This chapter investigates the use of imperative-formatted directives in Swedish medical consultations. The specific focus of the chapter is the division of labor between straight, non-modulated imperative turns and imperative turns which are modulated with a discourse particle or some other verbal mitigating device. The results show that non-modulated imperative turns are embedded in diagnostic work, nominating subsequent actions in a series. Orientations to projected trajectories of action and the other participant’s expectations are clearly present when modulated imperative turns are produced; they are also frequent in the opening and closing routines of the consultations. Thus, there is a link between routinized and projectable actions and the use of imperatives with a pragmatic modulating element.