ArticleHealthcare
Decoding clinical letters
The structure, the abbreviations, and where the action items hide.
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Clinical letters follow a predictable skeleton. Once you know it, you can skim straight to what actually affects you.
The usual structure
- History / presenting concern — why you were seen.
- Examination / findings — what they observed or measured.
- Impression / assessment — the clinician's conclusion.
- Plan / recommendations — the action items. This is the part to act on.
Decoding the shorthand
Common abbreviations: Hx (history), Dx (diagnosis), Ix (investigations), Rx (treatment), F/U (follow-up), PRN (as needed). If a letter uses one you can't decode, that's a fair question for the clinic.
The 'Plan' section is where your next steps live. Read it first if you read nothing else, and confirm anything unclear.