3 Conversation analysis of authentic care decision conversations 61 to address these problems. A slot can be created by putting care decisions on the agenda at the beginning of the consultation. Furthermore, preparation of the patient can be helpful. All four patient-initiations in our data were by patients that received the patient education. This indicates that these patients considered the topic relevant to bring up. Understanding of the relevance and background information (i.e., what are the treatment options and what choices do patients have with what types of consequences), can be seen as first steps in creating common ground. As discussed before, more common ground needs to be created. Regular discussion of care decisions during outpatient clinic visits could create more common ground over time. Finally, we recommend incorporating these dilemmas in physicians’ training. This creates awareness among physicians that they should address these dilemmas when discussing care decisions. Future action-oriented research should focus on the best way to do so.
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