This study discusses two ways in which indirectness functions in medical visits between a Nurse Practitioner (NP) and patients hospitalized with diabetes-linked problems: the NP's indirect defiances of patients’ declarations concerning their capacity to deal with their disease and the NP's use of ventriloquy (Tannen, 2010) to offer patients advice and medical instructions. NP's indirectness may be considered both as shunning of face-menacing acts for the patients' benefit and as second order indexicality, projecting her own identity as a skilled Nurse Practitioner who engages in a patient-centered medical approach.