Tips on Managing Complex Pelvic Health Cases
How do you eat an elephant? Managing the complex case.
I'll be honest, I love complex patient cases. I always have. Part of what really drew me to pelvic health was the fact that we help people with problems that are often so private and truly neglected in healthcare. It felt so clear to me that specializing in pelvic health was really less of a choice in my career and more of an acceptance of a mission – to help people, change lives, and change the narrative so many people face.
The reality is that many of our patients are still seeing 6+ providers before getting answers. They're still feeling so isolated with their symptoms. They are still made to believe that their problems are all in their head. And frankly, it's just not acceptable. So, how can we really make a difference for the most complex patient cases?
"If we listen to our patients, they will tell us what is wrong with them."
I remember a professor from PT school sharing those words, and it has stuck with me to this day. People need to feel heard. Simply being present with them throughout their sessions and allowing them to share their stories fully has power. It lets us sort through the journey and help them get on the right track.
Keep the view of the forest, despite the trees.
In complex cases, it's easy to be bogged down with all of the details, procedures, ups and downs. That's why I am big on really exploring the deep "why" before jumping into treatment. Listen to the patient, explore what is happening in their body --> then make sense of why. How do their symptoms tie together? How does the timeline fit their current complaints? Build the story-- finding the driver-- then solutions become more clear.
Don't be an island.
Multidisciplinary care is SO crucial for many of these patients. We don't need to be the end all be all for our patients, nor should we. So-- listen, then make appropriate referrals so patients can get the right medical and adjunctive management to support their journeys. And if you get stuck, don't be afraid to ask for help!! Collaboration with our fellow rehab providers (and clinical mentorship!!) can often be key to figuring out the tricky cases!
Avoid simply treating what you find.
I know this seems to be against mainstream advice... but honestly, the advice of "treat what you find" has always felt a little off to me. The reality is that objective findings matter when they matter. Sometimes, we can get bogged down in the "problems list" and really lose sight of the true driver of the problems. So--> Build the story-- truly, why is the patient dealing with the problem they're dealing with? What are the factors that are contributing? Then, prioritize your treatments and partner with the patient to move forward.
I hope this helps you think through your complex patients a little better!!