It’s Tuesday afternoon, and you’ve just finished a consultation that left you mentally drained. Your patient nodded through everything you said, agreed to the exercise programme, and even seemed engaged when you explained the importance of consistency. But something in their body language told you they’d probably do the exercises twice and then give up.
You’ve been here before. Many times.
And in that moment, you feel the familiar urge to retreat to what’s comfortable—focus on the technical aspects of treatment, stick to straightforward cases, avoid the messy complexity of trying to motivate someone who doesn’t seem motivated.
It’s tempting to get off the treadmill of difficult conversations entirely.
Angela Duckworth, in her research on grit, makes a distinction that cuts right to the heart of professional growth: “Staying on the treadmill is one thing, and I do think it’s related to staying true to our commitments even when we’re not comfortable. But getting back on the treadmill the next day, eager to try again, is in my view even more reflective of grit.”
For allied health clinicians, there are many treadmills we stay on—continuing education, clinical skills, professional obligations. But there’s one treadmill that separates good clinicians from exceptional ones: the willingness to keep improving at the hardest parts of our job.
The Treadmill Everyone Avoids
Most of us entered healthcare because we wanted to help people get better. We trained extensively in anatomy, physiology, and treatment techniques. We learned to assess, diagnose, and prescribe interventions with confidence.
But here’s what they didn’t teach us: how to handle the patient who challenges everything you say. How to motivate someone who seems determined to stay stuck. How to have a conversation about non-adherence without sounding frustrated or judgmental.
These communication challenges are the professional equivalent of hill sprints—necessary for growth, but exhausting and uncomfortable.
When faced with a patient who dismisses your expertise in favour of something they read online, it’s easier to become directive: “You need to do these exercises.” When someone repeatedly cancels appointments, it’s simpler to write them off as “non-compliant” rather than get curious about what’s really going on.
The problem is, when we permanently turn our back on these challenging conversations—when we decide they’re “just too hard” or “not worth the effort”—our growth flatlines.
What Getting Off Looks Like
I’ve seen brilliant clinicians plateau because they stopped getting back on the communication treadmill. They show up to work, deliver excellent technical care, but avoid the messy, uncertain territory of truly engaging with resistance.
It might look like:
- Defaulting to the same explanation when patients don’t understand, rather than finding new ways to connect
- Avoiding conversations about treatment costs or time commitments because they’re “uncomfortable”
- Giving up on motivational techniques after a few unsuccessful attempts
- Labelling challenging patients as “difficult” rather than getting curious about their perspective
The consequence, as Duckworth points out, is that “effort plummets to zero.” We stop improving in the very skills that could transform our practice—and our patients’ outcomes.
The Eager Return
But I’ve also witnessed something remarkable: clinicians who develop true grit around communication. They have the same frustrating consultation as everyone else, but they approach the next similar patient with genuine curiosity about how to do it better.
They don’t just stay on the treadmill out of obligation—they get back on eager to try again.
‘Sarah”, a physiotherapist I’ve worked with, told me about her “treadmill moment.” After a particularly challenging patient dismissed her exercise recommendations, saying they “didn’t have time for all that,” Sarah felt defeated. Her first instinct was to stick to simpler cases.
Instead, she got curious. She spent time reflecting on the conversation, seeking feedback, and learning new approaches. The next time she faced similar resistance, she was ready with different questions: “What matters most to you about getting better?” and “How could we make this work within your actual schedule?”
That patient became one of her most successful cases.
The Skills That Stop Improving
When we avoid the communication treadmill, specific skills deteriorate:
Curiosity dies. Instead of wondering “What’s really going on for this person?” we assume we know why they’re resistant.
Flexibility vanishes. We stick to our standard explanations rather than adapting our approach to different personalities and learning styles.
Emotional intelligence stagnates. We stop noticing the subtle cues that tell us when someone is overwhelmed, scared, or simply not ready to hear what we’re saying.
Collaboration skills rust. We default to being the expert who prescribes, rather than the partner who explores solutions together.
The irony is that these are precisely the skills that determine whether our technical expertise actually makes a difference in someone’s life.
Your Year-End Treadmill Check
As we approach the end of 2025, it’s worth asking yourself some honest questions:
What communication challenge did you avoid this year? Was it conversations about non-adherence? Handling objections about treatment recommendations? Dealing with patients who challenge your expertise?
Where did you “get off the treadmill” when patient interactions got difficult? What made you decide it wasn’t worth the effort to keep improving in that area?
When did you last feel genuinely excited to try a new approach with a challenging patient? If it’s been a while, you might be staying on the treadmill out of obligation rather than growth.
Getting Back On with Purpose
The difference between showing up and showing up eager to improve lies in how we frame these challenges. Instead of seeing difficult conversations as obstacles to good patient care, what if we saw them as the very heart of it?
Every patient who challenges your recommendations is offering you a chance to get better at explaining complex ideas simply. Every person who seems “non-compliant” is inviting you to develop deeper curiosity about human motivation.
The patients who make you want to avoid the communication treadmill entirely? They’re often the ones who have the most to teach you.
The Compound Effect of Communication Grit
Here’s what happens when you develop true grit around communication skills: your technical expertise becomes exponentially more effective.
You don’t just become a clinician who can assess and treat—you become someone who can truly connect, motivate, and guide people through change. Your knowledge doesn’t just sit in your head; it transforms lives because you’ve learned how to share it in ways that resonate.
This isn’t about perfection. It’s about the willingness to keep experimenting, reflecting, and trying again when conversations don’t go as planned.
Your Next Day
Tomorrow, you’ll likely encounter a patient interaction that challenges you. Maybe someone will question your recommendations, or seem disengaged, or push back against advice you know could help them.
In that moment, you’ll have a choice: retreat to what’s comfortable, or see it as another opportunity to get back on the treadmill.
The clinicians who choose to keep improving—who approach each challenging conversation with genuine curiosity rather than frustration—are the ones who transform not just their own practice, but the entire experience of healthcare for their patients.
As Duckworth reminds us, staying on the treadmill keeps us moving. But getting back on the next day, eager to try again—that’s where the real growth happens.
The question isn’t whether you’ll face communication challenges in 2026. The question is: will you be ready to embrace them as opportunities for growth?
Because when you stop improving at the hardest parts of your job, you stop improving at the parts that matter most.
If you’re ready to get back on the communication treadmill with support and structure, I’d love to help. Whether through coaching, workshops, or digital training, developing genuine grit around patient communication is possible—and it’s the skill that will define your impact as a clinician.
