April 16, 2024

Moving Interventional Psychiatry Forward: Dr. Rebecca Allen's Insights on Building a Thriving Multimodal Practice

Written by

Carlene MacMillan, MD

As an interventional psychiatrist at the forefront of innovative treatments for severe mental illness, Dr. Rebecca Allen is no stranger to challenging the status quo. From pioneering outpatient ECT delivery to spearheading cutting-edge psychedelic research, the president of the Clinical TMS Society is on a mission to expand access to life-changing treatments for patients who have exhausted conventional options.

Read on or listen to learn:

  • How Dr. Allen helped grow an interventional psychiatry clinic offering ECT, TMS, ketamine, and more
  • The importance of a multimodal approach in tailoring treatments to patients' unique needs
  • Her experience leading the top-enrolling site for the groundbreaking COMPASS psilocybin trial
  • Concerns about Oregon's unregulated model for psychedelic access
  • Advice for navigating insurance contracts and advocating for fair reimbursement
  • Balancing the challenges of clinical practice, research, and leadership in a rapidly evolving field

The Power of a Multimodal Approach

At Seattle NTC, Dr. Allen and her team offer an unparalleled range of interventional psychiatry treatments under one roof, including ECT, TMS, esketamine, IV ketamine, and ketamine-assisted psychotherapy. This multimodal approach allows them to precisely tailor the right treatment for each patient's unique needs.

"If you only have one treatment option, it's very hard to be completely neutral in figuring out if it's the right tool for the person in front of you," Dr. Allen explains. "You want to offer what you have so patients can access appropriate treatment in a timely manner."

Outpatient ECT: Challenging Conventions, Changing Lives

One of Seattle NTC's most noteworthy offerings is outpatient electroconvulsive therapy (ECT) through a trailblazing partnership with Swedish Hospital."Swedish provides the facilities, staff, and equipment while we provide the doctors," Dr. Allen explains. "As an independent practice, we go into Swedish to perform the treatments."

This innovative model has allowed Seattle NTC to become one of the largest outpatient ECT programs in the United States, providing life-changing treatment to those with the most severe depression. Yet Dr. Allen notes ECT still faces deep-rooted stigma and financial barriers. "The notion that psychiatrists do ECT for control or profit is totally false," she emphasizes. "ECT is extremely under-reimbursed."

Blazing Trails in Psychedelic-Assisted Therapy

On the cutting edge of psychedelic research, Seattle NTC is the #1 enrolling site worldwide for the COMPASS trial investigating psilocybin-assisted therapy for treatment-resistant depression. Rigorous safety measures are paramount, with specially trained therapists guiding patients through intense 6-8 hour dosing sessions and extensive pre- and post-treatment integration.

While excited about the potential of psychedelics, Dr. Allen sharply cautions against the unregulated model seen in Oregon's psilocybin program. "The notion that you can take a medication only tested in preliminary trials and release it for broad medical use without comprehensive safety monitoring is extremely reckless," she warns. "A flawed FDA approval system is still far better than circumventing it entirely at the state level."

Advancing the Field Through Bold Leadership at Clinical TMS Society (CTMSS)

As president of the rapidly growing Clinical TMS Society, Dr. Allen is aggressively expanding educational programming, spearheading a new scientific journal, and prioritizing diversity initiatives. Her goal is to empower clinicians to stay at the forefront of rapidly evolving research and treatment landscapes.

Juggling her intense clinical, research, and leadership responsibilities is a daily challenge. "I carve out my weekends fiercely, for my own sanity," Dr. Allen shares candidly. "Burnout is a constant threat in this field that we have to actively manage."

Advice for Trailblazing a Thriving Practice

For entrepreneurial psychiatrists looking to scale a practice, Dr. Allen advises enlisting expert help early on, from MBA consultants to contract law specialists. "We've grown tremendously by proactively seizing opportunities, but in hindsight, expert guidance from the start could've made the journey smoother."

When it comes to navigating insurance contracts, she cautions against accepting unfairly low reimbursement rates that become a permanent anchor. "Hire skilled negotiators to advocate for you from day one," Dr. Allen stresses. "Reading every contract meticulously is tedious but utterly essential - everything is negotiable if you push back strategically."

A Powerful Call to Action

As the need for mental health treatment soars, we urgently need more innovative leaders like Dr. Allen who fearlessly pioneer novel interventions and redefine the boundaries of psychiatric care delivery. Her insights provide a roadmap for psychiatrists striving to expand access, improve outcomes, and build thriving practices that transform lives.

By collaborating to advance science, share knowledge, and reimagine systems of care, today's psychiatrists can rise to the profound challenges before us and shape a brighter future for the countless patients who are desperately counting on us.

About Dr. Allen: Dr. Rebecca Allen is an interventional psychiatrist and the President of the Clinical TMS Society. She earned her MD and MPH from OHSU, completed her residency at Harvard University, and fellowships at Harvard University and Brigham and Women’s Hospital.

As Director of Neuropsychiatry and Research at Seattle Neuropsychiatric Treatment Center, she oversees clinical trials of novel therapies. She has held local and national leadership positions, including serving as a Member of the Board of the Clinical TMS Society, as chair of the Insurance Committee of the Clinical TMS Society, as the President of the Clinical TMS Society for 2022-23, and as the President of the Washington State Psychiatric Association for 2020-21.

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