Picture this: You’re about to sit down with a patient who hasn’t done their exercises in three weeks. Your frustration is building before you even start talking. You know this conversation could go sideways fast—they’ll get defensive, you’ll get irritated, and nothing will actually improve.
Sound familiar?
Here’s what usually happens: emotions take over, thinking gets cloudy, and the conversation becomes about who’s right rather than what actually helps. The patient leaves feeling judged. You leave feeling drained. The relationship takes another hit.
But what if there was a way to approach these conversations that kept you calm, focused, and genuinely helpful?
The Problem with Our Default Response
When stakes are high—whether it’s a non-compliant patient or a staff member who’s not pulling their weight—our brains default to a remarkably simple question: “How do I win this?”
We focus on being right, getting compliance, or proving our point. It’s understandable. After all, you’re the expert. You know what works. Why won’t they just listen?
But here’s the thing: when your primary goal is winning, everyone else becomes the opponent. And opponents tend to fight back.
Kerry Patterson and his colleagues in “Crucial Conversations” noticed something fascinating about people who navigate difficult conversations well. They don’t just wing it and hope for the best. They prepare differently.
They ask themselves a more complex question—one that completely changes how they approach the conversation.
The Three-Part Question That Changes Everything
Before walking into any challenging conversation, these skilled communicators ask themselves:
“What do I want for myself, the other person, and the relationship?”
Let me break this down, because each part serves a specific purpose in keeping you emotionally regulated and strategically focused.
Part 1: What do I want for myself?
This isn’t about getting your way. It’s about clarifying your genuine professional goals.
Maybe you want to feel confident that you’ve done your job well. Perhaps you want to maintain your professional boundaries while staying compassionate. Or you might want to finish the conversation feeling like you’ve truly helped rather than just lectured.
When you’re clear on what you actually want for yourself, you’re less likely to get hijacked by frustration or the need to be right.
Part 2: What do I want for the other person?
This is where empathy kicks in—but it’s strategic empathy, not just warm feelings.
For a non-compliant patient, you might want them to feel heard and understood. You might want them to leave with a realistic plan they can actually follow. Or you might want them to feel hopeful rather than defeated.
For a struggling team member, you might want them to feel supported while understanding the impact of their actions. You might want them to have clarity about expectations without feeling attacked.
This part of the question shifts your brain from “me versus them” to “how can I help them succeed?”
Part 3: What do I want for the relationship?
This is the secret ingredient that most people miss entirely.
You might want the relationship to feel collaborative rather than adversarial. You might want to preserve trust while still addressing the issue. Or you might want to strengthen the relationship by working through this challenge together.
When you consider the relationship, you stop seeing difficult conversations as battles to win and start seeing them as opportunities to build something stronger.
How This Plays Out in Real Life
Let me show you how this framework transforms actual conversations you probably have every week.
Scenario 1: The Non-Compliant Patient
Traditional approach: Walk in focused on getting them to do their exercises. When they make excuses, get frustrated and explain (again) why they need to comply.
Three-question approach:
- For myself: I want to feel like I’ve genuinely helped and maintained my professional integrity
- For them: I want them to feel heard about their real barriers and leave with a plan that feels doable
- For the relationship: I want us to feel like a team working together, not adversaries
How the conversation changes: Instead of starting with “You haven’t been doing your exercises,” you might start with “Tell me how things have been going with the home programme. I’m curious about what’s working and what’s feeling challenging.”
You’re still addressing the same issue, but you’re approaching it as their ally, not their opponent.
Scenario 2: The Resistant Team Member
Traditional approach: Focus on getting them to change their behaviour. When they push back, emphasise the rules and consequences.
Three-question approach:
- For myself: I want to handle this professionally and feel confident I’ve been fair
- For them: I want them to understand the impact without feeling attacked, and feel supported to improve
- For the relationship: I want us to maintain mutual respect while solving this together
How the conversation changes: Instead of “Your tardiness is affecting patient flow,” you might start with “I’ve noticed some challenges with our morning schedule. I’d like to understand what’s happening and work together to find a solution that works for everyone.”
Same issue, completely different energy.
The Magic of Mental Preparation
Here’s why this framework is so powerful: it does most of its work before the conversation even starts.
When you’ve thought through all three elements, your brain has already shifted from threat mode to problem-solving mode. You’ve considered their perspective, which naturally increases your empathy. You’ve clarified your real goals, which helps you stay focused when emotions run high.
Most importantly, you’ve primed yourself to see the other person as someone to work with, not someone to work against.
Your Two-Minute Pre-Conversation Routine
Next time you have a challenging conversation coming up—whether it’s with a patient, team member, or even a difficult colleague—try this:
- Pause for two minutes before the conversation
- Ask yourself the three-part question:
- What do I want for myself?
- What do I want for the other person?
- What do I want for the relationship?
- Write down your answers (even just mental notes work)
- Start the conversation with curiosity, not conclusions
The difference this makes is remarkable. You’ll find yourself staying calmer, listening better, and genuinely collaborating rather than just trying to get compliance.
Beyond Individual Conversations
This framework doesn’t just work for one-off difficult conversations. It changes how you think about your role as a clinician and leader.
When you consistently consider what you want for the other person and the relationship, you stop being someone who just delivers treatments and start being someone who genuinely partners with people in their health journey.
Your patients feel it. Your team feels it. And honestly, you feel it too.
The Ripple Effect
Here’s what I’ve noticed after three decades in this field: clinicians who master this type of communication don’t just have better individual conversations. They build something bigger.
They create practices where patients want to come back. They develop teams that actually support each other. They become the kind of professional that others seek out for mentoring and advice.
And perhaps most importantly, they feel more fulfilled in their work because they’re not constantly fighting against people—they’re genuinely helping them.
Starting This Week
I’d challenge you to try this framework for just one week. Pick one difficult conversation you’ve been avoiding or dreading, and use these three questions to prepare.
Notice what changes—not just in the conversation itself, but in how you feel going into it and coming out of it.
Because here’s the truth: challenging conversations are going to happen whether you prepare for them or not. The question is whether you want to stumble through them reactively, or approach them with the kind of intentionality that actually creates positive change.
Replace frustration with curiosity. Replace winning with helping. Replace fighting against people with fighting for them.
Your patients, your team, and honestly, your own wellbeing will thank you for it.
This type of communication framework is part of the deeper work I explore with clinicians in my coaching and workshops. If you’re interested in developing these skills further, feel free to reach out—I’d love to hear how this approach works for you.
Want more practical communication tools? Contact me for my CLEAN Model guide for handling patient objections with confidence.
Contact: annette@thinking.physio | thinking.physio
