SERVICES
Clinical Consultation
A clinical consultation begins with a two-hour appointment. A clinical consultation is a thorough review of your symptoms and concerns; medical, neurologic, and psychiatric history; previous treatments; and current goals of treatment. In addition to an interview, a consultation includes a physical neurologic exam, if indicated, as well as neuropsychiatric assessments as appropriate.
This face-to-face appointment is followed by approximately four hours of additional clinical work done by Dr. Maloy. This post-appointment work includes a combination of medical record review, obtaining any other information that is clinically necessary, developing a comprehensive case formulation, and writing a detailed consultation report.
Thus, a consultation typically requires six hours of work. Every patient is different and Dr. Maloy’s goal is to give each person the attention they require in order to achieve the best possible assessment. The duration of a consultation can vary based on clinical complexity and other factors. Sometimes a consultation takes more than six hours; rarely, a consultation can take less than six hours. A second appointment may be needed to gather more information or to review the results of the consultation.
The goal of a consultation is to achieve a comprehensive diagnostic understanding of your clinical situation.
You may choose to receive a consultation as a one-time event to help inform your primary clinical team or you may undergo a consultation as the first step of a longer-term patient with Dr. Maloy. The consultation allows Dr. Maloy to determine whether she might be the appropriate physician to provide treatment.
Follow-up Visits and Ongoing Care
If the consultation suggests that ongoing work together may be useful to you, Dr. Maloy will offer treatment. If the consultation suggests that you may need a different expert for your specific clinical needs, she will offer recommendations on best next steps for your treatment. Alternatively, you may take the consultation report back to the referring clinician, typically your primary care practitioner, or to another practitioner on your care team, and use the information to augment your work with them.
Dr. Maloy typically spends 45-60 minutes in each follow-up appointment and then completes post-appointment work for 15-30 minutes, depending on the treatment plan. Thus the total duration of time for follow-up appointments (time with the doctor and time she i s working for you when you are with her) averages 60-90 minutes.
Each person’s clinical situation, needs, preferences, and budget are all important aspects of their well-being. The appointment experience should be one in which you feel the time is used efficiently and productively, and that there is sufficient time for your concerns to be addressed without feeling rushed.
Dr. Maloy strives to arrange all aspects of your care with her to optimize your well-being. To this end, she encourages and welcomes open conversations about what works for you and what does not work for you. This open communication is imperative in building a harmonious and productive physician-patient relationship.
HOME VISITS
For patients with significant mobility restrictions, limited transportation resources, or other demonstrated difficulty accessing care, Brain Health Maine offers house calls to your home, rehabilitation center, nursing home, or assisted living facility. These are offered on a limited, case-by-case basis and travel time is an additional fee.
Art by Vivid Vessels Art
Preventive Care Consultion
Art by Lasma Botanical Art
An explosion of cases of dementia is occurring in the United States and much of it is preventable.
The Preventive Care Consultation is a neurologic and lifestyle assessment for individuals without current impairment who want to proactively support their brain health. We explore and identify your specific personal genetic and lifestyle factors to develop specific recommendations that can most effectively protect your cognition in the years to come.
Polyvagal-informed Treatment
Art by Valeriya Vasileva
Introduced by Stephen Porges PhD in 1995, polyvagal theory (PVT) puts forth a brand new understanding of the importance of the autonomic nervous system in shaping our experiences, both physical and emotional.
Before PVT was introduced, we already knew that the autonomic nervous system (ANS) regulates the ‘automatic’ functions of the body. These include heart rate, blood pressure, respiratory rate, and digestion, and more. Our autonomic nervous system is always active and always influencing our physical and mental health.
What Porges discovered was that a second branch of the ‘rest and digest’ parasympathetic nervous system emerged more recently in our evolutionary development. This ventral vagal division - as opposed to the dorsal vagal branch - enables connect and feelings of safety with others. Activation of this social engagement system became required for the health of the organism.
Many experiences can produce a dysregulation of our autonomic nervous systems. For example, trauma, depression, and anxiety are all accompanied by changes in the baseline ANS state, and healing from them is accompanied by improved activation of the ventral vagal system and more flexibility between states.
At Brain Health Maine, we teach the principles of PVT to most patients because this information is incredibly useful for increasing self understanding and producing meaningful clinical change.
Nutrition
Giving the body the nutritional building blocks it needs to not only maintain, but also to repair, itself is required for health. And yet food choices are highly personal. No one approach works for everyone.
Dr. Maloy uses evidence-based nutritional approaches to harness nutrition as another tool for symptom reduction and health promotion. She identifies all potential treatment targets - neurologic, psychiatric, psychologic, habitual, nutritional, and others - and identifies the most pressing interventions to act on first. Nutrition may not be an urgent concern, but, nonetheless, remains an important pillar of medical care. Dr. Maloy enjoys incorporating it as one part of a larger treatment plan with patients who are interested.
Art by Elfencode
Independent Medical-Legal Expert Services
Questions regarding neurologic injuries and psychiatric illness frequently arise in medical-legal cases. The connection between neurology and psychiatry is of paramount importance in many legal situations.
Dr. Maloy is an experienced independent forensic expert witness and enjoys bringing her knowledge to inform attorneys with behavioral neurologic, psychiatric, and neuropsychiatric cases. She prioritizes attorneys’ needs to meet their deadlines and enable them to provide outstanding representation to their clients.
Whether you need an expert to review medical records and provide guidance on a case you are considering; are preparing to file; or have an active case with an impending deadline, Dr. Maloy is happy to discuss your case and see whether her expertise may be appropriate for your needs.