Occupational therapy has undergone a paradigm shift from a more mechanistic to an occupation-focused perspective, which has influenced practice as well as the professional education curriculum. However, this shift has not been readily adopted in some practice settings. Anecdotal examples from students, and from practitioner colleagues, have led the authors, as experienced academics and practitioners, to consider what would further assist the profession in moving forward and embracing this change. In keeping with others in the profession, in this opinion piece we would like to support colleagues in practice by suggesting ways of progressing by small 'nano steps' along the continuum from medical to occupation-centred practice.