Behind the Scenes: A Glimpse of PHRC

Next week, the Pelvic Health and Rehabilitation Center will turn NINE. In 2006, Liz and I wanted to be more involved in the field  than our current work situation permitted. So, we quit our jobs, hoped we could pay our mortgages and started the Pelvic Health and Rehabilitation Center. We wanted to provide the highest quality of care to our patients, form better relationships with the local medical community, raise awareness about pelvic floor disorders, and teach courses. Initially, PHRC consisted of just Liz and me, no staff. As we got busier and began to hire administrative staff and physical therapists, we realized our next and equally important goal was to create a work environment where our employees would never be treated as poorly as we were previously. As we all know, managing pelvic floor disorders is hard on the people recovering from it and for those of us trying to help. We began hiring motivated, compassionate, independent, fun  people. Nine years later, PHRC is now a company:  5 clinics, 15 employees,  uncountable courses, lectures, textbook chapters, and soon a book. Liz and I are grateful to have the team and company culture that we wanted, so this week we all answered a few questions about the day-to day  inner workings of PHRC.

Every team member of PHRC works closely with each other, but their duties are different depending on if they have administrative responsibilities or therapeutic responsibilities.

Our administrative staff is essential to our operations, ensuring that the day-to-day flows smoothly, helping with social media and marketing outreach, and being the face of PHRC.

What do you like about working at PHRC?

Sara: My favorite thing about working at PHRC is being able to help people every day! Whether I’m helping patients by answering questions and scheduling appointments or helping the PTs manage their schedules, I’m always excited to help.Learning is one of my passions and I enjoy working at PHRC because I learn something new everyday.

Jenni: I truly enjoy helping people and I think that PHRC helps many people though direct patient care and through advocacy. I like the collaborative spirit at PHRC. I truly learn something new everyday.

Gabriella: I get to be a part of PHRC’s collaborative efforts to help people, educate, and increase awareness about pelvic pain. Most importantly, I get to witness women and men being empowered everyday as they take control of their health and their lives.

Connie: I like the fact when I wake up in the morning I get to work with a great group of people. I really look forward to coming to work.Becoming part of PHRC has been a great experience not only do I get to be a part of a great group but we all work together to help improve the quality of life for so many people, to see the look on peoples face when they come in & when they are D/C is amazing.

Our physical therapists are some of the best in the world. Their endless dedication to their patients shows in every aspect of their demeanor and care.  All of the PHRC physical therapists recognized in one way or another that there was a gap to fill in the field of pelvic floor physical therapy. Here is some more insight into their drive to be pelvic floor physical therapists.

 What do you like about working at PHRC?

Allison: I love the team mentality. We have meetings every week that give us an opportunity to bounce questions/ideas off of each other and ensure that we are able to give the best care possible.

Melinda: I enjoy everyone’s commitment to learning, critical thinking, and staying up to date.

Stephanie: I love the collaborative atmosphere at PHRC. Every person working here is committed to their job, to helping each other, our colleagues, and our patients. From a clinical perspective, I enjoy helping people who think they will never get better, I am from NJ after all and welcome this challenge. It is amazing to watch people regain their lives and to transition from the nervous new ‘patient’ in the waiting room to the healthy person that they were before they developed a pelvic floor disorder.

Rachel: I love how supportive everyone is and that I am always learning something new everyday!

Casie: I love knowing that I work with a group of the most talented clinicians who truly care about getting their patients better.  I feel lucky that by working here my access to so many invaluable resources is within such close reach.

Elizabeth: I am grateful for the collaborative environment with caring, smart, and engaged therapists. Being able to talk through a very complex patient with pelvic pain with 7 other therapists is irreplaceable. Our administrative staff is simply the best of the best. Barely a day goes by that one of my patients do not comment on the knowledge, empathy, and responsiveness of our admin staff. Without them none of us would be able to do our job well.

Malinda: The minute I met Liz and Steph, I knew I wanted to work for PHRC. I wanted to be a part of a supportive team with weekly staff meetings, journal club, awesome administrative staff, and a common goal to help people with pelvic pain. I tell people I feel very fortunate to love my job and the people I work with.

What inspired you to get started in pelvic floor physical therapy?

Allison: I actually heard about it from my gynecologist. I was having some pelvic floor issues myself and when she referred me to physical therapy I was like-I think this is something I can help other people with.

Melinda Fontaine: I heard an alumni talk about it when I was in PT school, and I liked the idea that I could help with really basic life functions, like peeing, pooping, and having babies.

Stephanie Prendergast: I worked in orthopedics my first year out of physical therapy school. I hated it. I either quit or was fired from 6 jobs within one year. I answered a job ad in the SF Chronicle (a NEWSPAPER!): Pelvic Floor PT wanted. Will train. When I heard that people, who were my age, could not sit down, wear tight pants, have sex, I knew I had to work in this field.

Rachel Gelman: There were two PTs who did pelvic floor at my first full time rotation in PT school. I thought it seemed cool, so I googled it and found PHRC! I contacted Liz and Steph and after spending a day here observing I knew this was what I wanted to do!

Casie Danenhauer: I’ve had my fair share of pelvic floor issues and had the opportunity to become a patient and shadow a therapist while I was in physical therapy school.  I was lucky enough to have an elective course where we did our first internal exam and it was then that I realized what an incredible opportunity I had to help people on such basic quality of life issues.

Elizabeth Akinicilar: My desire to stop treating straight orthopedic patients and get into a specialty where I could really develop my manual skills in an environment I felt I could actually make a difference in peoples’ lives.

Malinda Wright:  In my last year of PT school, the instructor responsible for placing students in clinical placement wanted to place me in a 2nd round of respiratory therapy. I baulked at this, because in the US we have respiratory therapist and I really wanted to learn about pelvic health. Fortunately, she placed me in a hospital treating women’s health and my interest in this field bloomed. I have never looked back.

How do you explain to people what you do?

Malinda Wright: I tell people I’m a physical therapist and I specialize in the pelvis. Most people mistakenly think I’m talking about the hips. I typically correct people and say I specialize in urinary, bowel, and sexual dysfunction as well as pain and prenatal/postpartum impairments. I also mention that I treat both men and women with these dysfunctions. Majority of the time people will ask me to explain what urinary, bowel, and sexual impairments are. When I explain, I always explain both sexs’ symptoms. I think it’s important for the public to realize men can have these symptoms too.

Melinda Fontaine: At a social gathering, I like to throw out that I’m a pelvic floor PT to see the reaction.  People are either caught off-guard or totally interested in it. When someone asks me what that means, I usually say it’s mostly about the four P’s: Pee, Poop, Pregnancy, and Pain.

Rachel Gelman: My best friend and boyfriend call me the vagina whisperer, but I typically tell people I am a pelvic floor physical therapist and that I treat men and women with pelvic floor dysfunction, which can be pelvic pain, pain with sex, urinary or bowel dysfunction. This is usually followed by looks of confusion and lots of questions and usually ends up with me having to be blunt and say I work on the pelvic muscles internally via the vagina or the rectum

Casie Danenhauer: Two ways- either they drop the topic completely or have A LOT more questions.  I try to use telling people about what I do as an educational opportunity because so many people aren’t even aware of what the pelvic floor is, even if they have dysfunction themselves!  The conversation usually ends with, “Ya, so I basically have my finger in a vagina or a rectum for at least 50% of my day…”

Stephanie: I tell them that my degree is in physical therapy and I describe the symptoms: burning vaginal pain, UTI and yeast infection like symptoms constantly and in the absence of infection, post-ejaculatory pain, penile pain, inability to sit and wear pants. There is always confusion and often a later conversation because they themselves or someone they know may ‘have something that sounds like that’. I tell people the therapists at PHRC are Masters of Pelvic Disaster and direct them to the right office.

What is your favorite tip to give your patients?

Allison: Sit on the toilet (even in public restrooms).

Malinda: Most of the world squats to poop, but Americans insist on pooping in toilets.  Get a Squatty Potty. And stop peeing just in case.

Stephanie: Pee squatting in the shower. It makes the first void of the day less painful.

Rachel: Bowel mechanics and to look at your vagina!! That kegels are not always the answer and to decrease the amount of time you sit, the human body was meant to stand/move!

Casie: Breathe and indulge in self-care!

Elizabeth: Don’t hover above the toilet seat!!!!

Melinda: How to sit properly on the toilet with a squatty potty, and that Dr. Google is not always right.

What advice do you have for patients?

Allison: Try to stay in a healthy mental space.

Melinda: You are your own best advocate.  Stay informed.  Ask questions.

Stephanie: You can and will get better, because you will. 15 years of experience has taught me that more often than not, certain treatment plans fail and need to be reworked. This can happen over the course of one treatment or several, but there is ALWAYS another option if something is not working or you cannot tolerate it. Stay committed and patient and know that you are not broken if something is not helping right away. Use your local medical providers to help you figure out what will help you.Do not be afraid of medications, when used properly medication can be a therapeutic part of the treatment process. Online forums are often scary and not reflective of the true landscape of healing from pelvic pain. Watch John Oliver. Humor helps everything.

Casie: Know that you are not alone.  It can feel very isolating to have pelvic floor dysfunction because it’s not talked about in our society, but there are a lot of people out there with issues similar to yours.

Malinda: Stay informed and write your questions down so you don’t forget them when you walk into the provider’s office.

Elizabeth: Remain hopeful that your medical team will help you reach your goals.

What advice do you have for other pelvic floor PTs?

Allison: Take continuing education classes to build a strong network and community with your peers.

Rachel: Take classes and join any journal clubs/social networks to be able to stay current on the research and discuss cases. Having another set of eyes to look at a case can help you recognize something that you didn’t consider in treating a patient. Plus, this work can be mentally challenging so it is helpful to have a support network of providers who can relate to you.

Casie: Be open to incorporating as many “schools of thought” as you can into your approach for treating patients.  For me a strong focus on the mind -body connection feels very important, but I also always have research articles to support what I’m doing from a more scientific perspective.

Malinda: Build a support network to bounce treatment ideas off of and to discuss more difficult cases.

Elizabeth: Work in a practice with other pelvic floor specialists who can mentor you. Make an effort to learn as much as possible about all the medical interventions related to pelvic pain, even if they are not within your scope of practice. Think of yourself as a colleague within the multidisciplinary team and nothing less.

Stephanie: When first starting treatment with a new patient, people do not always tolerate or immediately respond treatments. Think critically to troubleshoot through this. Promise that if you cannot help your patient you will help them find someone who will.

We hope this gave you a glimpse into our company as a whole. We are honored to have helped many people on their journey to wellness and we look forward to helping many more people the upcoming years! To learn more about our team, please visit our PHRC team page.

Kindest Regards,

The PHRC Team