As a specialist, the letter writer is one of the most crucial things for us. Communication to our referring docs is what makes our practices thrive. So opening up Word and typing a letter can be painful.
The bonus of AC's letter writer (and I agree it needs work), is that it has the referring physician built in with address, the patient's name, and the note I just wrote. Mine are somewhat generic but the communication is there. I just template a generic reply (i.e. I saw this patient and here's what I think. Let me know if you have any questions). I then add my assessment and plan which is the main part of what my referring docs need to know (i.e. am I operating on them or do they need something else).
It definitely is quicker than dictating an entire letter to the doc after I dictated the entire consult.