The study confirmed a finding that most seasoned clinicians already recognized, which is that patients wished to have discussions in layman’s terms. Telling patients they have a “6-mm noncalcified nodule on CT scan” is vastly different from telling them they have “a small growth in their lung that is about the size of a pea.” Showing them their scan can be extremely productive and really does not take much time, especially if you are outlining the plan as you go. Visualizing the nodule provides patients with a frame of reference for size and allows you to review the trade-offs of biopsy, surgery, or watchful waiting. Showing a patient how far a needle would have to traverse through normal lung to reach a small central nodule (especially one that you believe is benign) is likely to make a watchful waiting approach much more attractive to the patient. More than anything, patients want to know if you think this is likely to be cancer or not. This should be followed by a management recommendation and the reasoning behind the choice you recommend. A typical conversation with a patient with a 5-mm, well-circumscribed, lower lobe nodule may go something like this: “Mrs. Jones, you have a small growth in your lung. Although I cannot be 100% sure what this is, the fact that you have never smoked cigarettes and have no history of cancer, and given what it looks like on the scan, I think the likelihood that this is a cancer is extremely low. Still, to be on the safe side, I would like to see you back in 6 months, when we can do another scan and review it together. If there is no growth at that time, we will follow you periodically with scans for a total of 2 years. We choose to follow you for 2 years because if there is no growth after 2 years then the likelihood that this is cancer is virtually zero. If there is growth anywhere along the way, we will discuss doing a biopsy or even taking it out. Both of those options are more aggressive and come with some risk. Since I think the risk of cancer is so low, I would not want to expose you to procedures that might cause you harm.” I often end this discussion with something I have found comforts patients enormously. “Mrs. Jones, if you were my (insert appropriate relative here—mother, sister, aunt, child, and so forth) with a similar finding on a scan, I would recommend the exact same course of action.” I end the visit with a recap of my impression and plan and ask if they understood what they just heard and whether they have any questions or concerns. Their responses often surprise me. Despite a recommendation for watchful waiting, some patients, no matter how low the risk, want a biopsy or even surgery to be 100% sure the lesion is not cancer. Respecting patient preferences is strongly recommended by the authors of this study and the American College of Chest Physicians, who published guidelines on the evaluation and management of pulmonary nodules.5 I believe this patient-centered approach is the key to a satisfying patient-physician relationship.