Michael Cantwell, MD, MPH
One great aspect of working in a compounding pharmacy is getting to meet doctors from multiple disciplines with unique approaches to health and healing. We recently had the chance to interview Michael Cantwell, MD, of Rising Phoenix Integrative Medicine Center in San Francisco. He talked with us about how he takes the mind, body and spirit into account when working with his patients; his experience prescribing compounded medications; and current inspirations in his work.
~Krista Shaffer, Outreach Director at Koshland Pharm, and Peter Koshland, PharmD
Interview with Dr. Michael Cantwell
I believe a doctor needs to be a three dimensional diagnostician – looking at the body, mind, and spirit. It’s important to be fluent in those three areas. A doctor might treat some of those areas himself or refer out for others.
When it comes to the body, I look at issues such as the liver’s detoxification system. Some of what alternative medicine does is to see beyond the normal ways of looking at the body. Detoxification is something that is studied in conventional medicine but is often forgotten. The body’s detoxification system determines whether a person gets toxin-mediated inflammation, which probably contributes to many cases of affective disorders like anxiety, depression, and bipolar disease, and even possibly to diseases such as autism, Parkinson’s and Alzheimer’s. So detoxification can be very helpful to look at.
When it comes to the mind, there are different psychological systems of how we progress and develop our personalities, and there are subconscious factors as well. I do a lot of subconscious work in my practice, such as hypnotherapy and guided imagery, because it’s often an area that is neglected. I also send people out for regular therapy.
Then there’s the spiritual part. I’ve written a book, Map of the Spirit, that discusses how transitions in spirituality affect health. It gives people a clear way of making that calculation. It includes all religions, including existentialism, and puts them on a level playing field. There’s a lot of spiritual disease in our society, and to not be able to treat that would mean I couldn’t really live with myself.
Compounding Success Story
I prescribe glutathione for many of my patients in various forms – oral forms that are mass-manufactured, and creams, suppositories, injections, and IV drips that are compounded. As more toxins are put in the environment (such as organophosphates and parabens), more optimal function of the body’s detoxification system is required. This increase in environmental toxins can unmask places genetically where we might have weaknesses.
Through both blood tests and genetic tests, you can get a really good idea if there are deficits in the liver’s detoxification system. In the first stage of detoxification, the liver is trying to put hydroxyl groups on everything it needs to get rid of. It then needs to substitute another group for the hydroxyl group in order to put it through the bile. The two main groups that can be substituted for the hydroxyl group are a methyl group and a glutathione group. The liver’s ability to make methyl and glutathione groups are the main variables in whether a person gets toxin-mediated inflammation.
I’ve had many successes prescribing glutathione when patients have defects of glutathione synthesis. I had one patient with poor immune function who had symptoms including rashes, nerve pain, herpes, and low energy level–symptoms which would come and go. With glutathione 500mg suppositories from Koshland Pharm, my patient’s symptoms went away and his quality of life greatly improved.
I found that working within the insurance system as a holistic doctor is very difficult. Insurance really wants to reimburse doctors to treat bodies. In the insurance system, if you’re not treating a body, it’s not reimbursable. If you’re a psychiatrist, you can bill as a psychiatrist, but you’re still treating the body as a biochemical mechanism and giving medication.
Also, there is no Medicare billing for more than forty minutes. That’s the most you’re ever supposed to spend with people. I was finding forty minutes to be way too cramped. I was losing the part that really mattered to me, which was the spiritual connection.
At Rising Phoenix Integrative Medicine Center, we set up a place that was off insurance. I keep my overhead down and pass that saving on to patients, so I can charge a reasonable hourly rate. They can then submit the bills directly to their insurance and get half of it back.
I enjoy my work at Rising Phoenix because patients really come first. It’s an old school place where pretty much if it needs to get done for a patient, we’ll find a way to do it. In a corporate environment, many times it’s easier to say “no,”
but here there’s no one to say that.
Now I think I’m ready for my next book. It’s about the four things you need to have a joyful life. The first is to know the limits of your control – know what’s under your control, what’s out of your control, and what’s mixed. The second is to have a theory of why that control exists, which relates to my book, Map of the Spirit. The third is to have a purpose, and the fourth is to carry out that purpose. Nobody ever tells you it’s that simple, but that’s it. That’s really all you need to know.
To read more about Dr. Cantwell and
Rising Phoenix Integrative Medicine
To read a synopsis of
Map of the Spirit, see: