How to Choose a TMS Provider: Experience

TMS Serenity Center believes that you should carefully consider several factors when choosing your TMS provider. This week we wanted to show some examples of questions that you should ask about the provider’s experience when making this choice, as well as our answers to these questions.


How long has the provider been doing TMS and how many treatments have been administered?

Dr. Kimberly Cress began her TMS practice in April of 2010 and since that time has provided over 10,000 treatments.
Dr. Kim Cress with Patient

What is the experience level of the TMS therapist?

Roxane Zotyka has been a TMS therapist since April of 2010. Roxane is an experienced provider of TMS therapy and has received advanced education in TMS. She regularly attends the annual Clinical TMS Society Meetings and attended the first ever Brain Stimulation Conference in Singapore.

Is the MD versed in protocols and can he/she recognize what protocol to use and if and when it can or may need to be modified during treatment?

The only FDA cleared protocol for treatment of Major Depressive Disorder is treatment at the left DLPFC (dorsolateral prefrontal cortex) at a dose of 10 Hz. However, just as any one antidepressant won’t necessarily treat an individual’s MDD, the same is true in the treatment of MDD with TMS. In addition, some individuals have comorbidities such as anxiety. Therefore, some individuals could be over activated with a traditional 10 Hz protocol or some individuals will find their depression improves with 10 Hz protocol but there is lingering anxiety. During TMS treatment we monitor an individual’s response not only subjectively, but also objectively with the use of scales. For example, if a patient’s depression has improved but residual anxiety is still present during the TMS treatment, we may change the TMS treatment protocol in order to obtain mood stability. It is important to know these are off-label treatment protocols. However, we have added these treatment protocols as a part of our advanced education and have demonstrated their efficacy in our poster presentations at the APA and Clinical TMS Society annual meetings.

Is your MD a member of the Clinical TMS Society?

Clinical TMS SocietyThe Clinical TMS Society (CTMSS) was established in 2013 and is dedicated to optimizing clinical practice, awareness and accessibility to TMS. Dr. Cress has been involved with CTMSS since the beginning, including participation on the Board of Directors as well as the Executive Committee. She was instrumental in establishing monthly Grand Rounds to facilitate education to TMS providers by leaders in the field. She also created slide decks for TMS providers to educate their local clinicians as well as the general public about TMS. Involvement in the CTMSS is an essential way to facilitate on-going education about TMS as the field of neuromodulation continues to advance.

Do the Doctor and Staff participate in Continuing Education?

Thru the CTMSS, both Dr. Cress and Roxane are able to receive continuing education about the advances in TMS thru monthly Grand Rounds as well as the Annual CTMSS meeting. In addition, they both attended the 1st Brain Stimulation conference in Singapore 2014 and Dr. Cress attended the 2nd Brain Stimulation conference in Barcelona 2016.

If you are in the process of choosing a TMS provider, we hope that these questions and answers will help you in your search. If you have any questions or concerns, please feel free to contact us for more information.