Chronic disease prevention and management is largely dependent on patient behavior. A healthcare professional can educate, recommend, advise, refer, and prescribe, but these interventions will only be efficacious if the patient chooses to change behavior. Determining and implementing a treatment plan or offering recommendations without engaging patient buy-in commonly results in non-adherence and/or the absence of behavior change. This is analogous to planting a seed without cultivating soil and expecting a plant to grow. To address this problem, an approach to conversation with patients that serves a “cultivating” function is described. Common drivers of behavior change are discussed, along with how providers can identify these factors in an individual patient. Advantages to such a conversational approach are highlighted.