“Place the seven questions from The Coaching Habit near your keyboard. Set yourself the goal of asking at least one of them before you fire off advice, opinions, and suggestions. Maybe even ask two.” – Michael Bungay Stanier, The Advice Trap
Picture this: You’re explaining a home exercise programme to a patient with chronic back pain. They nod attentively, ask clarifying questions, even take notes. Two weeks later, they return having completed maybe 20% of what you prescribed. Your immediate instinct? Launch into more detailed explanations, provide additional handouts, maybe demonstrate the exercises again.
Or perhaps you’re facing a patient who openly challenges your treatment recommendations: “My friend had the same problem and she said physio didn’t help at all.” Your expertise kicks in, and you find yourself defending your approach with research citations and success stories.
Then there’s the third scenario – the patient who sits quietly, agrees to everything, but something in their body language tells you they’re not convinced. You sense doubt, so you pile on more reasons why this treatment will work, more reassurance about the process.
Sound familiar?
Welcome to what Michael Bungay Stanier calls “the advice trap” – that automatic impulse to solve, explain, and convince before we’ve truly understood what’s happening beneath the surface.
Why We Fall Into the Advice Trap
As healthcare clinicians, we’re trained to diagnose and treat. We see a problem, and our professional instinct is to fix it. This served us well in our clinical training when treating highly motivated patients.
But when it comes to patients dealing with chronic injury or illness where lifestyle or belief changes are required, this automatic advice-giving an actually create the very resistance we’re trying to overcome.
Here’s what really happens when we jump straight to solutions:
We miss the real problem. That patient who didn’t do their exercises? The issue might not be understanding or motivation – it could be fear of pain, previous bad experiences, or competing life priorities we haven’t explored.
We trigger defensiveness. When patients feel lectured to rather than listened to, they often withdraw or become argumentative. Your expertise suddenly feels like pressure rather than support.
We create compliance theatre. Patients learn to nod and agree to end the conversation, not because they’re genuinely committed to the plan.
The antidote isn’t to stop giving advice entirely – it’s to earn the right to give advice by asking better questions first.
The Seven Questions That Change Everything
Stanier’s seven questions from The Coaching Habit aren’t just coaching tools – they’re diagnostic instruments that help us uncover what’s really happening for our patients:
1. “What’s on your mind?”
Clinical translation: “What’s your biggest concern about this treatment?”
2. “And what else?”
Your secret weapon for going deeper. Use it after any response to uncover layers of concern.
3. “What’s the real challenge here for you?”
Clinical translation: “What’s making this feel difficult or overwhelming?”
4. “What do you want?”
Clinical translation: “What’s most important to you in your recovery?”
5. “How can I help?”
Instead of assuming you know what they need.
6. “If you’re saying yes to this, what are you saying no to?”
Clinical translation: “How will this treatment plan fit with everything else in your life?”
7. “What was most useful here?”
Clinical translation: “What part of our conversation has been most helpful?”
Breaking the Advice-Giving Pattern
Let’s revisit our three scenarios, but this time with questions leading the way:
Scenario 1: The Non-Adherent Patient
Instead of: “Let me explain again why these exercises are important…”
Try: “What’s on your mind about the exercise programme?” Pause. Listen. Then: “And what else is making this challenging?”
You might discover they’re terrified of triggering a pain flare, or they’re caring for an elderly parent and genuinely don’t have the time you assumed they had.
Scenario 2: The Challenging Patient
Instead of: “Actually, research shows that physiotherapy is highly effective for this condition…”
Try: “It sounds like you have some concerns based on your friend’s experience. What’s the real challenge here for you?”
This opens space for them to voice their fears without feeling like they need to defend their position.
Scenario 3: The Quietly Doubtful Patient
Instead of: “I want to reassure you that this treatment has a very high success rate…”
Try: “I’m sensing you might have some reservations. What’s on your mind?”
Give them permission to express doubt rather than trying to convince them out of it.
Recognising Your Advice-Giving Triggers
Before you can change the pattern, you need to recognise when you’re falling into it. Common triggers include:
Time pressure: “I need to get through this information quickly.”
Patient resistance: “They’re not buying in – I need to convince them.”
Professional identity: “I’m the expert – I should have the answers.”
Discomfort with silence: “I need to fill this space with something helpful.”
Previous bad experiences: “Last time I didn’t explain enough, so this time I’ll over-explain.”
The moment you notice these thoughts arising, that’s your cue to pause and reach for a question instead of an explanation.
The Pause That Changes Everything
Here’s the practical challenge: Place Stanier’s seven questions somewhere visible in your treatment space. Before you launch into advice, recommendations, or explanations, pause and ask yourself: “What do I actually know about what’s happening for this person right now?”
Then choose one question. Just one.
Start with “And what else?” – it’s the simplest to remember and the most powerful for uncovering hidden concerns.
Your 48-Hour Practice Challenge
For the next 48 hours, commit to this:
- Catch yourself before giving advice in at least three patient interactions
- Ask one question from the list instead
- Notice what happens – both for you and your patient
- Reflect on what you discovered that you might have missed otherwise
The Real Transformation
When you replace the urge to immediately solve with the discipline to first understand, something remarkable happens. Patients start telling you what’s really going on. Resistance transforms into collaboration. Those “difficult” conversations become opportunities for genuine connection.
You’ll discover that curiosity truly is the backbone of exceptional communication.
The advice trap isn’t about being a bad clinician – it’s about being human. We want to help, and giving advice feels like helping. But sometimes the most helpful thing we can do is ask a better question and then listen to the answer.
What if the resistance isn’t a barrier to overcome, but a signal pointing you toward what really needs attention?
Your patients are waiting for you to ask.
Ready to dive deeper into transforming patient conversations? These communication skills take practice, reflection, and ongoing refinement. If you’re looking for structured support in developing these techniques, I offer workshops, coaching, and digital training specifically designed for allied health professionals. Contact me to explore how we can work together to elevate your practice.
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