How to correctly do H&Ps and Consults
Too many times you see medical students, interns, residents, fellows and attendings doing an "H & P" incorrectly. Missing information. Non-pertinent information. The right information in the wrong order. This is a brief, concise guide to how you really do a history and physical for inpatient medicine.
With the advent of electronic medical records and computer generated templates, the art of writing a consult note or an H&P is being lost. Notes assembled from dropdowns and copied-forward text are very difficult for the next person to follow. If you want to stand out as a student, and become the kind of physician who communicates effectively with the physicians who actually read your notes, you have to learn this format. It has been tested and verified for the last hundred years as the best overall format for medical notes, both for communication and for documenting the patient's history and physical.
Nobody sits you down and teaches this. You watch someone above you do it, you copy them, and their habits become your habits. Then you spend the rest of your training writing notes that bury the useful information, bias your own thinking, and quietly cost you a level of billing on every patient you admit.
Everything on this site is free. Read the two main guides, keep the templates open on your phone during call, and feel free to send the link to anyone who needs it.
Start here
How to correctly do an admission H&P
The section by section guide: what actually belongs in the chief complaint, why the past medical history has no business in your HPI, and how to write an assessment and plan that reflects the work you did.
How to correctly do a consult
A consult is not an H&P with a different heading. Learn what changes, how to disagree with another service without starting a war in the chart, and how to stay in your lane.
Common night calls
The calls you will actually get at 3 a.m. and a structured way to think about each one, from hypertensive urgency and hypotension to hyperkalemia and respiratory distress.
Admit and transfer orders
Every line of the admission order set, in order, with the wording that keeps you out of trouble. Including the one condition descriptor you should stop using.
Tools and downloads
Question Banks
The exam wing grew into its own site, Alo Academy: over 4,000 board-style questions across 44 medical banks covering the shelf exams, rotation exams, USMLE, COMLEX and the specialty boards, with timed practice exams and AI analysis of every finished block. The first 10 questions of every bank are still free, and your existing sign-in works there.
Free patient tracker sheets
Printable rounding and tracking forms, laid out in the order you present. Read straight down the page instead of reformatting everything before rounds.
Antibiotic coverage tables
Sanford Guide style tables showing which drugs cover which bugs. Useful for the nights your pocket guide is in your other white coat.
ABG calculator
Enter pH, pCO2 and bicarbonate and get the acid base interpretation, the expected compensation, and the anion gap. Handy when your interpretation skills are rusty.
Drug guide
Forgot a dose? Need the side effect profile? A full online drug reference, with a mobile edition that works well on a phone.
Every note you will be asked to write
The templates in the sidebar cover the rest of the paperwork: the daily progress note, the discharge summary the next physician can actually use, procedure and operative notes, the off-service handoff, the obstetric notes, and how to pronounce a patient and document it properly.
Present illness goes in the HPI. History goes in the history. Acute, active problems go in the assessment and plan. Almost every bad note you will read breaks one of those three lines.
Get the printable tracker sheet pack
These are the printable PDF scut sheets we use on the wards: admit sheets and daily progress notes laid out in the exact order you present on rounds, patient trackers with an active problem list and separate columns for home and hospital medications, a ten patient sheet for bigger lists, and a cardiology and telemetry note. Print them double sided, fold them into your pocket, and stop rewriting the same information three times a day.
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