The Growth of Pelvic Health Care at UCSF

I think what makes pelvic health PT so special is its ability to impact a person’s dignity and quality of life. Many people assume that issues like urinary incontinence are something they just have to live with, but that’s not the case. We can help them regain control, and in doing so, restore their sense of self.

Leah McIntyre, PT, DPT

Director, Women's Health Residency
Assistant Clinical Professor
UCSF Department of Physical Therapy and Rehab. Science

Over the past year, UCSF’s Department of Physical Therapy and Rehabilitation Science saw remarkable progress in the field of pelvic health. The opening of the Bayfront clinic and the introduction of a new Women’s Health Residency program drove significant shifts in both clinical care and training. To explore this exciting transformation, we sat down with the director of the Women’s Health Residency, Leah McIntyre, PT, DPT, who has been instrumental in leading these efforts. In this Q&A, Dr. McIntyre shares insights into the rapid expansion of pelvic health services at UCSF, the importance of interdisciplinary collaboration, and how UCSF is positioning itself as a leader in the field.

Q: Can you talk about the recent growth in pelvic health clinical care and training in your department? It seems, with the opening of Bayfront and the new residency, there’s been a sea change.

A: Absolutely! We’ve seen remarkable growth in pelvic health at UCSF, and it’s truly exciting. There’s been a noticeable increase in awareness and interest in pelvic health, both from patients and students, which is a big driver. The opening of Bayfront has been a game changer, not only because it provides more space for practitioners, but also because it has created more opportunities for collaboration. We’ve always had great support from other departments, but now we’re able to partner with them more closely. It’s more than just physical space – it’s fostering an environment for teamwork and shared learning.

Q: Can you describe the new team of providers and educators in the field of pelvic health? What do they bring to the table?

A: While UCSF Health physical therapists have long provided pelvic health services, we have now added seven faculty members to expand this important service. What’s exciting is the diversity in their backgrounds – some come from private practice, others from larger health care systems, and many have strong orthopedic experience. For example, two of our newer faculty members, Catherine Schmidt, PT, DPT, and Jess Evaristo, PT, DPT, transitioned from doing 50-50 orthopedic and pelvic health to now focusing 100% on pelvic health. Additionally, we are excited to have two male therapists, Jordan Labrec, PT, DPT, and Andy Tsui, PT, MSPT expanding their practice to include pelvic health as well. This range of experiences allows us to offer a more comprehensive and unique approach to patient care.

Q: What has brought about this growth, and why is it important?

A: Nationally, there’s growing recognition of the importance of pelvic health, and that’s reflected in the increasing number of referrals we’re receiving. Other providers are more aware of what we do, and our strong outcomes speak for themselves. Pelvic PT is often seen as niche, but it’s actually an essential part of overall health care. We’re slowly changing that perception, and I think this shift is crucial. Pelvic health is fundamental to well-being. Patients deserve access to this type of care as a routine part of their health journey.

Q: How is UCSF setting itself apart in pelvic health and women’s health physical therapy? What makes UCSF the best choice for patients seeking this care?

A: UCSF has been a leader in integrating interdisciplinary care, especially in hospital settings, which really sets us apart. We’ve pioneered collaboration between different specialties and are embedded in clinics where we work closely with other health care providers. The teaching and research elements are also a huge part of what makes UCSF unique. Our work isn’t just about providing care – we’re advancing the field through research and by training the next generation of physical therapists. It seems like there’s been a big change in awareness about pelvic health care and pelvic floor therapy.

Q: Can you talk about what’s driving this interest?

A: Yes, awareness is definitely increasing, and that’s largely because of advocacy, education, and media coverage highlighting the importance of pelvic health. Patients are starting to understand that issues like urinary incontinence or pelvic pain aren’t things they just have to live with. There’s also less stigma around discussing these issues, which is a huge step forward.

Q: Speaking of stigma, do you think it still exists around pelvic health issues? What role can PTs play in addressing it?

A: Unfortunately, yes, there is still stigma, particularly around discussing sensitive functions like bowel, bladder and sexual health. Different cultures have varying levels of comfort in talking about these areas, which is why cultural sensitivity is so important in our practice. As PTs, we have a role in normalizing these conversations and empowering patients to seek care without feeling embarrassed or ashamed. Tell me more about your vision for the pelvic health physical therapy residency at UCSF. My vision for the residency is to grow and advance the specialty by preparing residents to provide culturally sensitive, empathic and evidencebased care. We want to train physical therapists who are not only excellent clinicians but also leaders in the field. The program will have a strong focus on research and teaching, so our residents will not only contribute to existing knowledge but also educate future generations of PTs. We’re aiming to have two residents in our first cohort by 2025.

Q: You mentioned culturally sensitive pelvic health therapy. Why is that particularly important in this specialty?

A: Cultural sensitivity is important in all aspects of healthcare, but it’s especially vital in pelvic health because of how different cultures perceive and discuss this part of the body. There can be more or less stigma depending on the cultural context, so understanding and respecting those nuances is critical to providing effective care. It helps patients feel comfortable, respected and understood.

Q: Can you describe some of the innovative, evidence-based approaches to physical therapy that UCSF’s Department of Physical Therapy and Rehabilitation Science is using?

A: We’re incorporating some really exciting technologies, including biofeedback and real-time ultrasound, which help us assess and treat patients more effectively. Ultrasound, for example, allows us to see in real time if a patient is correctly engaging their pelvic floor muscles. We’re also exploring wearable devices, particularly in the growing realm of telehealth, to give us even more tools to help our patients. Our goal is to continually push the boundaries of what’s possible in pelvic health care.

Q: Is there anything else you’d like to add about the impact of pelvic health PT?

A: I think what makes pelvic health PT so special is its ability to impact a person’s dignity and quality of life. Many people assume that issues like urinary incontinence are something they just have to live with, but that’s not the case. We can help them regain control, and in doing so, restore their sense of self. It’s truly an honor to be able to support patients in such a meaningful way, and I’m incredibly proud to be part of this work at UCSF.