Why Treatment Frequency Matters: It's Clinical, Not Commercial
We get it. As pelvic health physios, the mention of KPIs can make us bristle. We're not salespeople - we're clinicians committed to evidence-based care. But here's the thing about treatment frequency: it's not about over-servicing or hitting targets. It's about motor learning, tissue adaptation, and delivering the outcomes our patients deserve.
The Unique Challenge of Pelvic Health Patients
Unlike treating an acute musculoskeletal injury where pain drives motivation, most of our patients are dealing with hidden functional problems. They're not limping in with acute neck pain that stops them working. They're managing embarrassing leaks, painful intercourse, or persistent heaviness that they've often lived with for years.
This fundamentally changes our clinical approach. Most of our patients take considerable time until they're ready to take on a program independently. Using motivational interviewing to determine readiness to change becomes essential clinical work. We have to spend significantly more time on motivation and adherence than our colleagues treating acute musculoskeletal conditions - not because we're inefficient, but because that's what the clinical presentation demands.
The Science Behind Consistent Sessions
Pelvic floor muscle training follows the same motor-relearning principles as any skilled movement. NICE guidelines recommend supervised programmes of at least 3 months because:
Motor learning requires repetition: New movement patterns need consistent reinforcement, especially for muscles patients can't see working
Muscle adaptation is rapid initially: Neuromuscular changes happen quickly in the first 3-4 weeks, meaning the program you prescribed today won't be sufficient next week - it needs early progression and adjustment
Technique refinement needs supervision: Without regular check-ins, patients may develop incorrect patterns that undermine outcomes
Integration takes time: Applying new skills to daily activities requires ongoing support and troubleshooting
The Easy vs. Evidence-Based Approach
Yes, we could see patients every 4-6 weeks, hand them a leaflet, and tick the "patient education" box. But would that:
Allow us to progress their program as their muscles rapidly adapt in those first weeks?
Give us enough touchpoints to work through ambivalence and build sustainable habits?
Provide the supervision that NICE guidelines recommend?
Deliver the evidence-based care our patients deserve?
At PPPM, We're Big on Frequency Because...
It's not about the numbers on a spreadsheet. Maintaining frequency and intensity of programs matters because:
We're treating hidden dysfunctions, not acute injuries: Our patients need us to help them understand, prioritise, and stay motivated around symptoms they've often lived with for years
We're managing rapid physiological change: Muscle strength, endurance, and coordination shift quickly in those first weeks - frequent contact lets us progress programs appropriately
We're committed to clinical excellence: Evidence-based care means supervised programs of adequate duration with appropriate behaviuoral support, not one-off consultations
The Real Quality Check
If your Patient Visit Average is lagging and your cancellation rate is high, ask yourself:
Are you meeting Clinical Practice Guidelines?
This is what motivates us to do better – not a number on a page. We all want to be giving patients gold standard care. When patients aren't maintaining the frequency and consistency that evidence suggests works best, it's not just a business problem - it's a clinical quality issue.
Re-framing Success
Treatment frequency isn't about business metrics – it's about whether we're delivering the supervised, consistent care that Clinical Practice Guidelines recommend. When our PVA aligns with evidence-based treatment durations, we're demonstrating our commitment to clinical excellence.
The real question isn't whether we're seeing patients too often. It's whether we're providing them with the gold standard care they deserve.