Andrew Litchy, N.D.
Appearances
Health Chatter
Naturopathic Medicine
And so we tend to think about these things as much or more than just getting that number down, however you can.
Health Chatter
Naturopathic Medicine
Yeah, integration and communication between providers is always a challenge, even when you're working in the same healthcare system. And for us, since we're not in the hospitals, not in the clinics, communication is even more difficult. But we try and we do. And I frequently talk to other people's providers, their specialists about things. So we do sometimes coordinate care sometimes.
Health Chatter
Naturopathic Medicine
But I think care coordination is a challenge wherever you are, whatever kind of provider. I think of us, for people, how do we fit into their healthcare? It's a couple of ways. One, we can be thought of as another specialist on their team. And in that way, we have our, I hate to say it, but our box of things we work well with. And that is different than what the other specialists do.
Health Chatter
Naturopathic Medicine
So we're not in opposition, but we don't do the same thing. And we work together. So just... When I work with people with cancer, I don't give input on their conventional care, and we work with it to help it go as well as possible. So that's a place we integrate. Another place people will be here is in place of cancer. conventional primary care initially.
Health Chatter
Naturopathic Medicine
I always encourage people, they need to have their PCP, their relationship with it, with them. But as you said, implementing lifestyle is challenging. And it takes time. And it's not as simple as saying, oh, if only I ate better, I will, you know, there's
Health Chatter
Naturopathic Medicine
Yeah, there's, you know, even with quitting smoking, everyone who smokes these days knows they should quit every time they have a cigarette, right? But they still continue to do that. And so making lifestyle change requires a relationship. It requires helping the understanding of the secondary benefits people get from it, and really coaching and support to learn to make these changes.
Health Chatter
Naturopathic Medicine
So that that takes time. And I, by the way, I think I find that fascinating. Helping people make change is really an interesting part of what I do. And so that's, I feel fortunate we have time. I take an hour for patient visits and it can require that time over months to really get to help them make the changes they need to.
Health Chatter
Naturopathic Medicine
Well, yeah, so that's a matter of education, partially. I mean, you know, we've been using botanical medicine long before we had antibiotics. So there's a huge history of historical use of maybe the entire human history of using plants and natural methods to heal us, right? And so that's one. It's not new.
Health Chatter
Naturopathic Medicine
It's actually, we know how to do that very well when you have the traditional knowledge of it. And two, I think related, there's a concern of research and clinical guidelines for utilizing these things like that. And I think that in many ways is a bit of a stereotype about what kind of research we have around our plants and how we use them.
Health Chatter
Naturopathic Medicine
We have a lot of basic science information around the herbs we use. and a growing body of knowledge of like how to use them. Whole systems research or whole person's research is new though. It's only in the last 10, 20 years, we've had the math to start working with multiple variables in healthcare. And even then we're not great at it yet.
Health Chatter
Naturopathic Medicine
So sure, we have outcome-based research, but, but to really look at the, the the power of something like Chinese medicine or naturopathic medicine. We just don't have the tools quite developed to really answer some of those questions. So that is a, that is a limitation. But I think, um, yeah, these are, these are things we've used for a long time.
Health Chatter
Naturopathic Medicine
We learn, we know a lot about how to use them and we're catching up and really going to town on research on it as we speak. So. Thank you. Yeah. Thank you.
Health Chatter
Naturopathic Medicine
I don't know. I don't know. It's a great question. Why is there only a small semester course on nutrition in medical school? I don't know. I think there's some nice stories about that. I mean, I think the conventional idea that nutrition doesn't matter is beautiful.
Health Chatter
Naturopathic Medicine
I mean, the idea that the body is so powerful, you can put whatever you want into it, and it's going to be able to do what it needs to do with that. I love that. I wish it was true. But So I don't know.
Health Chatter
Naturopathic Medicine
Actually, no, I haven't spoken with pharmacists much. Pharmacists can interact with us. They often will do the medication or interaction checking for patients like that, or some pharmacists will really help their patient understand how a supplement or medication might be reacting if they have that.
Health Chatter
Naturopathic Medicine
So that's how we interact, but not a lot of direct interaction with pharmacists, at least me personally.
Health Chatter
Naturopathic Medicine
Yeah, there's actually a lot to talk about with the supplement issue and farms. We are trained in use of vitamins, herbs, and supplementation. And so most of us, not all of us, are experts in brands, utilization, and prescription of these. And it's a common tool we use like that. And yeah, and also the supplement industry is a bit of a Wild West, which is good and bad.
Health Chatter
Naturopathic Medicine
Yeah, because they're not regulated. You have a variety of products on the market and a consumer really doesn't. frequently doesn't have the education needed to understand why something costs $20 versus $80. Why would that be helpful or not?
Health Chatter
Naturopathic Medicine
And so most of the things you see in the drugstore are lower quality, lower cost supplementation that may be useless, mislabeled, or be okay, but it's hard to parse that out like that.
Health Chatter
Naturopathic Medicine
Oh, for me, I work with, I would say, a lot of... Or the issue, or not, yeah, whatever, yeah. Yeah, because, you know, we all have different specialties. Sure, OK. So I tend to... Common things in a primary care setting, cardiovascular risk, a lot of digestive issues. That's very common.
Health Chatter
Naturopathic Medicine
I personally specialize in adjunctive cancer care, complex chronic illness, and special need pediatrics like that. That's where I tend to practice.
Health Chatter
Naturopathic Medicine
Oh, yeah, lots of things. People can use it. Yeah, instead of taking a statin, you might have, for statin intolerant people, there are other replacements, ways of working with diet, lifestyle, supplementation. That's a common place. I think functional digestive issues are a huge, huge area where we can provide a lot of relief for people.
Health Chatter
Naturopathic Medicine
And that's often a big gap in conventional care is working with functional health issues. You know, IBS, people can be debilitated, unable to leave the house. And often the people just don't have enough training to actually help with them or drink more water, eat more fiber and like that. So functional health conditions are a huge place we help people.
Health Chatter
Naturopathic Medicine
And like I said, you know, adjunct care for autoimmune autoimmunity cancer care, serious conditions as well.
Health Chatter
Naturopathic Medicine
Yeah, absolutely. Absolutely. Okay. Yeah. Yep. And yeah, yeah, it matters so much. You know, your gut's just a huge immune active mucosal tissue, right? And inflammation there affects everything greatly. So at the very least, that's really important for systemic health. And like I said, people with IBS or certain heartburn conditions, it's not really a Prilosec deficiency.
Health Chatter
Naturopathic Medicine
It's, you know, it can be a bacterial imbalance. It can be a food reaction. A number of some mechanical issues are a lot of, a lot of possibilities of what that is. Yeah.
Health Chatter
Naturopathic Medicine
Yeah, yeah, absolutely. I think that's a really important point. One of the things I like about naturopathic medicine is really acknowledging the humanity of the provider and the humanity of the patient. And we really canonize and talk about that relationship. You know, docere, doctor is teacher, right? Doesn't docere mean teacher in Latin? And that is the foundation of the relationship.
Health Chatter
Naturopathic Medicine
It's mutuality, right? Not so hierarchical. When you have very little time, you have to just kind of convey frequently, you have to convey the information, make sure they understand, and that's what you got. And when you have time, you can enter in relationship you can skillfully and nicely push back or point out where people are not doing the right thing.
Health Chatter
Naturopathic Medicine
And because of the relationship and the shared space of you two as people in the room, people can make change and go past things that were holding them back from making those changes. And I think Maybe specifically to your question, that therapeutic relationship in that moment between two people is so important for providers and people to heal. And that's...
Health Chatter
Naturopathic Medicine
Well, sure. Well, a naturopathic physician, naturopathic doctor, it's someone trained in both conventional medicine as well as naturopathic or alternative modalities. And so we're a mid or physician level provider, depending on the state, that really we have one foot in both worlds of alternative, complementary and conventional treatment.
Health Chatter
Naturopathic Medicine
something I wish everyone had time to cultivate and in training to cultivate because how you hold yourself as a provider in that moment, um, take some, some practice, some skill, some coaching about how, how it is best for you to be, how can you be yourself truly and, you know, the right kind of person and right kind of provider. So, yeah.
Health Chatter
Naturopathic Medicine
Right. A couple of things with that. I always say I'm medication agnostic. But what I mean, there is a time for medication when it's the most elegant decision for the patient and the health care condition, you know, and sometimes really high intensity interventions are most elegant. Sometimes it's best to just do the surgery or whatever. So it depends on the person.
Health Chatter
Naturopathic Medicine
And, uh, and sometimes the, it is best to work with something with potentially fewer side effects or, um, can work more gently. And, uh, that's a, that's a discussion with the patient. Most people that come to see me would prefer not to do the medication. That's why they're there or interested in, in doing, um, doing something else besides that.
Health Chatter
Naturopathic Medicine
But they're frequently, I tell them it's best to just do the medication, you know? Um, and, um, And with both of these, I think thinking about the duration of treatment and the outcome of treatment is important too. So if you're going to do any intervention, when does it end and why? And what is it trying to change in the system so you no longer need it?
Health Chatter
Naturopathic Medicine
And that kind of thinking applies to medication as well as herbs, as well as diet. So, yeah.
Health Chatter
Naturopathic Medicine
Yeah, great question. We are registered, and we are registered with the Minnesota Board of Medical Practice. Got it. Registration is very much like licensure, except it is not. And so with licensure, you have your own guiding board and so on. And in Minnesota, we're developing that infrastructure to potentially move towards licensure. In most other states, we have licensure at the state level.
Health Chatter
Naturopathic Medicine
We have a pretty broad type of practice we may find ourselves in. Depending on the state, we could be acting as primary care providers, doing medication management, taking care of things that you see in a primary care setting. And also we act as adjunctive specialists or specialists in more serious and chronic conditions where we complement conventional treatment and conventional approaches.
Health Chatter
Naturopathic Medicine
And healthcare scope is determined at the state level, so it's not a federal regulation. Each state will choose scope and regulation of their providers.
Health Chatter
Naturopathic Medicine
Well, we use electronic medical records. I love looking at lab tests and history of things. And so we, yep, as much history as we can get is really important for patient care like that. And we certainly utilize research and evidence-based practice when appropriate. And so we're thinking about those things as well.
Health Chatter
Naturopathic Medicine
Yeah, I would say not regularly. Mere in private practice. And so certainly refer to community services and so on. But I'm not a Medicaid provider. And so like, yeah, my connection to those systems is, yeah, peripheral best.
Health Chatter
Naturopathic Medicine
They are not the same thing. They are not, yeah. Okay. Yeah, all those apathies are specialties, right?
Health Chatter
Naturopathic Medicine
So... Homeopathy is kind of a distinct system of health care developed by a fellow named Hahnemann in the 1800s. And it works with very, very low dose botanicals and substances. And it's kind of an energetic, kind of weird mechanistic medication system. Some MDs will use homeopathy as a treatment. It's a modality, just like Chinese medicine. But it is not identical.
Health Chatter
Naturopathic Medicine
Not all naturopathic doctors use homeopathy at all. And it's even a little controversial these days because of the lack of mechanism with it like that. And so not the same thing.
Health Chatter
Naturopathic Medicine
Although my favorite homeopath is a medical doctor and I refer to him for that. So it's, yeah. Gotcha. Gotcha.
Health Chatter
Naturopathic Medicine
Yeah, so one type of preventive medicine is early detection, right? And that's not what we're talking about with early detection. We're talking about identifying risk factors and treating the risk factors. So that will ideally prevent something from arising in the future. So yeah, that's what we mean by prevention, trying to get to the risks before it becomes a true disease entity. Yeah.
Health Chatter
Naturopathic Medicine
Neighborhoodnaturopathic.com. My clinic is Neighborhood Naturopathic.
Health Chatter
Naturopathic Medicine
yeah so most states will have an association of naturopathic physicians and starting at your state association is the best place to go and that way you'll know what kind of provider you're finding um i think we wrote about this a little bit naturopath is not a protected title in many many places and so you have a variety of providers that might use that handle um
Health Chatter
Naturopathic Medicine
And so it can be simply confusing who's who. By going to the state association of naturopathic physicians or doctors, then they'll have a find a doctor search option and you'll see who the registered or licensed naturopathic doctors are in your state.
Health Chatter
Naturopathic Medicine
Yeah, yeah. Well, I think it's right now it's important that people understand what we do, at least in Minnesota. That's the big challenge right now. I think there's a lot of just a lack of education precisely what we do, what our training and approach is. And that kind of differentiates us from other alternative providers like that. So I think that's the main thing to get out there is who we are.
Health Chatter
Naturopathic Medicine
our scope, how we practice and how we think and how we fit in with conventional as well as alternative care like that.
Health Chatter
Naturopathic Medicine
Right. Not many. There's one in Canada, and I believe there's five in the U.S. right now. So not too many. We have one in Chicago, Oregon, Washington, and then on the East Coast and Arizona, like that, and then up in Canada.
Health Chatter
Naturopathic Medicine
So thank you for that. Oh, my pleasure. And these are great questions. These are things that people are thinking and don't know. So it's perfect.
Health Chatter
Naturopathic Medicine
Yeah, I think the short answer is I worked in the ER too long. That's what it comes down to. Yeah. During my pre-med, I was a technician at Regions Level 1 Trauma Center. And so at Regions, technicians are in everything. So we're in the traumas, all the way to, you know, stalking, pushing people around, getting in places.
Health Chatter
Naturopathic Medicine
So we saw, it's a biased cross-section of healthcare, but saw a lot of things. And over the four years I was there, I found myself less enthralled and excited by the medical stabilization and surgery and the blood and the things that we do really, really well in the ER.
Health Chatter
Naturopathic Medicine
we did those very well and became more interested in the things that we don't do well there, which is chronic disease management, patient care, and really more longer-term healthcare approaches, right? And as I was there, I was looking at my career because I was going to be a medical doctor. I was considering what kind of things would I be doing in my career.
Health Chatter
Naturopathic Medicine
And I realized a lot of my passions, which were, you know, Exercise, meditation, nutrition, so on, were not going to be part of my scope. It was going to be, it could be quite interesting, you know, but I would be doing mostly diagnosis and medication management, probably, unless I went into surgery.
Health Chatter
Naturopathic Medicine
And so that, while really important, became less and less interesting to me personally over those four years. And I was thinking, well, maybe a psychiatrist, maybe I'll be a DO, and so on. And really, the last semester before I had to apply for med school, I discovered there was such a thing as naturopathic medicine.
Health Chatter
Naturopathic Medicine
Knowing that, it was a really good fit because all those things, mind-body care, nutrition, taking care of oneself, lifestyle, were incorporated with the physician-level training and level of thinking. So that's how I found myself here, just in time.
Health Chatter
Naturopathic Medicine
Well, we're in Minnesota, I think. That's what it comes down to. On the coasts, we're everywhere. So when I went to school in Portland, everyone had their naturopathic doctor. Most people had someone they were working with. I think of it a little like chiropractic was here for a while. There was many years where chiropractors were in Minnesota. People really didn't know quite what they did.
Health Chatter
Naturopathic Medicine
They just knew about them. They were around and not fully integrated. And so I think now in Minnesota, we're starting to get more NDs in state. When I moved here, there was five in practice. And now we're 50, 60, 70. So it's increasing. And there's just more time for education for people to understand what we do and what we don't do and who we are and who we are not.
Health Chatter
Naturopathic Medicine
Because there can be a lot of ideas of what we are that are not quite right. Yeah.
Health Chatter
Naturopathic Medicine
Sure. Well, people find me lots of ways. Through website referrals and so on. My website, we try to do a fair amount of education so people can understand what we do. And I think a lot of people still find us by word of mouth. More and more, I think we get referrals from other healthcare providers. And as people understand what we do more and more, there's more and more interest in it. Yeah.
Health Chatter
Naturopathic Medicine
Yeah, I don't think there's any particular movement by insurance companies to credential NDs. I think there's no signaling they're interested in doing that, which is, as you said, a shame because it prevents access. For providers, it's okay. We develop practices that don't take insurance, and so we can provide care, but it's such a limitation for people to access what we do.
Health Chatter
Naturopathic Medicine
in other states we are credentialed in insurance systems and so we we are in hospitals i did training in hospitals side by side with mds and and so minnesota we yeah you know i think we will probably get there um and frankly it confuses me why insurance would not have us involved because we are We're not expensive.
Health Chatter
Naturopathic Medicine
We don't recommend $30,000 treatments, and we prevent utilization of the healthcare system. So you'd think insurance, of all people, would really appreciate that benefit, but we're not there yet.
Health Chatter
Naturopathic Medicine
The majority of people that come to me come to me because they have a problem, but there are some people that do because they understand prevention can happen before problems arise, right? And so they want to optimize their health, optimize their functioning, and work like that. It's still, it is a minority, but it's a really fun patient population to work with.
Health Chatter
Naturopathic Medicine
we're working with peak performance and athletics like that. That's another wellness population. That's a lot of fun to work with. Yeah.
Health Chatter
Naturopathic Medicine
Yeah, I think those are two groups of people that would find me. Those that are suspicious, have lack of trust in the conventional system for a variety of reasons, looking for care outside that. Those that are concerned with the nature of some conventional treatments, they want to find alternatives for what they might see as problematic or a treatment with a lot of side effects.
Health Chatter
Naturopathic Medicine
And there are also people that seek us out for adjunctive or specialty care that they simply can't get in a conventional system. So those are the million types of people that find us.
Health Chatter
Naturopathic Medicine
Yeah. Well, I see people of all ages, anyone from, you know, six months all the way through through later stages of life. I would say most of our patients are middle aged and like that because these are this is when chronic illness starts to arise and people have maybe the time to even think about taking care of themselves like that. But no, I personally work with a lot of kids.
Health Chatter
Naturopathic Medicine
Right. You know, case analysis and treatment is really what I think what separates us from other types of providers, how we think about problems. I mean, we're not people do think about root cause or the whole person that are not naturopathic doctors, but that's really what we focus on.
Health Chatter
Naturopathic Medicine
so a couple things there um when when there's a symptom we always try to ask a question why is that happening and and then going to the why and then going deeper and deeper uh with that that's one aspect um and then we're we're thinking about different uh different influences on health uh
Health Chatter
Naturopathic Medicine
external environment, lifestyle things you do, eat, take care of yourself, genetics, and how all this interacts. And So when you view illness or symptoms as part of a larger process and trying to understand the things that cause that process to be happening, you have a lot more treatment options than simply addressing the presenting signs and symptoms.
Health Chatter
Naturopathic Medicine
And so that's what we mean with trying to get to the root cause is how can we work with the deeper influences of health, the deeper risk factors and things that are driving it like that. So it's something like diabetes, right? You have your hemoglobin A1C number, and then you might just prescribe a medication and watch how that goes down, and then your treatment is done.
Health Chatter
Naturopathic Medicine
The hemoglobin A1C is controlled, and that's great, and that's true. That will control a lot of the problems with diabetes. But then there's looking deeper. Why is that off in begin with? And that frequently is lifestyle, food choice, activity level, other health conditions can be driving that.