Barriers To Overcome

(Incontinence, POP (pelvic organ prolapse), Pelvic pain, Sexual Health)

Patients deserve to be diagnosed utilizing standard of care set by professional organizations.
(example 1, example 2)

Patients deserve to have all of their

treatment options explained clearly in terms they can understand. Recommendations should be based on clinical guidelines and scientific fact without bias.
(example 3, example 4) 

New and expensive medications are being prescribed which should only be used when less expensive medications have failed. Medication is being prescribed to elderly patients without heeding the warning of the American Geriatric Society, a professional organization. Prescribers are being warned not to give certain medications if patients cannot empty their bladder, but almost none of these patients are having their post void residuals checked. Clinicians are prescribing multiple medications with different actions at the same time without diagnosing the root of the problem. 

The majority of patients are being offered surgery to correct their prolapse when none of the very effective non-surgical treatments have been offered or attempted. Patients are not being examined in both a laying and standing position during yearly exams for early detection, nor are they given information to help them understand treatment and prevention of prolapse. Some patient advisory groups are set up and funded by the device/pharmaceutical manufacturers. New, yet to be proven laser treatments are being marketed as a “cure all” for vaginal dryness, incontinence and pelvic organ prolapse, but have little research with long term results. 

Cost of high copays or high deductibles are sometimes obstacles to patients receiving conservative treatment. Complicated preauthorization processes and narrow provider networks make it difficult for some patients to get proper care.  Conservative treatment normally requires multiple office visits.  Patients are more compliant when these offices are within 20 minutes or less from their homes. 

Healthcare professionals deserve to be reimbursed fairly for time intensive conservative treatments (face to face time). Quality vs. Quantity. Conservative treatment normally requires multiple office visits. Patients that are compliant, follow directions to the best of their ability, keep their appointments and arrive on time have the best clinical outcomes. 

Patients have limited access to proper care for these problems in large part due to the fact that most effective treatments require face to face time (cognitive therapies), for which reimbursement or a lack thereof is at such a low rate that no medical practice can afford to offer effective diagnosis and treatment. Meanwhile, a new drug for female sexual health, the first to receive FDA clearance, has little proof of its effectiveness and has its marketers spending $220 million to convince patients and prescribers that it will help. Many women suffer in silence, embarrassed that they have this problem. Additionally, sexual health issues for female cancer patients are just afterthoughts for most clinicians. 

Very few of these patients are being offered non-surgical therapies or product education prior to/post-surgery. Face to face therapies (physical therapy, biofeedback, and cognitive care) are not being offered due to the patient not being informed that these kinds of treatments can help, and to the limited number of professionals who offer these services.

CTAP is a 501(c)(3) nonprofit organization. All donations are tax deductible. 

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