SERVICES
Comprehensive clinical consultation
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. 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.
The consultation begins with a two-hour in-person appointment. This face-to-face appointment is followed by approximately four hours of additional clinical work done by Dr. Maloy, based on the time you spent together. 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 varies 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. \
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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.
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Focused Nutritional Education
Nutritional interventions are incredibly powerful, yet are sometimes an afterthought in medical care. Consequently, dementia, depression, heart disease, cancer, diabetes, and obesity occur more often than they would if adequate nutritional guidance were a part of all health interterventions.
Dr. Maloy has spent decades studying evidence-based nutrition to treat and prevent illness. She has likewise experimented, investigated, applied, and reworked this vast and complicated nutritional information into concepts and methods that make applying it more doable. Although there are many sources of nutritional information, there is no substitute to working with a physician who can address your own personal medical, behavioral, and psychologic complexities as you work to improve your health through nutritional change.
Dr. Maloy offers focused nutritional guidance as a stand-alone service for individuals and families who are interested in personalized expert guidance to optimize their health through nutrition and related behavioral changes. A comprehensive clinical consultation is not required prior to receiving this service.
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Polyvagal theory (PVT)-informed trauma therapy
In the early 1990’s scientist Stephen Porges, PhD, introduced polyvagal theory (PVT) to the world. At that time the medical community understood the autonomic nervous system (ANS) as a two-part system made up for sympathetric (fight or flight) and parsympathetic (rest and digest) systems that control the body’s automatic, unconcious functions: heart rate, blood pressure, respiratory rate, temperature regulation, digestion, etc.
With PVT, Dr. Porges demonstrated how the parasympathetic system in mammals was not just one system comprised of the vagus nerve, but was two systems - ventral and dorsal - that serve different functions and produce different associated emergent properties in the person as they inhabit them.
Deb Dana, LCSW, pioneered the clinical use of PVT in trauma therapy to counteract the ANS dysregulation caused by trauma that frequently brings depression, anxiety, disconnection, and overwhelm to survivors of trauma.
Understanding one’s own ANS is an incredibly empowering experience that gives the individual more choice and control over their daily experiences in life and, consequently, can bring opportunities for greater connection, joy, and peace.
Dr. Maloy utilizes a polyvagal-informed perspective in her work with all of her patients and also offers PVT-informed trauma therapy as a stand-alone treatment for patients who do not need her physician services in neurology and psychiatry, but instead want to focus soley on PVT-informed trauma therapy.
Forensic Medical 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 case.