We’re excited to introduce you to the always interesting and insightful Dr. Rachel Jalanivich PT, DPT. We hope you’ll enjoy our conversation with Dr. Rachel below.

Dr. Rachel, thanks for joining us, excited to have you contributing your stories and insights. How did you get your first job in the field that you practice in today?

I was in high school, taking a medical education class, and everyone else wanted to go into nursing. I was the only one who wanted to go into PT. I got the chance to work as an intern in a PT clinic for my high school class. I loved it!

Dr. Rachel, love having you share your insights with us. Before we ask you more questions, maybe you can take a moment to introduce yourself to our readers who might have missed our earlier conversations?

Hi, I’m Dr. Rachel Jalanivich PT, DPT. I am a Pelvic Floor Physical Therapist and I own Empowered Physical Therapy in Lake Stevens, Washington. I help women find relief from leaking urine, pelvic pain, painful intercourse, tailbone pain, urinary urgency, chronic UTI’s, prolapse, abdominal separation, chronic low back and hip pain, and more!

I am often asked how I got into this field. It’s a common belief that only postpartum women have pelvic floor issues. This isn’t farther from the truth. 20% of collegiate athletes have pelvic floor issues as well as 80% of gymnasts. I’ve never had kids and yet was challenged with my own pelvic floor issues since my teenage years. Ironically, even as a patient I still didn’t want to specialize in this field. It wasn’t until I heard some close mom friends joking about the inevitability of leaking with laughing after having kids. I tried to correct them that it was just common and not “normal,” and was met with eye rolls. In that moment I knew that I was compelled to do this work.

When I moved to Washington from California, I realized there was a severe lack of specialists who treat these very common (but not normal!) issues. I decided to open my own physical therapy practice to provide higher quality care than can be provided in high patient-volume clinics.

I take pride in treating patients functionally and holistically, recognizing the impact of pressure management, biomechanics, nutrition, and even foot and spine biomechanics on the pelvic floor.

How’d you build such a strong reputation within your market?

I’ll answer the question in a round-about way.. I made a tough decision to stay out of network with insurance. Many people don’t know, but insurance pays providers very different amounts of money based on what billing codes we use for your visit. For example, I could be paid something like $15 for performing manual therapy, but paid something like $50 for performing neuromuscular re-education. (Those numbers vary for every insurance company in every state and are being used for illustrative purposes only). This means that insurance is dictating what they believe to be the best treatments for you as the patient. Insurance also makes patients get a referral to physical therapy. In the majority of states Physical Therapists have direct access, which means that patients do not need a referral to be seen.
Imagine this scenario: you have pelvic pain, you wait a few days or weeks to see if it goes away on its’ own. It doesn’t. You call to make an appointment with your primary care provider; they’re booked out 2 months. You see your primary care and they want to try medication. You wait for the pharmacy to fill it, you take it diligently for weeks, still in pain. No change. You call to make a follow up. They tell you the meds need more time to work. You have been dismissed. If you have the energy to advocate for yourself, you keep calling, you get a follow up appointment, they may or may not refer you to a pelvic floor specialist. Oh, but insurance needs to approve the referral first and then send it to me. By the time you get to me, you’ve likely been in pain and dysfunction for more than 3 months, which makes you a chronic pain patient.

Or, you could have a different story.
You could experience pelvic pain that isn’t dissipating, search for Pelvic Floor Physical Therapy on Google, call me, and I’ll get you in within a couple of weeks. You don’t go through the run-around with referrals and insurance approval. You get better faster.

I wish the first story was something uncommon, but it’s a version of the same story I hear every single day from my patients. And those are the patients who kept advocating for themselves. Luckily I am able to give Superbills to help with my patients out of network benefit reimbursements, and I am able to accept HSA and FSA cards as well. Many of my patients choose to self-pay as well.
Being an out of network provider was a tough choice, but ultimately I believe it’s in my patients best interest. It was a terrifying choice actually, because if I’m not involved with insurance companies, many MDs won’t refer to me. I rely solely on patient referrals and referrals from other out of network providers. The only way to get patient referrals is to actually be truly good at what I do. I feel incredibly trusted with my patients care, and honored that they choose me over a provider who might be in-network with their insurance. I also see a low volume of patients, which allows me to spend more time with each patient to get to the root cause of the issue.

Other than training/knowledge, what do you think is most helpful for succeeding in your field?

This is such an intimate field. You have to be able to build rapport with patients quickly, to help them feel comfortable in a potentially awkward situation. I always tell my patients that us pelvic floor therapists have a very odd job, and we have the capacity to make what we do feel much more uncomfortable, or to provide a safe space and make it less awkward ;) Requirements include: the ability to talk about intimate issues, hold space to hear traumatic histories, laugh with patients (when appropriate,) and intermittently encounter bodily fluids on your gloves with a great poker face, and be able to describe bowel movements in detail.

Contact Info:

• Website: www.empowered-physicaltherapy.com
• Instagram: https://www.instagram.com/empowered_physicaltherapy/
• Facebook: https://www.facebook.com/EmpoweredPhysicalTherapy
• Youtube: https://www.youtube.com/channel/UCjv9bwZL4sGZIEB2im2FypA
• Yelp: https://www.yelp.com/biz/empowered-physical-therapy-lake-stevens?utm_campaign=www_business_share_popup&utm_medium=copy_link&utm_source=(direct)

Image Credits
Starla Shaulis Photography