KEVIN BROWETT – CEO OF THE MICHIGAN INSTITUTE FOR NEUROLOGICAL DISORDERS AND LAUREN AYMEN, DO, MS – DIRECTOR OF HEADACHE MEDICINE AT THE MICHIGAN INSTITUTE FOR NEUROLOGICAL DISORDERS IN FARMINGTON HILLS, MICHIGAN

Neurological disorders are a constant trial for the people who suffer from them. Good thing modern medicine is making inroads to helping solve these health issues. Jordan Levin is joined in this great conversation by Kevin Browett, the CEO of the Michigan Institute for Neurological Disorders and Lauren Aymen, DO, MS, the Director of Headache Medicine at the Michigan Institute for Neurological Disorders. They talk about providing relief for people suffering from neurological conditions, and the medical techniques they use. Kevin discusses plans to expand their practice by opening more sites, and improving access to care. Laura also discusses the osteopathic approach to treating neurological disorders.

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KEVIN BROWETT – CEO OF THE MICHIGAN INSTITUTE FOR NEUROLOGICAL DISORDERS AND LAUREN AYMEN, DO, MS – DIRECTOR OF HEADACHE MEDICINE AT THE MICHIGAN INSTITUTE FOR NEUROLOGICAL DISORDERS IN FARMINGTON HILLS, MICHIGAN

I am here with Kevin Browett who is the CEO of Michigan Institute for Neurological Disorders or MIND. Kevin’s innovative and creative leadership skills are key in helping MIND continue to provide the most comprehensive diagnostic, therapeutic and supportive services to patients and their families affected with neurological conditions of the brain, spine or nervous system. We also have Dr. Lauren Aymen from MIND as well, tuning in. She is a Doctor of Osteopathic Medicine. They are both certified in neurology. Thank you for both joining me.

Thank you, Jordan. It’s a pleasure to be here.

Thanks for asking me. I’m honored.

Correct me if I’m wrong, a regular MD or Medical Doctor treats just the symptoms. Whereas a DO or Doctor of Osteopathic Medicine treats the whole patient often needing preventative care. Is that correct?

Correct.

What is it about this type of medicine that calls you as well as neurology?

Osteopathy or osteopathic medicine is the idea that it’s not just medications that can treat the patient. You have to look at the whole picture, what are the patient’s resources that are available to them, are there any ways that they can improve their quality of life to help whatever their ailment is. It’s looking at the whole picture and not just looking at the disease and treating the symptoms. For what I do, which is specializing in headache medicine at MIND, we try to take all that into account when looking at the patient. Are there supplements that can help? Are there things that they can change about their lifestyle that could improve their headaches, as well as medications and things that they might need to have an overall better quality of life?

I find that a lot of times, doctors tend to be too quick to prescribe medicine based on the symptoms that the person told them that they are having. That can be correct but a lot of times, it’s always underlying issues. How do you go about a little bit more detail analyzing that situation?

The majority of the patients that I see are in their prime years of life, they are young, vibrant, and high functioning and these headaches are taking a toll on them. If I think about myself who is young, vibrant, want to be active and successful, I don’t want to be on medications that are going to make me feel awful. I always keep that in mind when I’m seeing these patients. I try to, when I meet them, look at their overall lifestyle. Is there anything that they could do to optimize their success as well as procedures? We do a lot of procedures at MIND that are not available at other institutions to help with migraines or other headache disorders. A procedure is nice because you come in and you get it done. It may need to be repeated as scheduled but it allows the patient to do better without taking a tablet every day.

Once they start doing better and the headache is lessened, then they can exercise more, sleep better and also, touch base on other issues that are probably affecting their headache. I always try to stay away from medications. I tell every patient, “My goal is if we can get you doing better on as few medications as possible, that’s what I want.” Some cases are refractory and more severe and they do require medication management. If that’s the case, we try to do as little as possible and get them off the medications as soon as they respond. Less is more. This is chronic relapsing condition with a headache disorder. It’s going to be lifelong management but we always try to minimize treatment as much as possible.

When I’m thinking about that, I’m thinking of myself. As somebody like me, I take a certain medication and I’m so used to taking that medication. I will be scared to pull myself off of that medication. I would assume that I have to put my trust in you that you have done the research understanding my health history over the years of what I have done to be able to make that assessment and allow me to be able to win myself off of a bit of medication.

Osteopathy is the idea that it’s not just medications that can treat the patient. You really have to look at the whole picture.

You’ve got to partner with your patients and they do need to trust you. It can be daunting when you meet somebody for the first time. If I’m changing a lot of things up in what they are used to, sometimes they look at me and they are like, “I don’t know if I want to do all this.” I will say, “The definition of insanity is doing the same thing. We need to change some things up and it’s the only way we are going to get you doing better.” If they put a touch of their trust in me and they see that they are heading in the right direction, we can usually get them there. That’s what makes my job rewarding. That’s what I like to do, is a partner with patients and go on this journey with them trying to get their quality of life better.

Let’s talk about the pandemic for a little bit. There are so many different types of neurological disorders like Parkinson’s, Alzheimer’s, MS and epilepsy to name a few. During the pandemic, did you notice any influx of migraine, tension and cluster headaches? Would it be due to human fatigue? Would you talk to the audience and explain what to look out for when a headache should be cause for concern?

During the pandemic, it was tough because a lot of my headache patients didn’t have access to certain treatments that they were used to, whether it was infusion therapies or procedures that they would have to come in person for. Even though mine was only closed for a short time, that made a significant difference for patients. Also, they were forced into situations that we would never want patients with headache disorders to be in, which is home and not exercising as they would be. Food was hard to come by and then they are forced at a computer screen for hours on end in this forward flex hunched position.

I was seeing what I would call tech neck. This pain in the neck would radiate off the back of the head and create this almost secondary headache. That was hard. I’m virtually having these encounters with people and they are describing this phenomenon to me. What they would do best would be something like physical therapy or even some type of injections, which they couldn’t do because physical therapy centers were shut down. It was tough. Since the world is starting to get back to more in-person encounters, people are doing a lot better but headache patients had a lot of hardships in 2020 for sure.

I would think that the instruction would be something about blue light glasses to make sure that we are protecting ourselves. I only say that because my father is an eye doctor so he has been adamant about making sure that I wear it when I’m on a computer.

More of my patients had glasses on during my virtual encounters and I would say, “Are those blue light blocking lenses?” They would say, “Yes.” They are motivated patients. They know what they need for these headaches but it was sad because it was hard to do what I do, which is to try to give them tools in their life to improve when you have all these restrictions. It was frustrating but we’ve gotten through it and people are back on track now.

I have a follow-up question to that. You mentioned something about physical therapy. I am a big proponent of physical therapy. Whenever we have clients who have an ailment issue going on, I always say, “Go get a few consultations to see what’s going on.” I have noticed that especially when I’m on my computer, I’ve got my shoulder going forward. My head will hurt more during the day because I need to remind myself to pull the shoulder back to get myself in the proper position. When I do that, the headache goes away. When you say mind, it’s not just up here but it is also the physical component of making sure that you are in the proper position, including sitting, walking and any of that stuff. How do you deal with that in terms of if you notice anything although they are not against it? That is what I’m saying.

When I assess a patient with a headache, we know that headache disorder starts centrally in the brain but it also spread to periphery parts of the brain. When I say periphery, we are talking about the base of the neck and the shoulders, as well as in front of the ears and above the eyes. Those are all periphery nerves that are also involved with migraines. When I meet somebody with a headache disorder, let’s say migraine, for example, because it’s so common, right off, I can see their posture. If they are sitting forward flexed and hunched, we are taking a look at their neck.

A lot of people, especially during 2020, were clenching. A lot of jaw tightness was triggering. Often when I discuss physical therapy, it’s for things like musculoskeletal issues associated with the headache like you mentioned, Jordan. Holding the shoulders back, pushing the shoulder blades together, reminding yourself to do that. Physical therapy is a great reminder a couple of times a week to do that. I would refer a lot to craniosacral therapy because they not only look at the base of the skull but they will also look at the spine alignment and the muscles that transcend the entire spine. We will get patients by just physical therapy. Even though they still have migraines, there’s no cure, it’s a chronic condition. That piece of it being that muscle-skeletal component will be significantly better and then their headaches will be a lot less, too, and then more responsive to treatment. It’s something I consider on every single patient and it has been much worse in 2021 for sure.

I’m looking at it. It’s crazy. For me, I would be doing a show. Typically, I would do a phone call. I would use my computer to caption the talking. Now I just say, “I should do a quick Zoom call.” I’m on Zoom a lot more than I ever was. When I get done at the end of the day, I’m like, “I’ve got to get outside. I’ve got to walk and stretch out.” It’s a common theme. Hopefully, that will change soon. Cases are going back up in Michigan so who knows what’s going to happen with this pandemic?

Jordan, one of the things that Dr. Aymen also can share with you is because of the mind structure, there are a lot of tools in-house that she’s able to access for a patient. She can speak to this. When she’s doing her assessments, if she does feel there’s something else that she needs to check on, she can send a patient to our MRI facilities that are in-house because we have two open MRIs. She can have an EMG done or she could do it herself just to check. Those are a few of the tools that we have right inside the building that the doctors can all access and use to help patients to make sure there’s nothing else going on.

Neurological Disorders: We know that headache disorders start centrally in the brain, but they also spread to peripheral parts of the brain.

Patients appreciate the fact that if I am concerned about other things, MRIs, EMGs, EEGs and bloodwork can all be done in-house. If they do need an infusion of some sort depending on what their issue is, we have an infusion center. They are out of the hospital for that. They are here in our building. With pandemic, people like that, and then also procedures. Botox would be an example and other peripheral nerve blocks, and then there’s a procedure called a SphenoCath or an SPG block, which is not done at many centers but we do it here. Several of our providers are doing it.

For my own patients, all those procedures, I do myself so it’s not like I’m sending them out to other providers that they are not familiar with. It is nice to have it as a one-stop shop. That’s why I want to improve access for patients because when they see a neurologist, and then they have to get sent out for a lot of difference either diagnostics or treatments and infusions, it gets confusing and it gets hard. Continuity gets lost a little bit in the mix. It’s nice to have it all on-site. I know Kevin has done a great job bringing that all together, too.

Do you work with patients with ADHD or any type of learning disabilities in coalition with the neurological aspect? I’m curious.

A lot of our neurologists here, not me personally, do treat people with either ADHD or other types of specified learning disabilities. We used to have pediatrics here and a lot of those patients have stayed on with the adult neurologists. We see patients with all kinds of cognitive disorders from young ages up to patients that are struggling with different forms of dementia. It’s a great place for those patients because the diagnostics are here and it minimizes the confusion and the travel time. Better continuity.

Kevin, you have had major experiences in startup companies. You have been the CEO of several companies. You have helped turn companies around and take them from excellent to outstanding. What do you think your superhero ability is that makes you so unique?

When the MIND opportunity came along, I was excited because being able to take a great company to what I call an elite status, which is where MIND is headed, it already had been here for several years. It already had this amazing team of doctors that are nationally known. It has the largest neurological practice here in Michigan and probably the Midwest in reality. The goal was how do we take and put the whole process together and expand itself. We have a Dearborn and a Madison Heights location, the Farmington Hills core, the hub of the business has all these services built inside of it. We are opening a brand-new location in Roseville in the summer of 2021.

We will take and expand this same model into what we will call Mini MIND so that we can have other locations that replicate what the Farmington Hills location does over and over again. You could go to Roseville and you could see a neurologist, and have an infusion done, an EMG or an EKG, but then we will also have a mobile MRI so you can get the MRI done there as well. It’s taking what’s great here, taking and making it a leap by expanding and being able to help more patients. I saw it as a huge opportunity to help more people.

Dr. Aymen is a good example. When you listen to her talk about how she cares about her patients and what a difference it makes, she’s not talking about just, “I get to do this procedure and that procedure.” She’s talking about, “I see the difference in that patient’s life after I see that. That’s why I do what I do.” That’s what gave me the passion to be here, is working with physicians. Their role is the healthcare of their patients and the betterment of that patient. You will see us expand all through Michigan, into the Midwest and ultimately, we will be re-player in neurology in the United States with the best doctors. We already have the best doctors. We just need a lot more locations.

When I think of that, I think of myself. To me, it’s all about if I can help one person a day, I’m happy. In this case, you are talking about a wide range of people because what I’m getting from both of you is it’s about education. If you can educate your patients to understand what’s going on with the premium package with things like solving a problem, how both of you are solving a problem to be able to get to the root of the cause and then taking through those steps. In the end, all they need is this one little blind spot with a patient for the company to be able to see, “All you have to do is one little thing and it will make a difference.”

When you see someone that’s suffering from a migraine, headache and how it destroys their day, their relationship with their family, their work relationship or someone that comes in with back pain and they can’t function, their whole attitude is down, whether it’s headache or back pain. They then will see someone like Dr. Aymen here and she’s able to understand what’s causing it, treat it and reassure them that maybe it’s not something worse and that it is treatable. They can walk out within an hour and see a significant change in their life, it does change their whole life, their family’s life, and everything about what they do so it’s amazing. What Dr. Aymen does and the other doctors are life-changing.

How many doctors you guys have in the Farmington Hills office?

You really have to partner with your patients and they really need to trust you.

The doctors do rotate from the other sites, normally we have somewhere around 18 to 20 doctors here in the Farmington site. When you go to the other sites, you may find anywhere from 2 to 6 doctors depending on the day of the week because the doctors do rotate through some of the hospitals as well to see patients.

Lauren, how did you arrive at MIND?

I trained in my residency with the providers that are here now. I did my neurology residency through the St John System. It was under Dr. Belkin and Dr. Ellenbogen who are the providers here. When I graduated, I was passionate about headaches and chronic pain so I did my fellowship at the University of Michigan. I did work there for a short time, gaining some experience. It was a great opportunity to learn and see some challenging cases but my heart was in private practice. The biggest issue I saw with where I was, was access to care. That’s everywhere. Especially with chronic pain. Pain is such a common issue. There are so many pain providers. Especially if you look at headaches, there are not that many headache providers nationally.

People with headache disorders are waiting a year to be seen and that didn’t make sense to me. You can’t sit there in pain. I looked at MIND as a possible opportunity to try to build a center that gave these cutting-edge treatments and I could offer them to patients with better access. They could get in and everything is in-house, get their problems taken care of and get them on the right road to recovery without having to wait for a year or more, which is terrible. That’s what my goal is here. Setting up this headache center, getting people doing better, and also educating them on what they have and how to make it better.

I like the concept of having as much as you can under one roof. What comes to mind to me is the doctor that you are working with on this facility, you know that you could trust them and they are going to do the best they can to help you and all the other doctors to be able to solve an issue with one person. If you have one patient and you’ve got all these different groups of people on that to be able to help, that’s a powerful thing. When a newbie or potential patient will come in, that puts me at ease a little bit knowing that I’m under one roof to have that access.

The nice thing here is I know I specialize in headaches but there are a lot of other providers here that specialize in different areas like multiple sclerosis or movement disorders. If I have a person and I am concerned that they could be having symptoms of MS or Multiple Sclerosis, I can send them to another provider here that specializes in it. There’s good communication between the doctors. I see everything that’s going on with their treatments. They can get their treatments in-house. It does make it convenient for the patients.

I know and trust all the doctors here so I understand where they are coming from with their decisions. That can help educate that patient, too, on why certain providers are making those choices. It’s nice. The physicians here have somewhat of a family feel where we have all known each other and work well together, where you don’t always get that in a bigger center. I have enjoyed working here and I look forward to what lies ahead.

It is a team, to Dr. Aymen’s point. They leverage off of each other. If Lauren needed someone, she would be able to reach out to half a dozen other doctors here in-house and have a consultation with them within a few minutes. That helps for that whole patient care lifecycle to cover all your bases. I have had this personal experience with a daughter that’s a gymnast where it took six months to get one doctor to another doctor to another service. When I brought my daughter here, she saw two doctors, a radiologist, got an MRI and headed out the door all in less than 2.5 hours. It’s the way that the structure is set up and the expertise. You would never feel like you were in a big organization. You feel like this was your local town doctor caring about you. It’s an amazing environment.

I’m glad you said that because when I go to the doctor, they always say, “I’ve got to go see XYZ.” You call them, make an appointment and you find out you’ve got to wait for two months. In pain or whatever’s going on, we can check on other doctors and you will find out the same thing. As you know in the medical field, it’s always up to me to go to a certain doctor. We say about the first appointment after lunch or the first appointment after morning because I know I would not going to have to wait. As you know, everybody waits for the doctor. It sounds like you have combined this system where you know when you get somebody in, they would be able to welcome you and I. That’s rather best.

The other thing that’s nice about here, which people don’t think about is if Dr. Aymen saw a patient and they needed to get tested, we go ahead and contact the insurance company. We get the authorizations. We take care of everything. A lot of worry about like, “Is this going to be covered? Do I have to get authorization from my insurance company to go get an MRI?” We have already taken care of it. We have done it internally so that the doctors can focus on seeing the patient, caring for the patient and not worry about everything else. The patient can leave not worried about what’s going to happen at that point.

You said you want to be able to open up Mini MIND, is that by the end of ‘22 or you are looking like 2022, ‘23, ‘24, ‘25 to be able to do this?

Neurological Disorders: The world is starting to get back to more in-person encounters. People are doing a lot better, but headache patients really had a lot of hardships in 2020.

The expectation is that we will have Roseville open up as the first Mini MIND in July 2021, and then probably before the end of 2021, there will be another on the South of us. In 2022, I would expect somewhere in the neighborhood of 4 to 6 locations. Most of those would probably still be in Michigan. We may start to see us open down into Ohio as we expand our reach going forward 5,000 to 6,000 square feet.

I have one question for both of you and my question will sum it up a little bit. What I find is important to understand is everybody has different ways of recalibrating, whether it’s yoga, meditation or whatever it is. Kevin, what do you tap into daily that allows you to reset and recalibrate? Of all the things you have going on, how do you get yourself back?

That was easy for me. Every morning, I get up at 3:00 AM and I go down and I work out from 4:00 to 6:30. I have done it my entire life because I love to work out. One, it’s quiet. It allows me to stay healthy and get focused. When I’m done with a busy day, the other thing that recalibrates is my family. I like to have quality family time. I want to shut off at the end of the day and spend time with them. That’s how I do it.

You get up at 3:00 AM. I get up at 4:00 AM. How about you, Lauren?

You guys are making me feel bad because I get up at 5:00. I have two young daughters at home so I’m not going to bed until 2:00 AM. I get up at 5:00 and I’m a big runner. I enjoy running. I have a treadmill downstairs in my basement. I get up and I will do a 5K or something to start my day. That gets me ready and clears my mind. I enjoy exercise and being healthy but for me, it’s almost the mental serenity of getting ready to start a new day. At the end of the day, I’m all ready to hang out with my family and enjoy my evening.

The last question for both of you, we will start with Lauren, what brings you joy?

I feel blessed. I love my job and I don’t know that a lot of people can say that all the time. I wake up every day and I don’t know who I’m going to see and meet, and the types of headaches I’m going to deal with. I love what I do. I have a wonderful husband and two loving daughters. It’s a full family so I’m happy and blessed. Doing what I do every day brings me joy. Helping people get their quality of life back, seeing mine to be successful, and see more access for patients with headaches is going to compound all of that.

What about you, Kevin?

For me, it rides right on Lauren’s comments. It’s seeing that you are making a difference. I say that because I want my wife and my children to look at me and say I don’t go to a job. What I do helps people have a better quality of life. If I do my job well, it allows Dr. Aymen to do her job even better and allows more of the doctors to do more. I see that as my purpose of helping people.

What the both of you are doing now, what you are brought here to do, puts you in alignment. When you are in alignment, everything else follows. Whoever wants to go ahead, how do we get ahold of you guys, whether it’s a website, phone or email?

There are a couple of ways. Contacting us through the website. There’s a contact us and there’s an appointment scheduler on the website. You can do that. You are always welcome to call the office line, which is (248) 553-0010. You can ask to make an appointment or for one of the doctors. That’s probably the easiest way. Don’t you think, Dr. Aymen?

Neurological Disorders: If patients put a touch of their trust in their doctor and they see that they’re headed in the right direction, the doctors can usually get them there.

That would be the easiest way to get yourself set up at MIND and go from there.

If someone has a doctor and they are having issues, they can always ask their doctor to make a referral to MIND or they can call MIND directly and one of the doctors can make arrangements, whichever.

I had a blast. I hope you guys did, too.

Thank you. We appreciate the time.

Thank you so much, Jordan.

Thank you, too.

IMPORTANT LINKS:

• Michigan Institute for Neurological Disorders (MIND)
• MIND – Facebook Page
• MIND – Instagram
• MIND – LinkedIn
• Dr. Lauren Aymen
• Kevin Browett
• SphenoCath

ABOUT KEVIN BROWETT

Kevin Browett is the Chief Executive Officer of The Michigan Institute for Neurological Disorders.

Browett has extensive operations and business development experience with a wide range of industry knowledge. He has led startups, Fortune 500s, and has been a change agent when it comes to the healthcare model.

In his role as CEO, Browett is responsible for multiple locations, 25+ providers, MIND’s extensive neurology-based service lines including MRI, Infusion, Pain Management, Diagnostic testing, as well as numerous specialty centers dedicated to specific conditions like Multiple Sclerosis and Neuroimmunology Disorders, Parkinson’s Disease and Movement Disorders, Alzheimer’s Disease and Memory Disorders, and Migraine and Facial Pain conditions to name a few.

MIND is a leading neurology practice dedicated to providing the most comprehensive diagnostic, therapeutic, and supportive services to adult patients and their families affected with neurological conditions. In an effort to improve outcomes and quality of life, MIND is one of the few comprehensive private neurological facilities in the country focused on the betterment of our patients through the use of onsite, cutting edge neuro-diagnostic technology, neuro-imaging, infusion services, and medical education and Research.

Browett sits on the Cranbrook Board of Trustees and serves as a board member for Duquesne University Business School and Oakland University. Sample Career Achievements:

Strategic Vision: Evolved 77-year-old newspaper company into media group, restructuring product mix and transforming direction and profitability. Won Newspaper of Year award in 4 of 5 years.

Pioneering Startup: Founded successful pharmaceutical distribution company, pioneering enterprise-wide process automation, merchandise mix, staffing, and store layout later adopted by CVS/Aetna.

Business Development: Grew pharmacy startup from nothing to 17 stores, 300 staff, and $30M in sales within 24 months. Built entire Peoples Drugs pharmacy operation, setting the foundation for acquisition by CVS.

Successful Turnarounds: Turned struggling Peoples home health care division into top ROI producer. Transformed Kmart pharmacy operations, growing sales from $700M to $1.6B in 18 months.

Innovative Product Development: Developed key strategic sourcing partnerships for Nutra Novus to create innovative, new products, driving sales from $17M to $32M.

M&A – Divestitures: Handled multiple mergers for CVS Pharmacy and Peoples Drugs, including acquisitions or divestitures of Rite Aid, and IMASCO.

ABOUT LAUREN AYMEN

Lauren Aymen, DO, MS, is the Director of Headache Medicine at the Michigan Institute for Neurological Disorders in Farmington Hills, Michigan.

After graduating from Michigan State University College of Osteopathic Medicine, Lauren Aymen was driven to make a difference. She started her neurology residency through Ascension Health at St John Hospital, treating patients with complex neurological disorders. She quickly gravitated toward patients living with chronic headaches and facial pain conditions as she saw an opportunity to improve their overall quality of life. She was inspired by their strength, motivation to get better, and willingness to try different treatment options. She saw several patients suffer in silence because their pain was poorly understood, treatment options seemed limited and access to care remained a barrier. She pursued fellowship training in headache medicine at the University of Michigan’s Headache and Neuropathic pain clinic.

After gaining the necessary experience, she saw a unique opportunity at the MIND clinic to develop a headache center that would improve access to care for patients while combining state-of-the-art technology and cutting-edge resources all under one roof. She is now the director of headache medicine at the MIND clinic and she has never looked back. Aymen is board certified in both adult neurology and headache medicine. She is currently the Director of the Headache and Facial Pain Clinic at the Michigan Institute for Neurological Disorders. Her practice specializes in the management of all head and facial pain conditions.

To schedule an appointment with Dr. Lauren Aymen, contact:
MIND 248-553-0010.
Director of Headache Medicine
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