This letter is an appeal for active clarity in letters between doctors. More than once a month I get a letter from a colleague that contains a variant on the following sentence: “The patient will require [an action].” The action may be a blood test (creatinine after starting an ACE inhibitor) or an imaging test, or a request for another consultation. The sentence, “The patient will require [an action]” does not indicate who is supposed to arrange the action--the doctor who wrote the letter or the doctor to whom the letter is addressed.
Please, if you are writing a letter to a colleague and you think an action is indicated, write “I am requesting [the action],” or, “…and I would appreciate it if you would arrange [the action].” This precision in the use of English will save the doctor to whom the letter is addressed the hassle of finding out what the author meant.
One of my patients is quite irate because a specialist wrote to a GP in 2006 that an imaging test should be done in a few months. The GP retired and the imaging test wasn’t done, and the patient now shows an unexpectedly large lesion on the CT scan of the lung. If the suggestion in the above paragraph had been followed, this patient would not have fallen through the cracks.
Thank you for your help.
--Robert Shepherd, MD
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
- Only the first three authors are listed, followed by "et al."
- There is no period after the journal name.
- Page numbers are not abbreviated.
For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org