TMS Works. Almost Nobody Gets It. Scott West, MD on Closing the Gap

The FDA cleared TMS for depression in 2008, yet by one estimate fewer than 1% of the patients who would qualify for it ever get treated. Dr. Will Sauvé sits down with Dr. Scott West, the psychiatrist who brought TMS to Tennessee in 2010, to ask why a treatment that works remains this hard to reach. West argues the real barrier isn't efficacy or even insurance, it's that patients and the clinicians who could refer them don't know the option exists, illustrated by a woman who lived two miles from his clinic her whole life and had never heard of it. Along the way he reframes TMS as a tool that treats brain circuits rather than a single depression treatment, and makes the case for treating depression as an urgent illness instead of something managed in six-week medication trials. The two also get into responsible off-label use, from a fibromyalgia protocol to a nine-year-old with Tourette's, and where the field is heading with QEEG-guided protocols and EEG captured under a live coil. West's advice to clinicians thinking about adding TMS: standard TMS still works, so build a real plan and don't let your machine become a "dead box." Brought to you by: Osmind.org, the #1 All-in-one Billing Solution + EHR for the modern private psychiatry practice