Chronic Pain Care: When Guidelines Don’t Fit

What if the guideline isn’t wrong—but incomplete?

And what if your patient isn’t “non-compliant”—just complex?

In this episode, I’m joined by Joost Van Wijchen to explore the tension between clinical guidelines and the messy reality of practice. We unpack the concept ofmindlines—the experience-shaped frameworks that actually guide what we do—and why uncertainty isn’t a flaw in care, but part of it.

You’ll learn:

• Why guidelines are population-informed—but patients are personal
• How “mindlines” shape clinical reasoning more than we realize
• Why outcome measures like the Oswestry don’t tell the whole story
• How the capability approach shifts focus from impairments to meaningful freedom
• Practical ways to navigate uncertainty without losing clinical integrity
• How to co-construct care instead of imposing solutions

If you’ve ever felt the tension between measurable outcomes and meaningful outcomes, this conversation will resonate.

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