Ten Ways To Spot A Guru - And One Solution If You Do

Health and health care are chock full of systems and approaches that have both empirical and arbitrary foundations. They are typically based on the beliefs and anecdotes of a “guru”. With any guru comes a flock of disciples that espouse the earth-shattering wisdom of their guru.

Something oftentimes gets a little confused in the process: the guru and their methods become more important than the patients themselves.

Well, I would suggest one important reminder today: It’s not about you, oh mighty guru.

Health and health care are all about the patient. With that said, these domains don’t need any more gurus. There are more than enough snake oil salesman to go around. What we need are true science-based medicine and patient-focused approaches that implement competent self care strategies, and not just more lip service.

Gurus will oftentimes acquire followers, “especially by exploiting their naiveté”. These disciples will often follow the guru blindly. The gurus might go so far as to foster a “cult of personality”.

We see this in many different genres. Although it might be hard to imagine, it happens frequently in the world of health and health care. But it also dilutes and diminishes the quality of care in the process. Deciphering this requires an informed consumer. Here are 10 ways in which you can spot a guru and their disciples – and one solution to the problem.

1. Complexity. Gurus love complexity. The more complex the clinical model, the better. Complexity means that they have somehow had the incredible insight to establish the multi-factorial relationships that exist – and you didn’t.

2. Wisdom. Gurus will always focus on their road to wisdom. They will profess that the road to understanding is a tough one. This is evidenced by their long arduous struggles and hard lessons of experience to gain the wisdom noted in the last point. The only way you can aspire to their greatness is to study with them – at some exorbitant rate, of course.

3. Authority. Gurus get angry when you ask questions, especially dissenting ones. Don’t dare question their authority. They will oftentimes resort to berating or belittling behaviors, or perhaps even trash your personality or your character, in an attempt to expose your “flaws” and to exert their authority.

4. Intellectual Discussion (part 1): Gurus will not engage in intellectual discussions regarding scientific plausibility or validity. They will partake in intellectual bullying and meander down many unrelated pseudo-scientific paths to “prove their point”.

5. Intellectual Discussion (part 2): Gurus will not engage in intellectual discussions regarding the reliability of the approach. They will simply tell you that “you just don’t have as much experience as I do”, and that reliability will only come with your own arduous struggle under their tutelage (see #2).

6. Personality. Gurus will typically have a big, larger-than-life personality. This “woo factor” makes it easy for clinicians to embrace such a powerful figure. If they have that confidence, and their stunning anecdotal results, of course they must be right!

7. Logical Fallacies. Gurus will use any number of logical fallacies to “prove” their point. This is related to a number of issues above, but merits its own point simply because it becomes a foundation for their world view.

8. Disciples. Gurus surround themselves with a “choir” of devoted disciples. These advocates will be used to do the heavy lifting when debates ensue and to help deflect criticism from the guru. They will adopt logical fallacies similar to their guru in question.

9. Emotion. Gurus usually have a marketing gimmick. It will almost always provoke some deep-seated emotional response in the disciples that inspires their belief in the guru and their ways.

10. Co-Dependency. Gurus use all of the above to establish a co-dependent relationship with their disciples and their clients. This feeds the needs of their self image. The “system” has more to do with this than its actual efficacy or benefit to the patient or to enhancing any specific long-term outcome.

Patients come to us with pain and limitation of function. They come to us for our knowledge and experience. They come to us seeking a positive outcome.

It is our responsibility – to our patients, to our system of health, and to ourselves – to challenge these gurus, to sift the gold from the garbage, and to advocate for best practices. All systems and approaches should be held to scientific scrutiny and sound intellectual discussion. These “difficult conversations” are what make our profession(s) stronger (be it physical therapy, chiropractic, massage therapy, or medicine). There is no doubt that this will be challenging to us emotionally as well. We must have these conversations to make our system one that supports science and health, and not belief and woo.

There is one solution though.

If the approach or “system” is more about the guru’s grandeur, coolness factor, or arbitrary foundations than it is about the sound scientific premises or net outcome of the patient or participant, then run away – as fast as humanly possible.

Photo credits: Genista