"When patients tell me they feel 100% for the first time in years—restored, clear-headed and free of medication side effects” — Osmind is excited to welcome Martha B. Koo, MD, FASAM, LFAPA, FCTMSS, as a Medical Advisor.

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Martha Koo, MD, is a pioneer in transcranial magnetic stimulation (TMS) therapy, having opened one of the first outpatient TMS centers in 2009. As a founding member of the Clinical TMS Society and Immediate Past President, she has helped establish the standards and practices that define modern neuromodulation treatment. She founded and leads Neuro Wellness Spa, an eleven-location interventional psychiatry practice across greater Los Angeles, and serves on the clinical advisory boards for Optum and Magellan.

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In her own words:

Why I Became a Pioneer in TMS—and Why I Joined Osmind

By Martha B. Koo, MD

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I'm Dr. Martha Koo, a psychiatrist who has spent the last 15 years helping patients experience something I rarely saw during my early psychiatric career in traditional psychiatry: complete recovery from depression.

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When I opened one of the first outpatient TMS centers in 2009, colleagues told me I was taking a big risk. TMS was new, insurance coverage was limited, and most psychiatrists were skeptical. But I had seen something that changed everything—patients who had failed multiple medications and psychotherapy suddenly telling me they felt "100% for the first time in years." That's not language you hear often in psychiatry. We're used to patients telling us they feel "better" or "less depressed." But TMS showed me what full remission actually looks like.

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The Problem with "Good Enough" Psychiatry

Here's what bothers me about how we practice psychiatry: we've become comfortable with partial responses. A patient comes in severely depressed, we try medication after medication, and if their symptoms improve by 50%, we call it success. We've accepted the idea that mental illness means you’ll walk through life with a chronic illness, always feeling somewhat diminished.

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Other medical specialties would never accept this standard. If someone comes in with severe hypertension and diabetes, we don't give them half-strength antihypertensives and antihyperglycemics, partially reduce their blood pressure and sugar, and allow them to continue in life suffering progressive heart damage, hoping for the best. In psychiatry, we routinely start with medications that only have a 30% remission rate when treatments like TMS can achieve so much more.

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My Journey into Interventional Psychiatry

My path to TMS wasn't planned. When I completed my residency training, TMS as a therapy for depression didn’t even exist. I have always been extremely interested in the mind and the brain, in psychology and neuroscience—what makes us think and feel how we do about ourselves and the world around us. I received stellar biological psychiatry training at UCLA, but I wanted more in-depth learning about human development and psychology. I continued practicing interventional psychiatry at UCLA, offering electro-convulsive therapy (ECT), while simultaneously completing my training in psychoanalysis and opening a private practice.

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I had been practicing traditional psychiatry for years—medication and psychotherapy—the standard approach. I believed I was doing good work, but I was also seeing many patients who weren't getting completely better, or who were getting some symptom relief along with burdensome medication side effects.

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When I first learned about the opportunity to offer patients TMS, I jumped on it. The idea of using magnetic stimulation to effectively treat depression, like using electrical stimulation but without the need for anesthesia and cognitive side effects, was something colleagues and I had discussed when I was at UCLA. The first TMS device was offered to private clinicians in October 2008, and I opened the South Bay TMS Center in April 2009, waiting the six months required for Neuronetics to build and deliver my device.

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That decision completely altered my career trajectory. And I remember the precise moment that changed everything. It was witnessing my first TMS patient complete treatment. She had been struggling with depression for over a decade. We had tried every medication combination imaginable, and she had been committed to psychotherapy. She was functional, and possessed a lot of insight and self-awareness, but she was never truly well. After only two weeks of TMS therapy, I saw the sparkle in her eyes. After her TMS series, she came into my office and said something I'll never forget: "Dr. Koo, I feel like myself again, better than ever—actually, I feel 100%." That's when I knew TMS wasn't just another treatment option.

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Building Something Different

South Bay TMS Center eventually evolved into Neuro Wellness Spa, a subsidiary of Your Behavioral Health, which also includes Clear Behavioral Health and New Life House. We have over thirty locations across Southern California, offering TMS, medication management, and psychotherapy as well as virtual and in-person higher levels of care including detox, residential and intensive outpatient for teens and adults struggling with mental health and addiction.

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One thing I'm most proud of is that we are in-network with insurance. Too many treatments in psychiatry become boutique services that only wealthy patients can access. I wanted to prove you could deliver an advanced, high-quality, continuum of behavioral health care while still accepting insurance and serving a diverse patient population.

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We've integrated multiple treatment modalities to provide accessible personalized care, how and where patients need it, with the goal of complete symptom remission. Some patients need TMS. Many benefit from combining psychotherapy and medication management. Others need 24-hour supervision in a residential setting. The key is having multiple interventions available, including both biological treatments and specialized clinicians, and knowing how to use them optimally for each individual patient.

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The Future I Want to See in Psychiatry

When I think about where psychiatry needs to go, my vision is grand but achievable: we need to move our treatment algorithm sideways and then flip it upside down. Instead of waiting for symptoms, a diagnosis and then treatment, we need to prioritize prevention. I envision a world where payors cover preventative mental health treatment, we have identified the biomarkers predicting future illness, and we possess the technology to know the most effective treatment for every individual.

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In my future world, when mental illness does hit, instead of starting with less effective treatments and working our way up to more effective ones after months or years of suffering, we start with the most effective treatment for that specific patient. Insurance coverage is guaranteed without the need for failed, ineffective trials. We're moving toward precision psychiatry—using real-world data, genetic markers, and clinical presentation to match patients with the treatments most likely to work for them. This isn't about replacing medication or therapy. It's about using all our tools more intelligently.

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Why I Joined Osmind

What excites me most about Osmind is that they're building the infrastructure for the future of psychiatry I just described. Osmind goes way beyond typical EHR systems. Their platform and team handles everything from practice management to billing services, plus they're capturing real-world outcomes data that's extremely valuable. This data will help us understand which patients respond best to which interventions.

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I've spent years advocating for better access to effective treatments through my work with the Clinical TMS Society, the Beach Cities Health District, and other organizations. Individual advocacy only goes so far. We need systems that make it easier for clinicians to deliver evidence-based care and we need researchers to understand what's actually working in real-world clinical settings. I am so excited to be collaborating with a team of brilliant minds and thought leaders.

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The Most Exciting Time in Psychiatry History

I've been practicing psychiatry for over 30 years, and I've never been more optimistic about our field. We finally have treatments that can achieve full remission for conditions that were previously considered chronic and treatment resistant: TMS, vagus nerve stimulation, deep brain stimulation, ketamine, psychedelic-assisted therapy, pharmacogenetics. We’re also witnessing a push to make treatment more accessible and powerful- with portable devices, accelerated protocols, and the addition of mechanisms to enhance neuroplasticity. We're seeing breakthroughs that are transforming lives on a scale I never could have imagined in the early 1990’s.

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Having effective treatments isn't enough. We need to focus on preventative care and early intervention. We need systems to identify those at risk or already suffering and deliver care efficiently. We need data to evaluate and optimize our interventions continuously. And we need platforms like Osmind that support clinicians who want to offer their patients the best possible care.

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That's why I'm excited to be working with Osmind. Together, we can speed up the adoption of these breakthrough treatments and build the evidence base that will make precision psychiatry a reality.

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For the first time in my career, I am confident we're going to get there.