From diets rich in hot pepper for the prevention of viral infections, bleach baths to treat disease, and homeopathy for virtually any symptom, questionable treatments have multiplied during the COVID-19 pandemic, and false health information has spread as fast as the virus itself.
Of course, specious medical practices didn't begin — and certainly won't end — with SARS-CoV-2, but many doctors say they now feel "scared," "deflated," and unprepared in the face of conversations with patients about unproven approaches.
"It's our professional duty to understand the prevailing pseudoscience in our culture," says Steven Novella, MD, associate professor of clinical neurology at Yale University School of Medicine and executive editor of the blog Science-Based Medicine, which takes a hard stance on everything from chiropractic medicine to acupuncture. But discussing these subjects with patients can be challenging, especially if they are already investing time, energy, and money into therapies for which there is no empirical evidence.
One such practice that has been growing in popularity is so-called quantum neurology, a trademark-registered nervous system rehabilitation system developed by chiropractor George Gonzalez. It is touted as helping with everything from spinal cord injury to autism and employs a handheld electromechanical instrument such as ArthroStim combined with LED and infrared lights. A preprogrammed 10-pack of these devices runs for $14,000 on Gonzalez's website.
The term "quantum neurology" is a bit of "word salad," says David Putrino, PT, PhD, a neuroscientist and director of rehabilitation innovation for the Mount Sinai Health System, in New York City. "A lot of the rationale is linking together concepts that don't typically link together."
Through his books, live demonstrations, and online classroom, Gonzalez claims to have trained more than 400 chiropractors in the United States and Canada in his method. That's a small portion of the more than 80,000 licensed chiropractors in North America, but it means the method has potentially reached thousands of patients.
Gonzalez, who could not be reached for comment, has relied almost exclusively on patient testimony rather than scientific evidence or research to support the advancement of "quantum neurology." The first and most prominent story comes from Gonzalez's wife, Lori, who reportedly suffered from something akin to cauda equina syndrome and subsequent sensory paralysis but recovered with the use of the "quantum neurology" system.
Despite their lack of scientific rigor, such testimonies can reflect real experience on the part of a patient, Putrino says. "These things can be self-perpetuating as well in terms of the placebo effect," he says. A practitioner's performance and conviction "can create a belief state in your patient — a neurophysiological state in which people are in heightened expectation of something that's going to happen." As a result, they may experience a remarkable recovery. But that doesn't mean the methods they used to feel better are scientifically sound.
Using science to combat a patient's personal "successful experience" can be frustrating for physicians, prompting some to ask if it's worth the fight. "The most popular refrain you hear from these people who create these [placebo] effects is, 'Who cares so long as these people get better?' " Putrino says. "It's tempting to think that way, but I think it's also worth acknowledging that many people experience a drop-off as they leave the practice."
Although the recovery may be short-lived, a patient's loyalty to the pseudoscientific treatment may persist. "You end up with this situation of maybe there's an effect, but it's not a lasting effect, and these people get locked into payment plans and programs that go on forever, and it can get quite predatory," Putrino says.
Fairly Evaluating Alternatives
Separating predatory exploitation from complementary and alternative medical practices is important. For more reasonable interventions, there typically is at least some evidence that can be evaluated for rigor and relevance to an individual patient's case.
The National Center for Complementary and Integrative Health, for example, is the US government's largest organization dedicated to researching "diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine." It has evaluated everything from yoga to acupuncture and found that some of those practices can be useful — at least in certain cases. Acupuncture, for example, is indicated for certain conditions, including headaches, migraines, and postoperative pain — the same conditions someone may be trying to manage with a pseudoscientific alternative like "quantum neurology."
When asked for comment on this particular practice, the American Chiropractic Association (ACA) reiterated their support for "evidence-informed care and generally accepted best practices based on current, high-quality research." The ACA stated that they have a code of ethics according to which "chiropractors should not mislead patients into false or unjustified expectations of favorable treatment results and that advertising should likewise not mislead patients or exploit their vulnerability."
Setting the Record Straight
According to Novella and Putrino, the key to conversations with patients about unproven medical approaches is honesty and transparency. Both acknowledge that being too aggressive in dismantling a pseudoscientific claim can alienate patients. They encourage talking about the fundamentals of the scientific method and helping people to evaluate the research behind a given practice.
What they do not advocate is simply dismissing the topic or ignoring pseudoscientific claims altogether. Physicians "have to have a reasonable working knowledge of alternative claims, especially within their own speciality," Novella says. "Patients will ask them about it, and if they shrug or say, 'I don't know' or 'I haven't heard about it,' the patient's going to trust the quack."
Putrino says it's important to be open-minded about what the patient is seeking. "If a patient is looking for something like ["quantum neurology"], that means they're not getting something they need," Putrino says. "Maybe the reason they found themselves on this website is because they're looking for something a little more holistic." When Putrino identifies these feelings in a patient, he may refer them to a practitioner of traditional Chinese medicine for acupuncture.
"If a patient is not making progress and looking elsewhere, we should lean into that," Putrino says. "Rather than pushing and trying to resist, let's see if we can guide you in a direction that is a little more grounded in good practice and efficacy.
"The overall, overarching concept here is, Do the work," Putrino says. "We are so far beyond the days where clinicians can just say to patients, 'That's dumb, don't do it.' "
Eleanor Cummins is a freelance journalist whose work runs the gamut of science. Her work has appeared in Vox, National Geographic, and The Atlantic.
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Cite this: Docs Question Chiropractic Approach Called 'Quantum Neurology' - Medscape - May 14, 2021.