The problem-oriented approach in psychiatry.

The problem-oriented approach to record keeping developed by Lawrence Weed is having a significant impact on the practice of Psychiatry. In this system, the physician is required to identify list and number all the patient's psychiatric, social and physical problems. The problem list is kept at the front of the record, much like a table of contents. All subsequent data including the clinician's plans and progress notes arc cross-indexed to the numbered problems. A plan for approaching each problem is constructed with the help of the list of assets and resources which include patient's existing or potential characterological strengths, vocational skills and talents, as well as resources and supportive factors within the family and community. At regular intervals progress notes are made which may be classified as subjective, objective or related to the treatment plan.This system is aimed at effective patient-care because the information can be easily retrievable and thus can be thoroughly analysed, correlated and synthesized into an ongoing treatment plan. Some problems posed by the system are discussed and the author offers a simple practical mode of recording.