Dear Editor:

In the March issue of Imaging Economics, you discussed the potential benefits of giving the patients their radiological examinations ("Good Marketing, Good Medicine"). This has been the normal practice for decades in my country: Giving the patients their films with the corresponding radiological report. Every patient, or their family, is responsible for delivering them to the referring physician, wherever he or she is. Inpatients in a hospital receive their films and reports at discharge. Chilean legislation does not require us to keep the films, just the radiological reports....In a private environment, it may take less than 1 hour for an average patient to get a routine bone or chest x-ray or an ultrasound examination, radiologist's report included. In more complex situations, such as CT or MRI, it can take 48 hours.

In my opinion, it would be of little value to provide images to patients without their radiological report....In our experience, there are only occasional complaints from referring physicians because of the

information that their patients may receive from a radiologist or from its report, with most of the complaints as a result of the radiologist suggesting a particular diagnostic path or a therapeutic decision that should be followed.

I agree that providing reported images to patients will make them responsible for their examinations and in some way get more involved in their health care process. But there is a major drawback that we radiologists too frequently have to face: that is to read films without the previous examinations or reports. In some cases, patients lost them and in others they argue that they were not aware of how important this can be, in order to make better diagnostic and therapeutic decisions. A major educational effort is necessary to overcome this problem.

We are now considering providing patients with a CD of their digital images without producing films; that would save money and CDs are easy to handle, but we cannot do the same with analog images. In our country it will take a long time before we are capable of going digital in every aspect of diagnostic imaging. Until then, most of our patients will continue moving around with big envelopes and bags, full of films and papers, ready to get lost.

John Mac Kinnon, MD

Santiago, Chile