A few weeks ago I was asked to do a special blog on SOAP charts, which was rather serendipitous, since the subject of SOAPing has been much on my mind of late.
You see, at Brenneke School of Massage, I received an excellent education concerning SOAPs. We drilled and re-drilled, wrote and re-wrote, using an excellent resource mentioned in an earlier Find Touch blog, Diana L. Thompson’s Hands Heal: Communication, Documentation, and Insurance Billing for Manual Therapists. By the time I graduated I was doing SOAP charts that almost threatened to become novellas. And even though we were told that our training was “extra thorough” and we would probably not need to produce such exquisite documents in the “real world,” I still expected to immediately transfer my SOAPing skills into the first massage job of my career.
Not so. When I graduated I chose to take a job with a business that was part of a national massage chain, because I reasoned I could get my hands on the maximum amount of tissue in a relatively brief amount of time, gaining a LOT of experience. That part happened in the way I expected. However, the first time I picked up what I thought was a SOAP chart, I realized it was made up of about ten 2x2 inch squares, EACH of which was a SOAP chart. I freaked. There was no way I could get all the information in that square, I fretted to the head therapist. Not to mention the fact that my handwriting has always been an argument for bringing penmanship classes back into the public schools. Any kind of handwriting task makes me look like Michael Jordan heading to the basket back in the day, with his tongue sticking out to the side in total concentration. I had to get it all in PLUS make it really small? I was sunk.
But to my surprise, no one in management seemed upset by the lack of space. In fact, I feel therapists were encouraged to spend as little time as possible writing anything down because it would “take away” from the massage. This kind of attitude is very confusing, especially to newbies who have been trained that SOAP charts are part of what makes us healing professionals.
Recently, I begin working for another such business that DOES encourage SOAP charts, but these are done electronically, after the massage, having no paper to take on-the-spot session notes due to the desire to make it a paperless process. Well, that may be eco-friendly, but it doesn’t help those of us who don’t always have perfect recall. In any case, we are still encouraged to keep even the initial intake under five minutes, and that can be very, very hard to do and produce a chart that reflects any clear and useful record of a session, especially if you need to develop client goals (A: Assessment) for insurance purposes.
The whole issue of SOAPs, then, can become very complex. We know they are important, and we are trained to do them well. Then many of us leave school and work for businesses that don’t give us time or space to do them correctly. Then our SOAP skills atrophy; then we find ourselves, as I find myself at the moment, back with Hands Heal, polishing up because now I’m not just doing good therapeutic work, I’m doing it for insurance purposes. And yet I still may have no more than five minutes to do this. One therapist told me she solves the problem by taking notes during the massage itself. Okay, I know THAT’S out... not only is my hand writing abysmal, I can’t rub my tummy and pat my head at the same time either. Never could. :-)
So in this particular blog, I’d love to have you contribute your own opinions concerning SOAPs... do you have time to do them as well as they should be done? And if you don’t, does this detract from the professional standards you have worked to build for your massage practice? And if so, what can we do, as a community, to change it and still keep everyone involved happy?
3 comments:
At our clinic SOAPs are a must. For these reasons
1) Half our sessions are inurance
2) A way to record key info about clients for the next time they come back
I don't belileve high quality therapeutic work can be done without the discipline of SOAP charting
I completely agree with you. And it seems just about every establishment is going to provide some sort of SOAP chart/form. Question is, how useful is it if you don't have the time or space to use it most effectively? I doubt sole providers, for example, have that problem. They tend to adjust their schedules (which they have the power to do) to include adequate time for SOAPing. I wonder if the more "volume oriented" establishments should look more closely at the time/space issue in terms of SOAPs and the care practitioners provide. I feel I always provided high-quality therapeutic work, BUT there were times I wished I'd had more time and resources for even more thorough record-keeping.
Aloha, I've been a self employed massage practitioner for about 13 years. I usually schedule an hour or more between my clients, and I do all 90 minute sessions. My clients are usually in my office for 2 hours. Only abot 10 percent of my clients are paid by insurance, and for the other 90% I could easily skip SOAP charting. I don't skip: I consistently write SOAP notes - sometimes much more thorougly than other times. This past year I've started typing my notes and I find that helps me to write more organized, readable and complete notes. It's not uncommon for me to spend 10 minutes writing notes though I prefer to keep it to 5. Ocasionally I wait too long to write my notes in which case they may be VERY brief. I find that writing the notes over time has helped me organize information in my brain, and to see patterns.
Post a Comment