We’re with Dr. David Wichman, the co-founder and chief medical officer at Freedom Behavorial Solutions. My friend, lets start at the beginning. Where are you from originally?
I was born and raised in Manhattan. I was born at the old St. Mary's Hospital back in 1977, the son of Daryl and Jan Wichman. They were both educators at Manhattan High School. My mom was head of the PE department and taught PE at Manhattan High for 30 plus years. And my father Daryl or Butch Wichman, everybody calls him Butch, was head of the math department and taught Calculus One and Calculus Two at Manhattan High for 40 some odd years. He retired, and then actually went back part-time and taught Calculus Two part-time for a long time.
That's awesome. It takes a special person to be able to teach math like that.
Oh Yeah. And he's the best math teacher I ever had. My senior year, I actually had my parents for three out of my six hours my last semester, my senior year. It was pretty cool.
Tell me about your family, you’re married and have kids.
Married to my wife Jackie. We have four very, very active kids. My daughter Lauren is 17, and then my son Ryan is 16, and then Jackson is 13, and Kingston is my youngest daughter, and she's 11.
Oh man. I bet they keep you busy!
Between dance and track and football and soccer. Yes. We are very, very busy.
So tell me about your background. What's your background that led you here?
It's a long road! <laugh> Out of high school, I went to Kansas State University and was actually a animal science and industry major.
Did you think you wanted to be a vet?
Yeah. I didn't know whether I wanted to be pre-vet or pre-med. I originally came into K State under the College of Ag and just loved the agriculture department up there. So, when I decided into my freshman year, sophomore year that I wanted to be pre-vet or pre-med, I stayed and just did animal science and industry. I loved that degree and doing that. And in
that degree was able to take enough classes to where I could qualify to go to vet school or med school.
And then around my junior year of undergrad, I decided I wanted to go to medical school. So I took the MCAT, did all that, and got accepted to University of Kansas Med Center in Kansas City. So, I went to KU Med for med school and then stuck around there and did residency in psychiatry. That was at KU Med and the Kansas City VA. My last year of residency, I was the chief resident out at the Kansas City VA. So as a fourth-year resident, I ran two inpatient units and was in charge of teaching all the residents underneath of me and running that. That was great leadership experience. Then coming out of there, I'd always been interested in coming back to Manhattan.
Well, before we get to that point, what was it about the psychology world that was appealing to you? What made you want to steer your ship towards that direction?
When I started med school, I originally came into med school thinking I was going to be a surgeon. I was going to be a surgeon or probably family practice doctor. I tell any students that are thinking about med school – “make sure you keep your options open when you go to med school.” I came in wanting to be a surgeon, or family practice. But then I got in, and you start doing all your rotations and you start doing things. I was kind of ruining the day that I had to do my psych rotations because I'd heard nothing but horror stories about psych rotations and doing that. And everybody's like, ‘you just get through 'em.’
I walked into the psych unit on day one, in the inpatient psych unit at KU Med, and got handed my three charts that were my patients and started reading about them.
I had a patient that was acutely manic and psychotic. He hadn't slept for many days and was actually crawling underneath the windows because he thought snipers were on the parking garage across the way through the windows.
This man needed some serious help!
Yes. I mean, he was very manic and psychotic, and then get more of the story and kind of everything there. He had been involuntarily committed by his wife because he was manic. We got him started back on his medications, and four days later - I was having one of the
most intelligent conversations with probably one of the most brilliant lawyers that I'd ever talked to.
Wow.
It just fascinated me that the human brain could do that. And that was the key. That was just kind of like, ‘wow, this is amazing!’ Then I just had repeat patient, after repeat patient, after repeat patient where the same things were happening. The mind is just an awesome organ. And that was where I was kind of turned on to psychiatry. Then throughout rotations I did surgery and loved surgery, too, as well. It came down to trying to figure out what I wanted to do.
I had it paired down to being a urologist versus being a psychiatrist. When I started thinking about the enjoyment of seeing patients every day, and truly feeling like you could help a patient, everything always led me back to mental health.
Because in mental health, I'm not treating just a condition. I'm not treating one bug, or I'm not treating one surgical anomaly, I'm treating the whole patient, the entire patient. It's a bigger picture. I just felt that I was able to connect more and do more for those patients in psychiatry than I ever was in surgery. And so that was a pretty easy choice when I actually started thinking about those personal feelings of good and health that you can bring towards patients.
Do you think it, in mental health, it can sometimes simply boil down to people just needing some real human connection?
Yes. I think that's it. When I teach residents, and when I teach nurse practitioners or PAs - I do a lot of lecturing around to PAs and nurse practitioner groups and everything – and that is patient connection is almost as important in psychiatry as the actual knowledge of prescribing meds. Being able to just connect with that patient and let the patient know that they're being heard. That it's validated, they're being heard. There is things that we can do to make life so much easier and to get them back to the person that they want to be, and who they know they are.
That's the most rewarding thing that you can do in psychiatry. But connection is almost as important as the actual writing of the medications and the modalities that we can use.
So tell me about your vision with Freedom Behavioral Health Solutions.
Yeah, okay.
Hold on. Wait, before we get to that - you've always wanted to come back to Manhattan, Kansas?
Yes! Even when I went to medical school, I've always loved Manhattan. Manhattan is probably one of the best communities that I know of. It's a great mix of a community. It's a smaller community, but it has everything that you need with K State here and everything. I was always thinking about coming back to Manhattan, and then when I was in my second or third year of residency, the hospital in Manhattan was looking for psychiatry, and so was Pawnee as well. And I started conversations in that second or third year of residency with some of the different entities back in Manhattan, and I signed-on at the hospital. It was Mercy Regional Behavioral Health at that time. I signed at end of my second year, third year to come back and be the medical director of behavioral health at the hospital here in Manhattan during my third year of residency.
How many years of residency are there?
There’s four years of residency.
So that was like declaring your letter of intent to play college ball as a junior in high school?
Yeah!
I knew early on that I wanted to come back to Manhattan to make Manhattan my home and raise my family in Manhattan. So, I signed pretty early on in my residency to come back to Manhattan and make it my home and practice. Manhattan is very special to me and I feel very driven about bringing the psychiatric services to Manhattan that it needs. Because it's my community.
Have you guys seen a big change in mental health post-covid?
Behavioral health has changed a tremendous amount even since I got out of residency in 2008. We have, as a society, done a very good job of working on stigma and getting rid of mental health stigma, and recognizing there is depression, and there is anxiety. You need to
treat it, and you need to talk about it. And so, the general thoughts about psychiatry have changed over the years and that has been probably one of the biggest benefits to that.
You know, the other huge barrier to psychiatry is actually being able to find that connection, and that connection in the doctor patient relationship is always important in a medical relationship. It's double or triple important in the psychiatry world. And that's where, again, I preach that connection of having that connection with the patient because it's easy to go in and tell somebody, ‘my throat hurts, or I've been coughing for a week.’ That is a relationship. But, coming in and actually laying out some of your deepest fears or some of your deepest feelings and emotions and trying to process that makes you very vulnerable as a patient. You have to be able to have that connection with your provider to be able to lay that out on the table, to be able to really, truly talk openly and freely with them to find solutions to that. And so, decreasing the stigma and kinda getting in the door is step number one. And society has done that a lot for that. But, that's where the providers have to be able to connect with their patients to really truly get at what's going on.
Which segues to the next most important question. You guys have a phenomenal staff. Tell me about your staff here at Freedom BHS.
The one thing about being in the psychiatry world for as long as I've been is I lecture nationally on many different things. Being able to travel the United States and seeing how other site clinics are run in different parts of the United States, you get a good look at other places, and you can take the good parts of all of those and try to put them into one clinic. And one of the big things that I have always been a champion of is your psychiatry clinic is only as good as your staff running it.
Amen.
The care, the empathy, and the buy-in from staff is as important as having excellent providers. We deal with things as providers every day to where if you are not happy, if you're not actually wanting to come into work every day, you can't actually treat patients well. So, especially in a behavioral health clinic, having very happy staff that gets along, that does well, is very important.
In residency, one of the first things I can still remember is Dr. (Barry) Liskow at KU Med giving this lecture about the importance of getting your own patients from up front. It was one of the things where one of the residents was like, ‘you know, why do I have to room my own patients? Why do I have to walk out and grab my own patients from the waiting room?’ You know, with internal medicine the nurse grabs them, does the vitals, and then brings them in. And Dr. Liskow at KU Med would always tells us, ‘your patient visit in a psychiatry clinic starts when they check in at the front desk.’ The front desk person needs to greet them with a smile. That interaction needs to start then. Then, your provider visit starts when you walk out to the waiting room and you call them back. That’s when your patient visit starts.
Is it because they don't think there's a barrier between you?
You and them? Yes. It basically starts on how they're interacting in the waiting room, and what their mannerisms are coming back. It's the full patient experience. It’s a little bit different that patient visit in the site clinic starts when they open the door. And that's why it's so important to have the right staff that cares that they're in the right state of mind. And the whole clinic is built off that.
That's always been my vision for psychiatry, to break down all those barriers that prevents people from coming into psychiatry and seeking help. It's a very vulnerable position for a patient to come into a site clinic and try to seek help. And so trying to cut down every single one of those barriers is by building a very open, inclusive, easy place for a patient to come.
One thing I’ve noticed about what stands out at Freedom BHS is your use of technology.
Yes.
What kind of technological advances does Freedom BHS offer?
The fascinating thing about psychiatry is that we're only in the infancy of what we could do with psychiatry. I equate psychiatry today, to where cardiology was in the 1970s or early eighties. They were just starting to figure out cardiac catheterization and doing actual procedures in cardiology. That's where psychiatry is today. I hope that I am not doing the same things in psychiatry when I retire than when I did when I started psychiatry. Because
that means we have come so far and understood so much more. To be an effective psych clinic, you have to embrace the actual technology coming out.
We’ve been able to advance in the last five to 10 years more than we have in the last 40. And that is with deep TMS therapy for treatment of major depression by using high powered electromagnets to stimulate certain areas of the brain. By use of medications like Spravato and esketamine, which are completely different pathways of treating than we have for the last 20 years with our SSRIs and monoamines. That's fully adopting therapy treatment modalities with virtual reality therapy and augmented reality therapy to help unlock those doors and break down even more of those barriers within psychiatric care. So, in terms of embracing that technology, I think to be a fully encompassing psych clinic nowadays you have to do the mainstays of med management and psychotherapy.
Those are never gonna change as your mainstays. But, being able to offer the transcranial magnetic stimulation with the esketamine/Spravato therapy with virtual reality & augmented reality psychotherapy, and combining those all under one roof and having active psychiatric management with a treatment team while you're doing those individual modalities is the way that you can actually get the best outcomes.
I was gonna ask you why come to Freedom BHS - and I think you just told me that answer!
Well my philosophy on that is simple. Other people can do TMS by itself. You can do Spravato by itself. You can do therapy by itself. We know in psychiatry - the data has been done, and it's been out there for 20, 30 years that in psychiatry - it's the combination of modalities. We know psychotherapy plus med management is always the go-to in terms of response. Part of the thing of offering some of the new tech modalities such as TMS and Spravato treatment is to use the newer technologies to get off some of the older medications or to move over and to do TMS so we can lower the medications that you're on or to get over to Spravato. So instead of being on four antidepressant medications, we can get you onto one or two and get the other ones off.
And so being able to do TMS or Spravato or virtual reality therapy in combination with the whole picture is so much more effective than doing just TMS alone or doing just Spravato alone. One of the goals of myself and Dr. Tripathi, who I teamed up again with to open this
clinic, is to have all of those services under one roof, and driven by very passionate and competent psychiatrist driving the ship to where we can have those best patient outcomes. That is kind of the goal of why we are doing what we're doing.
It's trying to make sure all of those are under one roof driven by psychiatry. Like that's where those modalities need to be.
Are y’all accepting new patients?
Yes. We are accepting new patients, and we actually don't have wait lists at this point. One of my goals for opening Freedom Behavioral Health Solutions and partnering up with Dr. Tripathi, who I used to practice with way back in the day at the hospital when we were together at the hospital for many years, was that for the community of Manhattan: If the need is there, we will build it. Our goal is to never have our wait list out past two to four weeks.
If we are getting a two to four week wait list, we are hiring more practitioners. In fact, we are actually hiring more practitioners now because we're growing. As long as the need is there, we will be hiring. And so that's our goal because when you need mental health treatments, deciding to reach out and say, ‘yes, I need help.’ - Waiting eight weeks to 12 weeks to get in for that appointment is not what you need.
So, the goal is that right now we can see immediately available appointments. The goal is that we're never getting past two to four weeks on a wait list. If we are, we are hiring more practitioners. Plain and simple.
Dr. T. is very well established in this community and in the Wichita community. With me being born and raised here, it’s about having those connections in the community and being able to recruit and bring in providers is, is one of the things that we can both excel on. One of the goals that is that we will build whatever we need to build to bring Manhattan the psych services that it needs.
When I come to Freedom BHS, do I get to see any provider I want?
Dr. Tripathi and I have practiced together for a long time and we've been friends for a long time and we do a lot of teaching to nurse practitioners. We have fostered a lot of career nurse practitioners, and one of the main goals of Dr. Tripathi and I in building Freedom
Behavioral Health Solutions is that a patient can come to Freedom Behavioral Health Solutions, and it doesn't matter if they're seeing me or they're seeing Dr. Tripathi or they're seeing Ethel, the nurse practitioner, or any of the future nurse practitioners that we're hiring. It’s that they can come to the clinic and they're collectively seeing all of us. We are building this in a way that it really doesn't matter which provider they're seeing. They get the collective knowledge and, if you build the clinic right, that patient connection is the same with all of the providers. We're not just hiring people; we're hiring the right people to build a clinic. That should be what we hope is the shining star of what a psychiatry clinic should be.
Which brings me to my last question for you. What is it that you love the most about Manhattan, Kansas?
The people, like plain and simple. It's the people of Manhattan. I travel all over the United States lecturing. I was just in Fargo, North Dakota, and I was out in Utah, and down in Texas lecturing and that stuff. I always want to come back to Manhattan, Kansas. The authenticity of the people of Manhattan is what brings me back. It's fun to go visit places, but it's always great to come back to home. The people here are wonderful, and Manhattan, again, is one of the best communities out there. It's the right size, and it's growing. It's growing right. It's growing properly, and it's the right size for the community. With Fort Riley here, with K State here, the arts we have available to the size of the town. It's the perfect combination of a city. But to boil it down, why do I love Manhattan so much? It's the people, plain and simple.
The mission of Freedom Behavioral Health Solutions is to empower individuals on their journey towards mental and emotional well-being. At Freedom Behavioral Health Solutions, they strive to Free your Mind, and allow everyone to maximize their time on this earth. Life is short—let's live it to the fullest!