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Posted by Stephen Bennett on Friday April 27, @05:55PM
from the dept.
Some of our students are being instructed not to write the "assessment" and "plan" parts of their notes. This is wrong. Students need to practice documenting their assessment and management of patients, and should write a full "SOAP" note in the chart.
Physicians must write their own separate note, NOT JUST COUNTERSIGN THE STUDENT NOTE!. The physicians' notes may refer to the student notes for the past, family, and social history; but physicians must document their own HPI, ROS, and exam in every case. Any questions, just page me. Thanks for your help.
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