Thu, 12/01/2022 - 11:32
Dr. Kevin Kinback has been in private and academic practice since the late 1990s. Always keenly interested in neuromodulation, his current practice, the Advanced TMS Center, is the longest running TMS center south of Los Angeles. He was drawn to TMS to help depressed patients who despite exhaustive efforts, didn’t respond even to maximal treatments.
“It was very frustrating, treating patients year after year, even with ECT, and seeing only half of them get better, with the other half out of luck,” he says. “The minute I heard TMS was FDA-cleared in 2008, I called the company and said, ‘get me one of these TMS machines.’” After receiving one of the very first TMS machines, Dr. Kinback quickly rose to prominence as a TMS pioneer, not only for his work treating patients but also for success with insurance reimbursements in a time when no payors offered standard coverage for TMS.
In 2012, Neuronetics held a national conference for TMS providers, asking Dr. Kinback to present as faculty. “It was kind of a mini version of the PULSES course,” he explains, “I was regarded as one of the early experts working with insurances [for TMS authorization]”. While Dr. Kinback was excited as an early TMS adopter and patient advocate, he acknowledges it was much harder and time-consuming than he first imagined. “Projection spreadsheets showing hundreds of thousands of dollars you can make – that’s in a perfect world,” he shared. “There really weren’t, and still aren’t, many dozens of people just pounding down your door to demand TMS…it doesn’t happen like that. It was very hard work, one patient at a time.”
Dr. Kinback became a founding member of the Clinical TMS Society, and a founding member on several committees, including Research, Newsletter, Standards, and the Insurance committee. Dr. Kinback co-chaired the Insurance committee for five years and is still on the committee today. “We fought as patient advocates since day one,” he says of the committee, who have directly and positively influenced Optum and Medicare coverage guidelines. For many years, he contributed articles to nearly every newsletter on many topics from billing & insurance, to TMS treatment safety during COVID. Shortly after joining the Society, he was elected as a board member and is nearing the end of his second term.
Dr. Kinback was also involved early on in TMS education. He chaired a special committee, and developed a CME course that was a precursor to the PULSES course. “I was very happy to be invited as part of the inaugural faculty in 2017 for the very first San Diego PULSES course,” Dr. Kinback shares. He has given lectures at several annual meetings, and advocates for expanding Society membership and education, and has recommended four residents and early career psychiatrists for PULSES scholarships; three so far completed the course and joined the Society.
Medical education has always been important to Dr. Kinback. Outside of the society he regularly lectures and presents on TMS and other topics. He serves as Adjunct Faculty at Johns Hopkins School of Nursing and Clinical Assistant Professor of Psychiatry at the Loma Linda University School of Medicine. “Residents and students rotate through my office…and I do grand rounds, university, and community lectures, and supervise residents individually,” Dr. Kinback says. In addition to this volunteer work, he also participates in TMS research. At least four of his poster abstracts were published in Brain Stimulation. Most recently, he and his pre-med assistants published a poster on TMS theta burst augmentation. “We plan prospective trials next,” Dr. Kinback shares. “I really want more research to find ways to improve TMS outcomes.”
Dr. Kinback offers a unique perspective on the future of the Society as one of its founding members and long-serving board members. “One very challenging aspect is coming out with whitepapers, position statements and official Society publications on which everyone can agree. Even just 24 board members using many different TMS practice models struggle with divergent viewpoints on how TMS should be done or supervised,” Dr. Kinback explains. “It took us about two years to crank out the first whitepaper with about fifteen people [involved].” Although reaching agreement can be difficult work, Dr. Kinback emphasizes that “Society members and leaders have common goals, eventually overcoming individual differences and through professional interaction and mutual respect, resulting in consensus and general guidelines.” He shares, “One of the most gratifying aspects of the TMS Society is that despite differing viewpoints and motivations, in the end we seem to agree that we want more people to know about TMS, we want more ideal insurance coverage, and for all patients to have equal access to TMS as an early treatment option.”
As his time on the board draws to a close (for now at least, as he is required to rotate off the board for a year), Dr. Kinback shares his hopes for the future of the Society. Over the past few years, he has seen an increase in diversity and inclusivity and wants that to continue. “Even if you have a minority opinion, everyone should be heard, respected and listened to,” he says. He also hopes to see increased communication between the board and the general members. “The general Society members only get to elect eight board members each year. I’ve always wanted to have the board members be more representative of the opinions and goals of all the individual members,” Dr. Kinback explains.
“I would like for any member to be able to approach any board member with an issue, trusting that Director to bring the issue to the Board as a concern. Board members should be more representative of Society members, and I would love Society members to have more of a voice.” Dr. Kinback advocates for leaders to always work toward the Society goals and not just their personal agendas. When serving as Newsletter Co-Editor, Dr. Kinback would send out surveys to get member feedback to see what they had interest in learning. “I very much advocate for every Society member to have an equal voice and a seat at the table,” and for leaders to “pay it forward,” and help mentor those newer to TMS. In recognition of his years of contribution, Dr. Kinback was given the Society Service Award in 2018, and this past year he was named one of the inaugural Fellows of the Society.
Dr. Kinback plans to stay involved with the Society, and Committees. Notably, he has become a founding Board Member, and Secretary (Officer) of the newly formed Foundation for the Advancement of Clinical TMS (FACTMS). While continuing to lead a busy psychiatry group in Orange County, he plans to keep practicing TMS, do research, and to remain active in the Society and the Foundation. He wants to leave Society members with the message to get more involved. “I really encourage every member to join a committee, attend a PULSES course, and recruit other members,” he says, “even 14 years after FDA Clearance, not enough doctors or patients know about TMS, so we need everyone working together to help further the cause within their communities.”