The MDM goes right after the assessment. In ED notes and some consult notes they have changed notes to APSO (assessment, plan, subjective, objective) it sucks.
Anyway, I did a note today with cramp pain and paresthesia and pain at the plantar fascia. Went with Vitamin B12. So I did Vitamin B12, IF, folate, etc.
On the MDM, I wrote more like considered autoimmune diseases, MS, other causes of paresthesia, etc. DVT unlikely due to know redness or warmth and a 13 year old in good health, playing sports and no smoking or contraceptives with no family history. If nothing else pans out, consider Doppler. Vitamin B12 can cause cramping, paresthesia, exquisite pain especially hands and feet, etc.
The MDM explains exactly what you were thinking and how you arrived at your diagnosis. Of course, you wouldn't use it for an ear infection.
The ED has a hard time not just writing the entire HPI in the MDM, a consequence of the APSO note.
