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Dr. Robert Fallis, Saint Thomas Health Services Center for Multiple Sclerosis

Because of his participation in the local chapter of the National Multiple Sclerosis Society, a Nashville neurologist took a seat in January on the national organization’s Council of Clinical Advisory Chairs.

Dr. Robert Fallis, medical director of the Saint Thomas Health Services Center for Multiple Sclerosis, is Clinical Advisory Committee chairman of the Mid South Chapter and joins 14 other local chairs on the new national committee designed “to try to ensure quality clinical care for patients with multiple sclerosis all through the country. It allows the National MS Society to have an impact on quality care from the local level,” Fallis explained.

Fallis was quick to point out that the committee, as its name implies, is strictly advisory in nature and doesn’t interfere with clinical management, though the committee members do include not only neurologists, but also physical therapists, psychologists, psychiatrists and other health professionals. The committee offers “a day-to-day, in-the-trench perspective about what the MS patient actually needs,” Fallis said. He described the committee as “the avenue through which the MS Society works to ensure that all aspects of clinical care can be driven to a high level, and the actual practicing physicians who deal with these patients have a reference level and some guidelines that they can look back to to give them ideas of what the patients need and what the current standard of care would be.”

The committee encourages a partnership between the MS Society and healthcare professionals and advises and critiques content and training curricula at the national level. “Also we’ll be able to bring a perspective to the national level in terms of how the healthcare system is responding in terms of insurance and third-party payers,” Fallis added.

Thanks to the National MS Society and the work of its local chapters to raise money for needed research, Fallis said strides have been made in the disease’s treatment, and he pointed to two advances in particular. The first is the slow-but-sure introduction of a new group of medications called monoclonal antibodies.

“They are phenomenally effective; they do have some side effects, as all drugs do, yet they are very strong and good medications. That’s a real plus,” Fallis said.

According to the MS Information Sourcebook, published by the National MS Society, monoclonal antibodies react with immune cells by stopping their activity. This would be positive for treating MS, according to the Sourcebook, “because an abnormal immune response is believed to be responsible for the destruction of myelin that occurs in the disease. Myelin is the fatty sheath that surrounds and protects nerve fibers. Its destruction causes nerve impulses to be slowed or halted and produces the symptoms of MS.” Monoclonal antibodies are produced by injecting an animal with a specific antigen, thereby inducing a correspondingly specific antibody response by the animal’s immune cells.

The second advancement that Fallis hailed is the “tremendous amount” of research being conducted with nonconventional magnetic resonance imaging (MRI). These new MRI techniques help neurologists reach a much earlier diagnosis that wouldn’t be identified with conventional MRI. “Areas that you would never suspect to be damaged or involved are involved,” he said. “At the end of the day, what’s so important with this disease is that we want to have our patients diagnosed as early as possible and placed on a preventive medicine as soon as possible. All evidence points to the fact that the earlier they are put on medication, the more effective the medication is and the better the outcome for the patient.”

The STHS Center for Multiple Sclerosis, founded last year, is a collaboration of four neurologists at three sites. Fallis said one of the center’s accomplishments is a common database to track patients’ clinical parameters. “That’s a big step forward,” he said.



March 2008

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