Part 1 (My Space): What Do I Need for Starting My Pelvic Health Practice?

As a former Lone Ranger pelvic health PT, I know what it is to try to get a women’s health practice off the ground in an outpatient clinic.  As the Director of Education for the Academy, I have received several emails through the years with the question “what do I need for my new pelvic practice?”  While there is no absolute right or wrong in determining the needs and wants of a new pelvic practice, the considerations from an experienced pelvic PT can be helpful.

In this three-part series, I will share from my experience:

1. What you need for examination/evaluation and treatment space; and
2. What supplies and equipment you need; and
3. What are some additional resources to help you in getting your practice established.

For each of these three parts, I will share “Needs” and “Wants” for initiating your practice.

So today, in Part 1, I share considerations for your SPACE.

NEEDS for your SPACE:

1. An appropriate room for individual client care.  A private room with a door is a must.  If you are in a busy outpatient clinic, choosing a room with the least amount of nearby traffic is valuable to avoid excessive distracting noise from outside the room.  If there are windows, install adequate window coverings for client privacy.  A sink in the room is very valuable (and some would say a must); if this is not possible, being sure to have adequate hand sanitizer and a sink in close proximity to the room is needed.  In the case of no sink in the room, extra care for universal precautions will be pertinent.

2. Treatment table or plinth.  A hi-lo plinth is preferable over a fixed table in the room, though not absolutely required.  Adjustable head/foot components are also helpful for positioning patients comfortably, though appropriately covered foam rollers or wedges may be used instead.

3. A stool for you.  You will want a place to sit while you take your client’s history and likely for examination procedures and many of the treatments.

4. Room set up.  Good lighting is important for your ability to visualize the perineal area; add lamps if needed.  Position the plinth so that when the patient is supine, the client’s feet are away from the door.  This plinth position gives the client additional assurance for privacy in that her perineum is not facing a door that could accidentally be opened.

5. Adequate cabinets and drawers, or other storage space.  Having space to store enough supplies for several days’ worth (or more) of client sessions is helpful for eliminating undesirable time and energy for the therapist to leave the room to retrieve necessary items.

WANTS for your SPACE:

1. An inviting, comfortable room.  

Think ambiance.  Think spa-like.  Consider the senses – and then consider the sympathetic senses.  Clients are coming to us with very sensitive concerns, and often feel anxious about the first few visits (and maybe more).  Providing a space that is inviting can assist a client in feeling relaxed and comfortable with their care.  So let’s consider the senses. . . .

SIGHT. You may consider consulting with a professional decorator to create a space that promotes calmness through the visual senses.  Consider neutral but current wall colors, window coverings, and art.  Poll friends, co-workers and others on art with phrases or quotes; what kind of impression will these give to your clients?  They will be looking at these every time they see you!  To share a funny story, one of my first patient rooms had a picture of the ocean, which I believed to be very relaxing.  That is, until a patient, near the end of her discharge from therapy, shared that it always made her think of needing to use the bathroom with her urgency/frequency problem.  Needless to say, I changed out the art in that room.

SOUNDS.  Are the walls in your clinic thin?  If your clients can hear much of what is going on outside the room, they will not feel confident that their privacy is being protected.  Or are you in an older building with strange creaks and noises coming from the ceiling, walls and pipes?  Or can the space be eerily quiet at times?  What’s a pelvic PT to do?  Consider a calming sound machine, or gentle spa-like music to play faintly in the background.  Again, ask others their opinion on the effect of these sounds – calming, or offending or irritating.  Many sound machines will offer a variety of options and may offer the best benefit for giving clients a choice in the most calming sound.

SMELLS.  Do you have an older building with musty smells?  Do your cleaning supplies have very strong scents that linger?  Are there other odd odors near your clinic?  Consider an ozone machine, which will remove unwanted scents.  While a scented candle or wall plug-in is tempting, these can be very irritating (and even trigger strong reactions) in patients with sensitivity to scents and other environmental illnesses.  An ozone machine tends to be safe for all patients.  Additionally, consider a trash can with a foot pedal lid; the lid will keep scents from waste products sealed, and the foot pedal for opening the lid will prevent cross-contamination.

FEEL and TOUCH. As much as possible, adjust temperatures to keep the room from being too cool; patients will be undressing partially and will be very uncomfortable if cold.  Consider the choices for linens.  Some clinics will use real linens – meaning washable sheets and pillow cases.  Is the fabric scratchy and stiff?  Are you able to choose linens that are softer?  If using disposable linens, choose one that has a “soft” side that faces the client’s skin.  In my last clinic, our disposable sheets were “plastic” on one side (to protect the plinth from body fluids and lubricant); the other side was a soft tissue-like material, which I always situated to face the client’s body.

2. Near a bathroom.  

Many of your clients will be seeing you for bowel or bladder symptoms.  Additionally, before and after pelvic examinations or treatments, many clients will need to empty their bladders.  Some clients may also want to replace incontinence or sanitary pads after treatments.  Choosing a space with an attached bathroom is the most ideal.  If that is not an option, having a bathroom as close as possible is preferable.

Watch next for Part 2, as I discuss what equipment and supplies you will need and want for establishing your pelvic health PT practice!