Terry, I had a lot of the same problem. The entire chart organization in AC was just very different than I had been used to, coming from a SOAP problem oriented medical record background. I felt like a moron.
Personally, I use the Past Medical History for things that are over and done with: a section for surgical, a section for medical ("pneumonia, 1983") and maybe a section for things like last colonoscopy and vaccination status (until we decide to try out the health maintenance section). My partner, on the other hand, uses it as a place to list active problems that need to be addressed pretty much at each visit. I just leave those in the problem list.
The review of systems makes me a bit nuts. Unless I am doing a comprehensive examination, I always feel that pertinent negatives go in the HPI, and the ROS should be blank. Reimbursement rules dictate something go in there, so I put something in there, but it never seems germane or useful. Might as well template a recipe for goulash and put it in.
Reading lots of posts here, it is evident that one of the good things about AC is that you can adapt it to whatever style you want. Each "field" is really just that; a place to put in whatever you want. Some folks started in early versions of AC just dictating everything into a single field, for example. I ended up somewhat changing my "style" but not entirely. But then again, I am old and crotchety enough that I really don't care if anyone else likes my notes and have no illusions about being paid better if I do it their way.
