Knowledgeable clinicians agree that multimodal treatment plans are the gold standard in modern pain care. Conservative management is well-supported in research for treating chronic pain. Patients living with chronic pain frequently resist referral or report negative experiences after working with physical therapists. How do we reconcile the evidence base with lived patient experiences? This session will address the challenges that primary care providers and subspecialty clinicians, like surgeons, face when negotiating a comprehensive treatment plan with patients. Engaging in active self-management strategies is effective but takes commitment, effort, and time. Barriers to engagement in physical therapy are multifactorial and require clinicians to have insight, empathy, and skill to ensure a successful shared decision-making process. Communication tactics and psychosocial considerations will be discussed in this session, and participants will walk away with practical strategies they can implement immediately in their practice to improve outcomes for patients in pain.