Responding to misconceptions is an essential part of adaptive instruction. Nevertheless, research on both tutoring and expert–layperson communication has identified at least two problems that online counselors share with both face-to-face and online tutors. First, they generally do not notice when laypersons’ understanding differs from correct content knowledge. Second, even when they do notice this discrepancy, they do not handle misconceptions appropriately (e.g., they simply present the correct information instead of explaining why the layperson's understanding is incorrect). This paper presents two studies on experts’ responses to laypersons’ misconceptions in online medical counseling. The results indicate that experts do not address the misconceptions communicated by laypersons, even when they are aware that such misunderstandings exist. The discussion concentrates on two explanations for these results: One is related to the differences between reflection and speech production and the cognitive processes underlying the two operations, while the other concerns the role of face-threatening acts in instructional contexts.