By: Debra Stultz, MD
I’m lucky. My TMS coordinator/technician is a bright, positive, enthusiastic, energetic, caring, and insightful individual who believes as much as I do in the benefits of TMS. I have never underestimated the “Savanna Effect” in the success of my TMS patients. She is now applying to medical school and I am faced with the challenge of finding her replacement. As I have been considering this, I have been struck by the significance of this position in our office. We have long known the importance of the therapeutic alliance between a physician and their patient, but this alliance extends between our staff and our patients as well. They truly are physician extenders that bridge the gap between the provider and the patient. They are the front line defense in handling phone calls from future patients and other providers. They answer questions for them on what to expect, the length of treatment and possible benefits. They gather information for the prior authorization and coordinate in the collection of the depression scales. I believe the technician must be a naturally empathic and insightful individual who displays a genuine interest in the patient in a calm and confident manner. Their personality and passion must mirror that of the provider in the belief of the value of the TMS treatment. The technician’s own personal observations during the daily TMS hook up process can provide valuable information to the physician on the patient’s progress and any new psychosocial stressors or other medical complaints that could influence the treatment. Their reassuring glances and calming voice can be very helpful to anxious patients during their initial mapping and throughout treatment. The role of the technician in reminding patients on a daily basis to keep their sleep/alcohol intake steady to prevent seizures, to alert us to any new medications changes, and to review any possible side effects is essential. They must be reliable in attendance, information given to the patient and observations recorded about the patient. We must have confidence in them to alert us of any increased movements or activity suggestive of a seizure, ensuring safety for all. These techs must engage and nurture the therapeutic alliance with our patients, but also have appropriate boundaries with the client. In my opinion, they are not there only to observe from a distance and just push a button. Techs are an important part of the therapeutic intervention. As my journey continues to find just the right person to add to my TMS team, I hope outlining the qualities I am looking for will be helpful in guiding your search for the next TMS technician you add to your TMS practice.