed treatment.
Chapters
Coaching allows you to put all the pieces of the puzzle together. In medical school, we were all taught that, nope, you have to go through this, do these special tests, do this, and this equals this. But we know that's not how the human body works. The human body, you have to put every, all, every piece of aspect of their life together. For instance, we treat erectile dysfunction, okay? Someone can come in with an erectile dysfunction. It could be as simple as lack of blood flow because they're lifting maybe some heavy weights, okay, at the gym, and then they were going to sit all day long. They're engineers, and engineer brains— again, I don't have research on this, but from treating over 10,000+ patients, I can tell you someone's an engineer, sits all day, they have a lot of times an issue with erectile dysfunction. It's not a given, but a lot of times that's the, that's the truth. And I truly believe it's how they focus on the computer and something about that brain-pelvic floor connection is why they tend to have that erectile dysfunction. And so I'm saying this because that's just one aspect. So from a PT/OT perspective, they may come in and hit it from, oh, we must lengthen those muscles. An OT also might come in and be like, well, let's work on how you're sitting because that's your daily function. Okay, well, a chiropractor might be like, oh, it must be coming from your back. So then let me go treat your back and we're only going to treat your back. Okay, then an MD is going to treat it from, oh, it must be that you're losing testosterone. Maybe even an MD is that, you know, is really uneducated. They may treat it from that aspect or let me, hey, let me just give you some Viagra pills. Is that solving the problem? No, it's masking it. We're not getting to the root. Maybe a DO is like, well, maybe we'll look at your testosterone. Okay, well let me try to give you supplements for, or maybe some testosterone for that. But here's the thing, here's the thing what's missing out of all of it. Everyone is just going right to the problem. They're not asking about holistically the whole entire picture. They're not asking the guy, what's your stress level like? Hey, did you have a recent breakup? Hey, what's your, you know, what fantasy do you have? I need to know this because this is how a lot of times males perform. Um, how's your work situation been? How's your relationship been? Do you think any doctors are asking about how's your relationship with your partner? No, they're not. They're not asking about stress levels. Hey, tell me about your workout routine, I'm curious about that. Um, when did you start really noticing this? These are things that as a coach I am not going outside my bounds Okay, my boundaries. But what I am doing is putting all the pieces of the puzzle together, and I'm not staying in my box just saying, "Oh, must be those muscles down there, so I'm only going to treat that." That's not effective for the patient, nor is it effective for you to get the outcome that both of you guys are looking for. So if you put your coach's hat on and you start looking at it from different lenses, that's what a coach does, then you're going to get different outcomes, and typically they're going to be better. And yes, I've treated many patients with erectile dysfunction through teletherapy. How? It's because I've trained them on what to do and walk them through mentally where they're stuck, mentally where the block is. Okay, so it can be physical, it could be mental, could be both. Or it could be a heart issue. Yes, where they need to see a cardiologist, 100%. Which is why as a coach, you don't have to do everything. And I'm not saying on this podcast you need to do something you're uncomfortable with. I'm not— that's not the point of this podcast. The point is that you need to do things that are— you've got to think bigger and outside the box. And if you're uncomfortable with it, then who can you refer to that's maybe a colleague that you then you can connect with and be like, hey, by the way, can you let me know what your findings are? Because I'd be curious because I got to put all the pieces of the puzzle together. That's a coach.
