Transcranial Magnetic Stimulation.
It’s called TMS, but that’s its official name. Now you can see why we call it TMS—it’s just easier to say. It has a large variety of uses: Depression, Bipolar Depression, Post-Traumatic Stress Disorder (PTSD), Anxiety, Parkinson’s, Tinnitus. For many patients with these conditions, and who have not responded to other treatments, TMS has proven extremely effective. It also has the benefit of being drug-free, noninvasive, and FDA approved. Alivation is one of the best—and largest—providers of TMS in the United States today. Dr. Duffy has been a leader in TMS, having treated more than 800 patients, and delivering over 24,000 sessions.
One of the biggest benefits to TMS is the lack of pain. When people hear the treatment name, they assume it must at least cause a headache. It doesn’t. At most, some patients feel a mild tapping sensation, and possibly light pressure on the targeted areas after. Compared to the side effects that can be experienced with prescription medication to treat these same conditions, that’s a walk in the park. Each session lasts around 20-25 minutes, and the treatments vary from, on average, 31 to 36 sessions. There is no anesthesia or sedation, so you can drive yourself home after the treatment without worry. There is no pain.
Alivation was one of the first to provide this service in the region. We started back in 2011, during the Premier Psychiatric days, and it’s been one of our core services ever since, and something we proudly offer. There are a variety of reasons for this, but the primary one is simple: it works. TMS has proven to be very effective, and the resulting positive life benefits for patients have been noticeable. In terms of Next Level Care, this is it. When we first became interested in TMS, it was still considered experimental. Now it is FDA-approved, with a host of peer-reviewed studies done by medical journals corroborating these findings[i].
Of course, patients are always a little bit hesitant when they see the machine. It’s natural to be nervous for a new treatment. The machine cycles through pulses as it works; it sounds a bit like an AC unit. Over the course of each session, the machine will make various sounds, nothing particularly loud. Some patients have been known to find the experience soothing, and will actually fall asleep during it. They are woken up, however, as one needs to be awake during the treatment. It is also recommended to think about positive things, good thoughts. Patients who are optimistic, hope for a positive outcome and desire treatment are more likely to benefit from TMS. Those who make lifestyle changes concurrently with it have excellent benefits.
There are four TMS machines at Alivation: three are in active use, one is in research. Alivation has regular appointments for use in all of them. Since 2011, the use has gone steadily up. Taeler and Tony, Patient Services Care Coordinators at Alivation, said the effect on patients is outwardly noticeable. Many will come in sunken, downbeat; by the end of their session cycle, they are more alert, friendlier. Many begin to view the TMS process itself as a positive experience in their lives, and enjoy the interactions with the providers and care coordinators. Alivation’s providers, in turn, enjoy seeing the patients’ quality of life improve so drastically.
We have experience sheets for patients to fill out, to make sure they’re getting the most out of their experience. The results are often incredible:
Patient before TMS: “Most of the time I was exhausted & worried. I couldn’t even function most days. I felt completely worthless.”
Patient after TMS: “I have gotten my first job in 5 ½ years. I am looking forward to tomorrow. I have more energy. I enjoy doing things for myself.”
One simply said, “I now have hope.”
There are dozens like this, patients hobbled by depression freed from it. Many report better relations with friends and family, more hobbies, lifestyle changes, new jobs. One referred to themselves as “a productive citizen” who “found my self-worth” after. From a medical standpoint, these are the kind of things that keep us going. But when a patient says they felt they were failing at life, had no worth, fantasized daily about suicide, and then turns into an active, happier individual, the polar opposite to where they were when they started? Then that makes everything we do worthwhile.
Alivation in Perspective
Lincoln is home to any number of medical complexes. Numerous mega hospitals, clinics, and other medical centers are just part of our landscape at this point, cultural and physical. You can’t drive a mile without seeing several dotting the eyeline; we all know people employed by them. The question becomes: if everything looks alike, how do you stand apart? What makes one facility pop out from all the rest? How can we be memorable?
Alivation could go bigger, that’s an option. Start as a family clinic, end up with a helipad and fleets of vehicles with our logo on it. Fun, but not really the direction we wanted to go. None of us have pilot licenses, besides.
So we found a different way.
Rather than expand ourselves outwardly only, we expanded inward. We invest in people and technology foremost. Our size is always in response to our needs. We’re like a goldfish in this way, expanding to meet the size of the bowl. Our building is big, but we could always go bigger. There’s enough room in the Midwest for it, and Lincoln and the surrounding communities have demonstrated a need for our services over the years. Where there’s a potential need, we provide access.
As a facility, we have the same sorts of conundrums many medical facilities do. We are sometimes faced with a massive influx of people needing care, and the ability to see them all on a timely basis. No one, least of all our staff, ever wants patients to wait for longer than necessary. We know this because we, the staff, when we’re patients for the doctor or the dentist, don’t like to wait longer than necessary, either. Doctors are also the fussiest patients, we should mention.
There is the recurrent headache of the paperwork, which is a necessary evil. We need as much information as we can get to do the best job possible. We try to provide transparency, and we ask it of our patients and prospective patients as well. It’s one of those old rules we still value: honesty is the best policy. Early disclosures of signs and symptoms is the fastest path to recovery and optimal treatment.
To better meet demand, we’re always selecting new providers, or looking for opportunities to work with other clinics. Growing pains are a side effect of rapidly expanding our treatment and service options. The old saying is “Fast, cheap, good—you can pick two.” We don’t bemoan success, and we won’t begrudge holding higher standards for ourselves and trying to have all three. We want patients to have access to the best care, as quickly and as affordably as possible. That’s the fundamental equation we strive for.
Do we succeed at that?
We think so, but we will never stop trying to do better. Whenever a family has had to wait too long in the lobby, we’ll improve that. Whenever patients need adjustments in their care, or they need to try something different—we work on that, too. There isn’t a day when we don’t consider needs. It simply isn’t in our company DNA to sit idle, rest, or ignore feedback and the opportunity to improve. We’re as active as we can be, and Alivation is always busy with people moving fast down the halls.
All this counts toward our inward expansions, helps us be a better facility. We won’t leverage it into a beautiful but overly large center we don’t need, but rather utilize it into a place everyone is proud to call their own. When the time comes for patients to seek care, we like to be the ones they remember.
Meet the Crew
It says Premier Heights on the circular road into Alivation—a remnant of a time before now. Emails still come in addressed to Premier Psychiatric, as do letters or phone calls and the like, and if you search Google you can find reviews for a clinic that technically doesn’t exist anymore. They’re all told the same thing: it’s Alivation now. The facility changed up, rebranded and expanded in 2017 to become what it is today.
There’s no brainchild without the brain, and this facility leapt from Dr. Walt Duffy’s. He founded Premier Psychiatric in 1998, and since then it’s grown exponentially. His family is on staff: wife Rosalie is an office assistant, and their children Will and Matt can be found plugging away in offices in the ground level, in offices adjacent to the IT department, across the hall from the CEO, and only a hall-walk from People Resources.
The building is new, and the walls need more artwork as a result. It can be easy to get lost, as everything looks alike at the moment. Kylie Ensrud, the People Person (HR), has been tasked with finding wall art to decorate, and she has her work cut out for her. Everywhere are signs the facility is young, but as the Duffy’s have learned over the years, growth can be sudden, unexpected. Blink and change will happen.
Alivation is made up of three entities: Alivation Health, the clinical services, Alivation Research, and Alivation Pharmacy. They all work together, distinct LLCs but synchronized and integrated. If you walk down the halls you see their staffs interacting all the time, holding doors for each other or patients, having lunch together in the shared breakroom, or maybe just laughing as friends. There is structure but not hierarchy. Dr. Duffy, always busy with patients, is a frequent sight roaming the halls, on missions. Need a chair or a desk from storage? Rosalie can hook you up.
Alivation’s motto is “Next Level You”, but there is less sloganeering than you might think for a newly-minted outpatient facility. All the staff live by that motto here, but autonomy is prized, the ability to do your job to the best of your abilities and set your own loads or schedules. That’s more than sufficient, so dedicated are the staff to their duties. It makes inspiring hope and creating new possibilities that much easier. That sort of atmosphere, one of independence and ability, flows from CEO Trevor Bullock. He believes in it, and it makes others believe in it, too.
Given this burgeoning culture and the changes associated with rebranding, the difficulties of all those name and stationery changes, the question becomes why do it at all? The biggest reason is the kind of problem that’s good to have: success. Premier Psychiatric proved wildly successful in its almost twenty years of life. Purchasing new facilities and starting research and pharmacy divisions was a natural outgrowth of this success and was a way to cater to patients directly and do everything in-house. We just prefer control—it makes for better service. You can receive a script from a doctor and have it filled just a few feet away. The old problems of driving across town for separate but interconnected services do not exist in Alivation.
The research division is one of those fascinating places filled with quiet people always thinking. If you ask them, they’ll tell you what they’re up to, what they’re interested in, and what other facilities across the world are doing. If you press them, they’ll be happy to go into great detail about their research and will subtly reveal the great passions that drive that sort of thinking for tomorrow’s world. There is both an urgency and an excitement that permeates the talk. You won’t escape without learning something new.
One of the outright cooler features of the facility is the use of dry erase walls. Most offices, and the main conference room, employ this system. It is simply a wall painted with dry erase board material, and it matches the rest of the room you’re in—you don’t even notice or think anything of it until someone uncaps a dry erase marker and begins graffitiing their thoughts, or drawing charts, or listing facts and information right on the wall. Staff often leave humorous messages in other peoples’ offices (that might be the best perk of the system). It’s much more convenient than conventional dry erase or chalk boards and allows the free flow of thoughts from people who have many of them a day. There is no time to be limited in expression.
All these facets brought together form Alivation as more than just a clinic, or even a company—it’s an idea. The idea of doing better, of not being afraid to trip over your own feet running to the exciting future. It’s a facility driven by passion, which has carried over from the Premier Psychiatric days, and everyone who works here shares that sort of vision and believes that the betterment and increased wellbeing of people will be developed and implemented by people. Like the company, these things are intertwined perpetually, and they work in tandem. It’s right there in the name: Alive + Innovation = Alivation.