Hello Ben,
I've run into the same problem of the current medication list being changed by deleting or adding medications at the end of the note. This is very dangerous, especially when dealing with other doctors. This just happened with a patient who is seeing a psychiatrist and another one who is seeing a cardiologist. Phone calls back and forth to determine what medications the patient has actually been taking, and what effect they had.
I reconcile medications at every visit, not just when the patient is new to the practice. Just as medication reconciliation is being emphasized, a stumbling block occurs which makes things worse and more confusing.
Norm