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Background: The quality of treatment is especially critical in the context of complex and chronic diseases such as multiple sclerosis (MS). The Brain Health Initiative, an independent international consortium of neurologists, reached a consensus on time-based quality standards prioritizing brain health-focused care for people with MS., Objectives: To gain deeper insights into the transferability of these quality standards to a specific area, we conducted a survey among MS experts across various MS centers in Germany., Methods: Participants were asked about time frames considered high standards and those currently being implemented in daily routine based on their experience., Results: The results reveal a large gap between ideal conceptions and their adaptation in the real world, mostly due to a lack of resources., Conclusions: Nevertheless, these guidelines and recommendations can be aspired to as ideals. Consensual and inclusive clinical pathways complemented by measurable quality indicators are needed to improve care and approach these ideals. Neither exists in the current management of MS., Competing Interests: Declarations Ethics approval and consent to participate Not applicable. Consent for publication Not applicable. Competing interests IV declares that she has no competing interests.KA received personal compensation from Roche, Sanofi, Novartis, Merck, Teva, and BMS for consulting or speaker service.HI received speaker honoraria from Roche and financial support for research activities from Teva, Biogen and Alexion.JH declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest.HT has no personal pecuniary interests to discluse, other than being the Secretary General of the German Multiple Sclerosis Society, Federal Association (DMSG), which recently received funding from a range of public and corporate sponsors, including G-BA, The German MS Trust, Biogen, Bristol Myers Squibb, Hexal, Merck, Novartis, Ottobock, Roche, Sanofi and Viatris.SGM declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.GG reports: In the last two years, GG has received compensation for serving as a consultant or speaker for or has received research support from Aurinia Pharmaceuticals, Biogen, BMS-Celgene, GlaxoSmithKline, Janssens/J&J, Japanese Tobacco, Merck KGaA/EMD Serono, Moderna, Novartis, Sandoz, Sanofi and Roche/Genentech.TZ reports the following: a scientific advisory board and/or consulting for Biogen, Roche, Novartis, Celgene, and Merck; compensation for serving on speakers bureaus for Roche, Novartis, Merck, Sanofi, Celgene, and Biogen; and research support from Biogen, Novartis, Merck, and Sanofi., (© 2024. The Author(s).)