In this conversation, I chat with Dr Ahmad Malik, a foot and ankle surgeon, about his experience in the medical field and the impact of guidelines on patient care. We discuss the influence of guidelines on medical decision-making, the commercialisation and privatisation of the NHS, and the erosion of clinical expertise. Ahmad shares his concerns about the de-skilling of surgeons and the focus on efficiency over patient-centered care. He emphasises the importance of critical thinking and individualised treatment in medicine.