Here's what I'd do. sm

Posted By: nm on 2006-06-30
In Reply to: Here's what I mean - tf

Subject: Here's what I'd do. sm

The patient comes in with two problems.

PROBLEM #1. The first problem ...

Examination shows ...

Treatment yadda-yadda-yadda and a ha-cha-cha.

PROBLEM #2: Blah-de-blah.

Or, say if problem #1 is hypertension, instead of writing "problem" you could just put in bold or capitalize it or both.

I would NOT consider combining them or moving things around.

Complete Discussion Below:

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Format for multiple problems - tf
- Here's what I mean - tf
  - Here's what I'd do. sm - nm
  - Since no QA, just do what you feel - FT MT
  - If QA has no recommendations, you don't have to have headings in there at all. Just do the report - as separate paragraphs for each prob. nm
- Best to ask your QA how the client prefers this to be done. nm - nm
- Can you see samples of how the other MTs handle it? Are these SOAP notes? Can you number the probs - under Assessment/Plan? nm
- Not sure what you mean. - FT MT

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