Dear Patient,


Below is a letter that was never written (letter A):

Dear Patient,

Your doctor Dr. XYZ has asked me to review your chest X-ray yesterday, since you were complaining of feeling out of breath.

I have reviewed your X-ray very carefully and realized that your heart size is larger than normal and you seem to have extra water in your lungs. This may suggest a form of heart failure, and may have caused you feeling out of breath.

That said, I would strongly recommend that you follow-up with Dr. XYZ shortly and have a more in-depth conversation with him about this and other possible alternative diagnoses, as imaging alone may not offer a complete picture of your health.

If you have any question about this letter, please feel free to email me at:

Thanks for allowing me to be part of your healthcare team.




Below is the letter (letter B) the patient actually receives:

One view chest X-ray

Reason: Shortness of breath


There is cardiomegaly with pulmonary vascular congestion and edema. Superimposed bibasilar atelectasis/infiltrates are not excluded.  There are pleural effusions bilaterally.


Probable congestive heart failure.  Clinical correlation is suggested.

If you are the patient, which letter do you prefer to receive?


Lake Tahoe, 4/1/2014





Neuroradiologist by trade, enthusiast for big data, digital marketing, 3D printing in healthcare

1 Response

  1. April 14, 2014

    […] and hard to digest for a patient. However, I am very much inspired by recent poll results on the majority of the readers favored the more personal radiology reporting style than the cut and […]

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