Our latest episode features an in-depth conversation with Dr. Phern Chern Tor, a psychiatrist and head of Neurostimulation Services at Singapore’s Institute of Mental Health. In this insightful session, Dr. Tor speaks with neurocare's Dr. Trevor Brown about the critical aspects of operating a Transcranial Magnetic Stimulation (TMS) service in a clinical setting. Aimed at professionals in the fields of neuromodulation and mental health, this episode dives into the practicalities of managing a TMS practice, with a focus on maximizing patient safety, minimizing adverse effects, and highlighting the economic benefits of TMS in mental health treatment frameworks.
Dr. Tor explains his approach to evaluating a patient’s suitability for TMS, stressing the importance of considering both clinical history and motivation for treatment.
“Assessing for the patient’s motivation for TMS is crucial,” Dr Tor explains, adding that understanding each patient’s mental and emotional readiness, as well as their clinical background, significantly impacts their response to treatment. Dr. Tor shares that a well-trained clinician can often mitigate these risks by carefully reviewing past experiences with other treatments, any history of adverse reactions, and discussing realistic expectations with patients before starting therapy.
Dr. Tor also shares valuable insights on the economic role of TMS in a cost-effective, stepped-care model for mental health. By offering TMS as an intermediate treatment option before progressing to more intensive interventions, mental health services can manage resources more effectively. Dr. Tor explains that integrating TMS into a stepped-care approach can help practitioners provide a wide range of treatment options tailored to the severity of each patient's condition, making TMS a viable and accessible option for many patients with treatment-resistant depression.
“Starting slow and going at the patient’s pace is important to minimize side effects,” Dr. Tor advises, advocating for a gradual introduction to TMS therapy. He highlights the benefits of easing patients into treatment, which can help them adapt to TMS without overwhelming side effects. Dr. Tor shares that this measured approach not only enhances patient comfort but also leads to better long-term treatment outcomes by minimizing initial discomfort and building patient confidence in the process.
One of Dr. Tor's strongest messages throughout the episode is the importance of continuous education and team cohesion. "Education, education, education, and team building with your team,” he stresses, encouraging professionals to invest in robust training for the entire TMS team. This focus on training ensures all team members are well-prepared to handle patient needs and can uphold the highest safety standards.
Dr. Tor also highlights the need for seamless communication across the team. “You need a responsive communication system between the responsible clinician and the TMS clinician or nurse,” he explains, underscoring how a cohesive approach enables quick adjustments based on patient feedback. This responsiveness is critical to patient safety, allowing clinicians to promptly address concerns and maintain consistency in care.
To foster the most stable treatment environment, Dr. Tor advises practitioners to “try to keep things the same during the entire period of time.” Consistency in protocol—be it in dosage, timing, or session structure—gives patients a sense of routine, which reduces anxiety and helps them mentally and physically adjust to treatment. This continuity can be especially beneficial for patients with anxiety or those new to neuromodulation therapies.
About Dr P.C. Tor
As a leading figure in neurostimulation and a Clinical TMS Society member, Dr. Phern Chern Tor brings a wealth of experience and knowledge. His expertise in patient-centered neuromodulation, combined with a rigorous approach to patient safety and team education, offers clinicians invaluable perspectives on running an effective TMS service.
This episode is packed with practical advice and evidence-based strategies for mental health and neuromodulation professionals. Join Dr. Tor as he delves into the nuances of managing a successful TMS practice—from assessing patient suitability and building a strong clinical team to adhering to safety parameters and fostering a supportive treatment environment. Catch the full episode now on our YouTube channel and learn how to make TMS a safe, cost-effective, and impactful part of your mental health practice.
About the series
The neurocare group is a global network of experts in neuroscience, psychology, and engineering, with a mission to empower best practices and bring innovative and sustainable mental health techniques to more patients in need through our network of clinics. Through this interview series, the head of the neurocare Academy, Dr Trevor Brown, interviews leading minds in this field, to present the state of research and possibilities and effective models of care in mental health and cognitive performance.
If you are a patient looking for more information about these techniques or to find one of our clinics worldwide, visit www.neurocaregroup.com/patients/
Are you a practitioner interested in learning how you can apply TMS and other neuromodulation techniques in your own practice?
Learn from the experts at neurocare Academy on our LMS (ms.neurocaregroup.com) neurocare Academy also offers in-person training and supervision in workshops throughout the world.
For more information visit: www.neurocaregroup.com/academy/