Discussion of each Problem on the P.L. - here is where your speculations and differential diagnosis are recorded. Rx - treatment Pt. Then consider what organ systems or body regions might be involved. You will then ask the patient all of the questions found on the Review of Systems list under cardiovascular, pulmonary, and musculoskeletal systems. Any question not listed is considered not to have been asked.
Patients often have two or more acute or chronic medical problems.
Lumping is convenient, but often confusing to the reader. It makes it difficult to determine what you were thinking about when you evaluated the patient. It is often difficult for the clinician to ensure that they have evaluated each problem in a complete manner if the data is lumped. Some problems seem easy to lump - e.g. cough and sore throat. Most clinicians would record a SOAP note with the hx for both complaints, followed by the objective findings, followed by an assessment with a P.L and discussion, concluding with a plan for both complaints.