Would your loved ones know your wishes for your care if you could no longer speak for yourself? Statistically, and unfortunately, it's not likely. Only about three of 10 Americans have discussed their wishes with their families and have created an advance directive to guide these kinds of decisions and ensure that they are treated in ways that honor their personal preferences.

In Minnesota, we have built a strong and honorable tradition of collaboration when an important challenge touches our community.

That's why we, the physician leaders of our respective health care delivery systems in the Twin Cities, have joined in deep support of National Healthcare Decisions Day today. Recognized by Congress, it's a collaborative effort of national, state and community organizations, committed to ensuring that all adults with decisionmaking capacity have the support and tools they need to discuss their health care choices, and to communicate and document their health care decisions. These are truly important actions that empower us as patients and support our families and care teams.

We see the effects of this firsthand in Twin Cities hospitals, emergency rooms and long term care facilities every day. We see confusion among family members who struggle about whether the decisions they make for a loved one are right. In urgent situations, we see critical minutes lost while distraught family members weigh hard choices under extreme pressure. There's often also painful stress, uncertainty and guilt about these decisions.

The answer to "What would I want if unable to speak for myself?" varies, but it's never putting one's family in such difficult situations as described above. No one, given the choice, would choose these awful moments for the people they love.

And fortunately, the decision to create an advance directive is an easy one to make. We've made progress in advance directive adoption in recent years, but we have much more work to do. That's why we are joining to encourage more open conversation across our communities -- in families as well as businesses, and in faith, cultural and community groups -- about advanced-care planning.

We know this is not an easy conversation to have, but it is an important one to begin. A great place to start is the Honoring Choices Minnesota website (www.honoringchoices.org). Honoring Choices Minnesota is a community resource dedicated to helping you learn how you and your family can start talking about the type of care you want to receive before you face a serious illness. You can learn from stories of other families who've faced tough decisions. And you can understand the steps you can take to have your own directive in place.

The doctors, nurses and other caregivers in our organizations do all of our work in partnership with you. And we strive to do that work in a way that dignifies you and respects your wishes at every moment of your life. You can help us do that by having an advance directive in place, and by joining our effort to widen the conversation.

Steven Connelly is chief medical officer, Park Nicollet Health Services; Brian Rank is medical director, HealthPartners Medical Group, and Penny Wheeler is chief clinical officer, Allina Hospitals & Clinics. The article was also signed by: J. Kevin Croston, chief medical officer, North Memorial Health Care; Bobbi Daniels, chief executive officer, University of Minnesota Physicians; Donald Jacobs, chief of clinical operations, Hennepin County Medical Center; Steve Kolar, senior vice president and chief medical officer, HealthEast Care System, and Dave Moen, president, Fairview Physician Associates.