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Dr. Harvey and Dr. Malzberg break down the operational blunders that turn patients away and drag psychiatric practices down. They look at how overloading prospective patients with paperwork, like requiring old medical records or obscure documents just to get an intake, effectively creates a "sales prevention team." They also cover the chaos of bad EHR systems designed without clinician input, plus the confusing, constantly shifting referral paths that leave patients and doctors in the dark. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thetmspodcast.substack.com

Even though TMS is a solid option for treatment-resistant depression, it remains hugely underused across psychiatry. Dr. Harvey and Dr. Malzberg unpack why this gap exists, starting with public skepticism about "magnets" and outdated confusion with higher-risk procedures. They explain how busy doctors often default to routine med adjustments out of habit or lack of time, while deeper issues like professional inertia and thin residency training keep many patients from ever getting offered the treatment. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thetmspodcast.substack.com

Dr. Harvey and Dr. Malzberg take a weird detour to look at Persinger’s infamous "God Helmet," a snowmobile helmet wired with weak magnetic coils that supposedly triggered spiritual visions in 80% of wearers. They walk through how 1990s media hype turned it into a pop-science sensation, and how a proper double-blind study in 2005 completely debunked it as pure placebo and suggestibility. They also address why some people still confuse it with real TMS, wrapping up with a look at the bizarre ethics of using brain stimulation to tweak religious beliefs. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thetmspodcast.substack.com

In this episode Drs Malzberg and Harvey discuss the recent acceleration of progress in psychiatry, and ponder the future. A bright and sunny future? Or, a dystopian hellscape? Could go either way… This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thetmspodcast.substack.com

Dr. Harvey and Dr. Malzberg dive into Part 3 of their guide to running a terrible TMS practice. This episode looks at the major mistakes practices make with referring clinicians, from alienating local colleagues through petty behavior to cutting them completely out of the loop once treatment starts. They also laugh through examples of bad communication, including fake science in update letters, long rambling updates, and basic grammar mistakes like misusing reflexive pronouns. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thetmspodcast.substack.com

In this episode, Dr. Harvey and Dr. Malzberg dive into the key takeaways from the Annual Meeting of the Clinical TMS Society in Boston. While the conference was packed with groundbreaking research—covering new brain targets like the posterior parietal area, accelerated protocols, d-cycloserine, and expanding TMS applications for conditions like Alzheimer's and schizophrenia—the hosts shift their focus to the ultimate test of conference networking: the hors d'oeuvres. Tune in as Dr. Harvey takes a roaming mic around the conference floor to get attendees' unfiltered opinions on the snack budget and puts top TMS experts to the test to see if anyone can actually spell "hors d'oeuvres" (with a special shout-out to Dr. Alvin Lau!). This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thetmspodcast.substack.com

Neuroscientist Dr. Colleen Hanlon joins The TMS Podcast to discuss whether transcranial magnetic stimulation can meaningfully treat addiction…. and what the future of brain stimulation may look like. She explains the emerging evidence for deep TMS in alcohol and nicotine use disorders, how clinicians should think about seizure risk in patients who are actively drinking, and why abrupt alcohol withdrawal is more concerning than stable use. The conversation also explores accelerated TMS, BrainsWay’s ongoing alcohol-use-disorder trial, and rotational field TMS, a next-generation technology designed to stimulate neurons across multiple orientations. It is a practical look at how TMS may expand beyond depression into addiction, PTSD, pain, and other psychiatric conditions. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thetmspodcast.substack.com

Which TMS machine should a psychiatry practice buy? In this episode, Dr. Steve Harvey and Dr. Greg Malzberg walk through the real-world factors clinicians should consider before choosing a TMS device. Rather than naming brands, they focus on the practical questions that matter: upfront cost, rental and per-use fees, coil replacement, service responsiveness, portability, cooling systems, exit options, and the hidden risks of working with a manufacturer. The episode is especially useful for clinicians thinking about starting or expanding a TMS practice who want a more thoughtful checklist than simply comparing the sticker price. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thetmspodcast.substack.com

TMS for OCD is more than just using the same treatment protocol as depression. In this episode, Dr. Harvey and Dr. Malzberg discuss how transcranial magnetic stimulation is used for obsessive-compulsive disorder, including FDA-cleared protocols, the H7 coil, symptom provocation, dorsomedial prefrontal cortex and anterior cingulate targets, and what patients can realistically expect. They also cover why TMS for OCD is less commonly used than TMS for depression, how insurance coverage affects access, and why clinicians need to be careful not to overdiagnose OCD when intrusive thoughts may fit a different formulation. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thetmspodcast.substack.com

TMS gets a historical frame in this episode, using the Chestnut Lodge case and Rafael Osheroff’s lawsuit to explore how psychiatry changes when old assumptions fail patients. Dr. Steve Harvey and Dr. Greg Malzberg discuss psychoanalysis, medication, neuromodulation, and the danger of treating any one approach as the only legitimate answer. The conversation connects a famous psychiatry history case to today’s patients who cycle through depression medications without hearing about TMS, while also warning against turning TMS or any newer treatment into hype. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thetmspodcast.substack.com

TMS safety risks are the focus of this episode, with a balanced look at why transcranial magnetic stimulation is considered very safe while still requiring thoughtful precautions. Psychiatrists explain the rare but serious concerns patients should understand before treatment, including hearing damage without earplugs, seizure risk during stimulation, and metal-related issues near the magnetic field. The discussion also covers practical clinic safety steps, why medication changes can matter during a TMS course, and why “no side effects” is not the right way to describe any treatment. It is a clear, grounded overview for anyone considering TMS or educating patients about it. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thetmspodcast.substack.com

How TMS works is the focus of this episode, which moves beyond the idea that depression is simply a chemical imbalance. Dr. Harvey and Dr. Malzberg explain why TMS targets the left dorsolateral prefrontal cortex, how that surface region may influence deeper connected brain networks. They also discuss neuroplasticity with appropriate caution, emphasizing that it is not magical brain fertilizer but one possible part of how treatments for depression create change. The result is a clear, honest psychiatry conversation about TMS, depression, brain networks, and what science still cannot fully explain. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thetmspodcast.substack.com

Serotonin hypothesis of depression is the center of this episode, as two psychiatrists unpack why the low serotonin “chemical imbalance” story became so popular and why it falls short. They trace the monoamine hypothesis, discuss serotonin, norepinephrine, and dopamine, and review evidence that challenges a simple serotonin deficiency model. The conversation also explains why this does not mean SSRIs or antidepressants stop working, using clear analogies and clinical examples like delayed medication response, serotonin syndrome, tryptophan depletion, TMS, and depression research. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thetmspodcast.substack.com

TMS practice management is the focus of this episode on how clinics fail when business decisions start overriding clinical judgment. The conversation explores patient care vs profit, physician leadership, non-medical managers, clinician autonomy, Spravato pressure, and why treatment quality is also a business strategy. For psychiatrists, TMS providers, and private practice owners, this is a practical discussion of TMS clinic operations and healthcare management grounded in the realities of psychiatry. It is especially relevant for anyone trying to build a physician-led TMS clinic without letting quotas, sterile workflows, or non-clinical control erode patient care. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thetmspodcast.substack.com

TMS practice mistakes are at the center of this episode on why TMS clinics fail and what those failures reveal about better care. The conversation covers timid rollout, underestimated demand, remote management, referral boundaries, physician leadership, and the damage that happens when business pressure starts to shape clinical decisions. For psychiatrists, practice owners, and clinicians interested in transcranial magnetic stimulation, this is a practical discussion of TMS clinic management rooted in real-world patterns rather than abstract theory. It is especially useful for anyone starting a TMS practice or trying to understand why a service is underperforming. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thetmspodcast.substack.com