Which action best describes the Subjective portion of a SOAP note?

Which action best describes the Subjective portion of a SOAP note?

• A. Objective measurements and imaging results.
• B. Assessment and Plan.
• C. Physical exam measurements.
• D. Patient-reported symptoms and history.

Answer: (D)

The subjective portion of a SOAP note contains the patient's own report of what they're experiencing. It describes symptoms and relevant history as told by the patient (onset, location, quality, severity, duration, timing, and factors that worsen or relieve them), plus past medical history, medications, allergies, and any psychosocial details relevant to the current issue. This information is not measured or observed by the clinician but provided directly by the patient. The other parts capture data obtained through examination or testing (objective measurements and imaging) and the clinician's interpretation and proposed management (assessment and plan), so describing patient-reported symptoms and history is the essence of the subjective portion.

The subjective portion of a SOAP note contains the patient's own report of what they're experiencing. It describes symptoms and relevant history as told by the patient (onset, location, quality, severity, duration, timing, and factors that worsen or relieve them), plus past medical history, medications, allergies, and any psychosocial details relevant to the current issue. This information is not measured or observed by the clinician but provided directly by the patient. The other parts capture data obtained through examination or testing (objective measurements and imaging) and the clinician's interpretation and proposed management (assessment and plan), so describing patient-reported symptoms and history is the essence of the subjective portion.