70 Chapter 4 advice based on patient characteristics such as age and comorbidity. During the study period, no guidelines existed on how to deal with patient preferences or shared decision-making. Furthermore, no patient decision aids to facilitate shared decision-making were in use. However, the department was developing a decision aid for patients with advanced ovarian cancer. Figure 1: Physician culture: Key features of habitus, capital, and field. Acting as a team Doctors often tried to reach a consensus on their joint medical advice for a patient before meeting that same patient, as observed in the morning and tumor board meetings, especially in cases where medical guidelines were not readily available. This group advice had a prominent place in the subsequent patient consultation. As one of the gynecologists phrased it: Interviewer: “How does reaching consensus influence how you give medical advice to the patient? Or does it not influence your actions?” Doctor: “Yes, it does have influence because if we’ve reached a consensus in the meeting, I will tell the patient: ‘This is the advice of our tumor board’”. (Source: interview with a gynecological oncologist)
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