What makes an excellent pelvic health clinician?

When mentoring staff I often invite clinicians to reflect upon this question: “Why is Physio A’s diary always full and mine isn’t?”

As a business owner, I love to hear this question from my staff because it shows they are motivated to improve both their utilisation and effectiveness. In order to answer the question for my staff I have had to explore this scenario from many different angles.

In my opinion the answer essentially comes down to two components of the practitioner’s skillset.

The best utilised clinicians in my team are those that have the strongest combination of:

  1. Excellent clinical skills AND

  2. Excellent communication skills

There is no doubt that the default position for up-and-coming physios is to put the greater part of  their time and effort into developing their clinical skills and treatment techniques.

However, having said that ,to be a “great” physio requires so much more than just the clinical skills. I would even argue that without effective communication skills much of the time spent on developing one’s clinical skills can be negated.

The most effective physios I have worked with, have key strengths in:

1. Developing a strong rapport and trust with the patient
2. Understanding the patient’s expectations of care (and how to meet them)
3. Conveying information in a way that resonates with the patient and
4. Developing a treatment plan that is both effective AND achievable for the patient

Without these skills, then even top tier clinical knowledge is unlikely to translate into positive results for the patient.


Pelvic health is not an area that many physios practice immediately after graduating. Most people spend time developing their skills in other areas of physiotherapy and with broad patient populations. To work in pelvic health there is a requirement to learn a whole new set of clinical skills. However, it is not just the clinical skills that differ in pelvic health, the communication skills also change (and become more important) in this population for a number of reasons. 

When I am treating a pelvic health patient (especially a patient with young children) I am mindful of the effort the patient has already gone to attend that appointment. They often have dropped kids off at a babysitter, left work early, or in many cases have planned their whole day around that appointment. Therefore, their expectations are set much higher for this patient. With this in mind, I am very quick to seek an understanding of the patient’s goals and expectations for the appointment and will tailor my assessment and treatment in order to meet this. Time poor patients want bang for their buck (or more so their time)!

When developing and delivering a treatment program, you must be realistic. Parents especially, have lots of competing demands and will often prioritise themselves last. Time and time again I see Physios sending patients home with a list of 5 - 6 (often excellent) strategies to take on as homework.

Great pelvic floor clinicians will consider that when that patient leaves the clinic to resume their day, they more than likely resume responsibility for the mental load they also juggle (e.g. I’m running late for school pick-up, soccer, the GP, what am I going to get for dinner, do I have that present for Joe’s party on the weekend?). For most patients, they simply do not have time or capacity to implement 5 - 6 NEW things in their daily lives. 

I encourage mentees to slow down, listen to and understand the person sitting in front of them. This can enable them to give the patient a greater chance of success by accurately predicting how much and which treatment strategies can reasonably managed between visits. Getting small wins on the board early by setting the patient up with a chance to succeed in their ‘homework’ goes a long way to building their confidence in you as the therapist who can and will help them. A list of 5 strategies can seem simple to you, but can overwhelm the patient, leaving them to shelve the treatment plan you wrote and decide pelvic physio is simply too much for them right now. 

Over my years as a Pelvic Floor Physio and a Mentor in this area I have spent lots of time refining and coaching people to improve their “non-clinical” skills. Therefore, when we developed the PPPM program we wanted a comprehensive program that not only focussed on improving physio’s clinical skills but also the ‘soft’ communication skills that are so very important to the success of your treatment. So, for pelvic health clinicians of all levels I encourage you to reflect on your communication skills and don’t neglect to seek PD and assistance in improving these - just as you would not hesitate to do with your clinical skills.

Rebecca Liberatore is the co-owner and founder of Pelvic Floor Physio Mentor. She is passionate about helping Physios to implement what they have learnt in the course and clinically reason cases that come into the clinic day in and day out. She has a goal of assisting patients all over the country having access to high quality pelvic floor physio treatment by supporting practicing physios to improve their confidence, skills and knowledge through the PPPM program.


Karina Coffey