For many patients the pathology report plays a key role in diagnosis and treatment planning. The report is traditionally addressed to the clinician and not to the patient. Although nowadays the patient can read the report, the complex content most often is incomprehensible to him/her. In an era of shared decision-making in which the patient must be fully informed, direct communication between patient and pathologist could be of added value for successful therapeutic management. Some successful initiatives have been reported. However, in the Netherlands direct interaction between the pathologist and the patient is still rare. This article is a plea to view the pathology report from a patient's perspective and to investigate how the communication of the content can be optimized. This article discusses possibilities for practical implementation, potential benefits and bottlenecks, as a basis for starting a discussion with practitioners, pathologists and patients in the Netherlands.