The argument always used to be ‘how can an online consultation replace a face to face physical physio assessment?’
The simple answer is that is can’t! In the same way as online food shopping isn’t the same as the experience of wandering round the supermarket and checking out the produce before you buy. One isn’t better than the other; they are different, and each has its own advantages and disadvantages.
For a number of years some pelvic health physios have been dipping into the world of ‘telehealth’ while others have held back for very legitimate reasons. The most obvious initial stumbling block is the challenge of significant change. It’s hard to loosen our grip on a model of pelvic health care that relies heavily on the physical aspect of needing to touch to assess.
There are also the considerations around confidentiality, GDPR, recording details of what took place, concerns about connectivity and quality of calls, the list goes on. The practicalities of stepping safely into this ‘new world’, whilst running a busy clinic, made many people put any thoughts of developing an online service firmly onto the back burner.
Well Covid-19 turned everyone’s world upside down and it’s been staggering to see how quickly pelvic health physios and other health providers have not only risen to the challenge but also shared information and supported each other throughout the process.
What about our patients? How have they found the experience?
I posed some questions to a patient who contacted me at the start of lockdown and here are her answers. Perhaps some of them aren’t what we’d expect!
Why did you decide to contact me for an online appointment?
As long as I can remember I’ve needed to wee often and usually at the most inconvenient times. More recently I’d not been reaching the loo before I leaked. I just thought ‘I really need to get help with this.’ I’m an anxious sort of person so all the Covid-19 issues, having a child at home with asthma and money concerns were making me feel constantly edgy. Even silly things like not being able to sneak a couple of packs of leaky lady pads into my supermarket shop was stressing me out. I knew about you as a friend had sent me a link to one of your videos on YouTube.
What was it about the video consultation that worked for you?
It was the opportunity to just offload all my concerns. I felt that I just talked ‘at’ you. I didn’t realise how much I’d bottled up all the frustrations and fears I’d had about my bladder – even crazy thoughts like ‘is this cancer?’ or the interstitial cystitis problem I’d read about online.
Going through the bladder diary I’d completed was helpful. I like to analyse and see what’s happening. I don’t like being told what to do without understanding the reasons why making changes would help.
The advice about fluids, bladder training and even the way my emotions were affecting my bladder made sense.
Would you have preferred a face-to-face consultation?
Not really because I had concerns about going to see a ‘women’s health’ physio in case I crossed paths with anyone I knew in the Pilates/physio practice where you’re based. The online experience in my own home felt more private and personal. There were no issues getting to clinic and parking either!
I found the initial advice I was given really helpful and it was great when the email summary of the plan we’d made landed in my inbox. I like to go over things a few times, it helps to make things stay in my mind more easily so links to videos and articles are really good.
The information about relaxation and mindfulness helped me a lot too. I didn’t realise how much my anxiety was affecting my bladder.
Will we meet again do you think?
Moving forwards, I’m going to focus more on my own health. I’d like to lose some weight and get fitter. It would be helpful to touch base in a few month’s time to check I’m still on track and my bladder issues haven’t deteriorated.
I’d also like to be more ‘connected’ with my pelvic floor and feel that I’d probably need help with that but if it could be done online that would be great.
The whole Covid experience is making me realise how long I’ve been running on a low battery with no spare energy to rise to new challenges. I need to try and give myself some space. My aim is to simply carve out some time once the children are settled, put some music on and turn out the lights for half an hour.
It will be fantastic when we have the opportunity to reflect on the huge changes that have taken place in the way we support patients. It’s going to continue to be a steep learning curve as we analyse outcome measures and develop best practice guidelines for online work.
Whatever happens over the coming months and years my feeling is as pelvic health physios the spirit of supporting each other as well as our patients will underpin everything we do.
Written by Chartered Physiotherapist, Jane Appleyard.
Find out more about Jane here.
The information on this website is written to give general information and does not in any way replace advice from your G.P. or qualified healthcare professional. If you have any specific concerns about your health you should seek an individual consultation with your G.P. for diagnosis and advice.
