Pelvic Health Patients Are Waiting Too Long Between Visits. Is the Workforce Shortage to Blame?

Everyone's talking about the pelvic health workforce shortage. 

But almost no one is talking about what it's actually doing to our patients between visits, when that’s actually the part we can fix today.

Let's stop pretending this is a mystery

The new APTA State of Pelvic Health Physical Therapy report confirms what every one of us already knows in our bones: 76 percent of us report a shortage of providers in our area. Only 17.4 percent think supply is adequate.¹ That's a workforce that is outnumbered, full stop. But the conversation always stops at the shortage, as if the story ends there. 

It doesn’t, though, because while the shortage is the cause, the real damage happens downstream in a part of the care journey nobody puts on a slide: the space between the eval and the follow-up.

Read this stat again

Almost half of us (48.6 percent) say follow-up visits are often or very often delayed beyond what's medically appropriate. 

Let’s look closely at that statement for a moment, because it's ours. We’re the ones telling APTA in a national survey that the gap in our own episodes of care isn't medically appropriate. We’re holding our own care model to the standard we'd want for our patients, and naming where it falls short.

I love that about this field! Pelvic health PTs are never satisfied with "good enough!" We're constantly pushing to get better, which means being willing to call out where we're missing the mark, even when it's our own model we're describing.

So the question worth asking is simple: If the model we're currently running (start a plan, then leave a gap before we check back in) isn't medically appropriate, what is? 

Bring on the PTAs… but it’s not the whole answer

APTA's report points to expanding PTA utilization as a meaningful lever here, and I agree that it should be part of how we grow capacity long-term. But hiring and training can take years to scale, and the patient sitting in front of us today needs a plan for this episode of care, not the one workforce growth will eventually support.

Both things can be true: PTAs are part of the future of this field, and we still need an answer for the gap happening right now.

The tradeoff we don't say out loud

We talk a lot about the front-door wait, a median two weeks just to get evaluated. That's real. But there's a version of this problem we talk about less: Starting a patient on a plan, then leaving them on an island until a follow-up that, by our own account, comes later than it should.

A long wait to start is a barrier to entry. A long gap after starting is momentum with no one watching what happens to it.

And we can't talk about that gap without noting that some of these patients have waited years to seek help. By the time they get to us, that first eval can feel like the first real relief they've had. Someone is finally listening, a plan is finally in place, and there’s hope that things might actually change. 

Our schedules shouldn't be the next disappointment in that journey. Not after everything it took them to get to us in the first place.

What the data doesn't fully capture

Here's something from practice, not the report: By the time that follow-up finally happens, we may still be filling in the clinical picture. Yes, the eval visit is technically closed. The code is billed, the note is signed. 

But billed and complete aren't the same thing. We often don't yet know how a patient tolerates their exercises outside the clinic, whether the lifestyle changes we discussed actually stuck, or whether they're progressing, plateauing, or quietly regressing.

Right now, we don't find out until the delayed follow-up. We're handing patients a plan and disappearing, instead of using the gap to keep building that picture.

RTM is the bridge

If our current episode of care isn't medically appropriate by our own account, and PTA growth is a longer runway than our patients have, the next best thing is making sure we're still there—remotely—while the calendar catches up.

That's what remote therapeutic monitoring (RTM) is for. It’s not a stand-in for the visit. But it is the thing that keeps us present in a patient's recovery and keeps that clinical picture coming into focus when the calendar won't allow another slot.

A patient logs symptoms, reports how they tolerated the exercises, and flags a lifestyle change that didn't stick. We see it in real time and can act before the delayed follow-up happens, not weeks after we'd have liked to know.

This isn't a hard sell to our field, either. Respondents in APTA's report were genuinely optimistic about technology's role here. Telehealth specifically was named as a way to reach patients facing geographic, financial, and logistical barriers. 

There’s just one condition, and we kept naming it. Telehealth has to complement hands-on care, not replace it. That's exactly the lane RTM lives in.

How Medbridge builds for exactly this

If your organization is trying to close this gap without asking already-stretched clinicians to do more, it’s time to take a closer look at these solutions:

• Remote Therapeutic Monitoring keeps us connected between visits, surfacing how patients are tolerating their program and adhering to lifestyle changes so that we're building the full clinical picture instead of guessing at it.

• Guided digital Pathways give patients real structure in the gap, instead of an exercise sheet and silence.

• Patient-Reported Outcomes gives us an objective signal on what's changing, so the follow-up visit is spent progressing care, not reconstructing what happened since the last one.

None of this asks us to see fewer patients in person or hand a clinical decision to an app. It asks for the opposite—eyes on more patients, for the full length of their episode of care, without adding an hour to a week that's already full.

The bottom line

The APTA report describes clinicians holding our own care model to a standard it isn't meeting. That kind of honesty is what pushes a field forward. But naming the gap can't be the finish line. We didn't build this specialty by accepting "that's just how it is," and we shouldn't start now. 

RTM is the innovation this moment is asking for. It’s the difference between a patient who feels forgotten in the gap and one who feels like their PT is right by their side. 

References

1. APTA State of Pelvic Health Physical Therapy report, American Physical Therapy Association and APTA Pelvic Health, July 2026.