The 5 Levels of Care in Pelvic Health: What Is The Gold Standard?

The 5 Levels of Care in Pelvic Health: What Is The Gold Standard?

Let's cut through the noise....If someone you loved needed pelvic floor therapy tomorrow, where would you send them? 🤔 Are there actually different levels of pelvic health care? We believe the answer is yes. The interesting part? Most pelvic therapists already act as though these different levels exist—we've just never had a common language to describe them. Think about it... If your spouse, your parent, or your child developed pelvic floor dysfunction tomorrow, who would you recommend? Most of us wouldn't say: ❌ "Just find any ortho PT." ❌ "Start with telehealth or try an online program." ❌ "Here's a great Instagram account." We'd recommend a pelvic floor specialist.  Someone who is trained and able to perform both an internal and external evaluation and hands-on treatment. That instinct reveals something important: we already recognize that different models of care have different capabilities. In this episode, we introduce what we're calling the Five Levels of Pelvic Health Care—a framework for thinking about the different therapeutic ceilings of pelvic health, from free educational resources all the way to the current gold standard of in-person pelvic floor specialists. In this episode, we discuss: ✅ Why different models of care have different capabilities ✅ What we mean by a model's therapeutic ceiling ✅ The Five Levels of Pelvic Health Care ✅ Why every level has value—and expands access in different ways ✅ Why preserving the gold standard matters while thoughtfully increasing access This isn't about ranking clinicians or criticizing different models of care. Every level has passionate clinicians doing their absolute best for patients. Every level has an important role to play. But patients deserve honesty about what each model can—and cannot—provide so they can make informed decisions about their care. If you've been following this series, this episode brings everything together and introduces a framework we hope helps move the conversation around standards of care forward. There's only two big requirements for us: 1. Be honest about your therapeutic ceiling. Don't present your level as though it replaces—or is equivalent or superior to—a higher level. 2. Be exceptional within the level you've chosen.  No matter what setting you've chosen to practice in, strive to learn, grow and provide incredible care. About Nicole & Jesse Cozean Pelvic health is hard. We want everyone in this field to have a joyful, impactful career. And for business owners to build something that truly works for them. 🎙️ Rising Podcast – Leading pelvic health podcast with 1M+ downloads 👤 Founders – PelvicSanity, one of the nation's leading cash-based pelvic health practices 🎙️ Co-creators – PelviCon, the first-ever pelvic rehab conference 📚 Clinical educators who have trained more than 3,000 pelvic PTs & OTs worldwide 💼 Business coaches who have guided more than 1,000 pelvic rehab business owners Get in Touch! Learn more at www.pelvicptrising.com [https://www.pelvicptrising.com], follow Nicole @nicolecozeandpt [https://www.instagram.com/nicolecozeandpt] (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com). Check out our Clinical Courses [https://www.pelvicptrising.com/clinical], Business Resources [https://www.pelvicptrising.com/business] and learn more about us at Pelvic PT Rising...Let's Continue to Rise!

What Do We Actually Gain From an Internal Pelvic Floor Evaluation?

To be honest, we never imagined we'd need to explain this.  Fair warning: this episode gets a little nerdy. Over the last two episodes, we've talked about why we believe internal pelvic floor evaluation remains the gold standard in pelvic rehabilitation. This week, we're answering the obvious follow-up question: What do we actually gain from performing one? For those of us who were trained to perform internal evaluations—and who use them every day in practice—the value seems almost self-evident. It's become such a fundamental part of how we think, reason, and treat that we rarely stop to ask why. It's also where our profession has focused its education, research, and clinical training for more than 40 years. But recent conversations in our field have challenged us to step back and articulate something we've largely taken for granted. So that's exactly what we do in this episode. We break down the first principles of an internal pelvic floor evaluation:  * How it reduces uncertainty * Improves diagnostic accuracy * Helps individualize treatment * Identifies findings that might otherwise be missed * Gives patients understanding and validation This is why the ability and willingness to perform an internal evaluation - when clinically relevant and with informed consent - has remained the gold standard in pelvic rehabilitation for decades. If you've ever struggled to explain why internal evaluation matters—or simply want to think more deeply about one of the defining skills of our profession—this episode is for you. International Continence Society Paper In the episode we mention a paper from the ICS that was extremely helpful in listing out many of the areas where we gain information, specificity or new information.  You can review the article in full here: https://mail.google.com/mail/u/3/?ui=2&ik=c052c6fa3f&attid=0.1&permmsgid=msg-a:r7722291455026827186&th=19f9addb07427973&view=att&zw&disp=inline&acrobatPromotionSource=gmail_chrome-list Get in Touch! Learn more at www.pelvicptrising.com [https://www.pelvicptrising.com], follow Nicole @nicolecozeandpt [https://www.instagram.com/nicolecozeandpt] (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com). Check out our Clinical Courses [https://www.pelvicptrising.com/clinical], Business Resources [https://www.pelvicptrising.com/business] and learn more about us at Pelvic PT Rising...Let's Continue to Rise!

What We're Getting Wrong About "Access to Care"

"Access to care" sounds like something everyone should support. So why do we think it's become one of the most misleading phrases in pelvic health? In this episode, we argue that we've been solving the wrong problem. Because the goal isn't access to care.  The goal is access to quality care. We discuss: *  Why lowering the standard of care isn't the same as increasing access  *  The difference between access and quality  *  Why patients are still falling through the cracks despite having "access"  *  The six biggest opportunities to improve pelvic healthcare  *  Why raising standards—not lowering them—is how we truly help more people  If our profession wants to serve more patients, the answer isn't diluting what makes pelvic health special. It's building more clinicians, better businesses, stronger education, and higher standards.  About Nicole & Jesse Cozean Pelvic health is hard. We want everyone in this field to have a joyful, impactful career. And for business owners to build something that truly works for them. 🎙️ Rising Podcast – Leading pelvic health podcast with 1M+ downloads 👤 Founders – PelvicSanity, one of the nation's leading cash-based pelvic health practices 🎙️ Co-creators – PelviCon, the first-ever pelvic rehab conference 📚 Clinical educators who have trained more than 3,000 pelvic PTs & OTs worldwide 💼 Business coaches who have guided more than 1,000 pelvic rehab business owners Get in Touch! Learn more at www.pelvicptrising.com [https://www.pelvicptrising.com], follow Nicole @nicolecozeandpt [https://www.instagram.com/nicolecozeandpt] (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com). Check out our Clinical Courses [https://www.pelvicptrising.com/clinical], Business Resources [https://www.pelvicptrising.com/business] and learn more about us at Pelvic PT Rising...Let's Continue to Rise!

Is Internal Evaluation + Treatment Still the Gold Standard?

Is internal evaluation the gold standard in pelvic health?  We believe the answer is yes. Lately, we've seen more clinicians claiming that internal pelvic floor evaluation isn't necessary—or isn't the gold standard of pelvic rehab. We don't think this is just another social media debate. We think it's one of the most important conversations our profession needs to have. We're going to be diving deep into this topic.  But for Part 1, we discuss: *  Why this issue matters so much for the future of pelvic health  *  What the pioneers of our profession fought to establish  *  The strongest arguments against internal evaluation—and where we think they fall short  *  Why "access to care" shouldn't mean lowering the standard of care  *  Why extraordinary claims require extraordinary evidence  (Also, the caveat we shouldn't need....Every internal evaluation should be clinically appropriate and performed only with informed patient consent.  Of course.) Instead, this episode asks a bigger question:  What should the gold standard actually be for pelvic rehab? About Nicole & Jesse Cozean Pelvic health is hard. We want everyone in this field to have a joyful, impactful career. And for business owners to build something that truly works for them. 🎙️ Rising Podcast – Leading pelvic health podcast with 1M+ downloads 👤 Founders – PelvicSanity, one of the nation's leading cash-based pelvic health practices 🎙️ Co-creators – PelviCon, the first-ever pelvic rehab conference 📚 Clinical educators who have trained more than 3,000 pelvic PTs & OTs worldwide 💼 Business coaches who have worked with more than 1,000 pelvic rehab business owners Get in Touch! Learn more at www.pelvicptrising.com [https://www.pelvicptrising.com], follow Nicole @nicolecozeandpt [https://www.instagram.com/nicolecozeandpt] (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com). Check out our Clinical Courses [https://www.pelvicptrising.com/clinical], Business Resources [https://www.pelvicptrising.com/business] and learn more about us at Pelvic PT Rising...Let's Continue to Rise!

Is an Online Business Really the Future?

"Everyone" seems to be saying the future is online.  Create a course.  Sell a membership.  Telehealth in your pajamas.   Stop trading your time for money.  Retire on a beach. As owners of both a thriving brick-and-mortar practice and a successful online business, we wanted to share a reality check. In this episode, we discuss: ✅ Why most pelvic PTs are looking at online business for the wrong reasons ✅ Why building an online business is often harder than building a local practice ✅ The biggest mistakes we see clinicians make before they ever get started ✅ Why content creation is a full-time job—not passive income ✅ How AI is changing the future of online education ✅ Why we still believe the greatest opportunity is delivering exceptional in-person care One of our biggest takeaways: Don't chase what looks exciting online. Build the business you're actually passionate about. Business Accelerator If your goal is to build a thriving pelvic rehab business, we'd encourage you to double down on what you already know how to do: provide exceptional patient care. The Business Accelerator helps you build the marketing, systems, pricing, and confidence to grow a profitable brick-and-mortar practice—without chasing every new trend. Learn more about future cohorts: 👉 www.pelvicptrising.com/accelerator [http://www.pelvicptrising.com/accelerator] About Nicole & Jesse Cozean Pelvic health is hard. We want everyone in this field to have a joyful, impactful career. And for business owners to build something that truly works for them. 🎙️ Rising Podcast – Leading pelvic health podcast with 1M+ downloads  👤 Founder – PelvicSanity clinic in Southern California  🎙️ Co-creator – PelviCon, the first-ever pelvic rehab conference  📚 Author – The IC Solution, helping 20,000+ patients worldwide  🎓 Clinical Educator – Trained 3,000+ pelvic PTs & OTs globally  💼 Business Coach – Guided 1,000+ pelvic rehab businesses to grow, thrive and enjoy their business Get in Touch! Learn more at www.pelvicptrising.com [https://www.pelvicptrising.com], follow Nicole @nicolecozeandpt [https://www.instagram.com/nicolecozeandpt] (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com). Check out our Clinical Courses [https://www.pelvicptrising.com/clinical], Business Resources [https://www.pelvicptrising.com/business] and learn more about us at Pelvic PT Rising...Let's Continue to Rise!