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
Victoria