Clinical reasoning point for students and residents:
Depending on how far along the diagnostic process you are for a given issue, the content/structure of the assessment/plan for that problem should evolve.
Let me pitch 2 different frameworks:
1/4

When your problem is "# Fever," a common framework to organize its A/P is
# Symptom / syndrome
- Discussion of ddx (incl prioritization/reasoning)
- Next diagnostic steps
- Next therapeutic steps
2/4

But what if it's hospital day 3 now and your problem is no longer a symptom like fever, but a diagnosis like Streptococcal pneumonia
First, a problem well-stated is a problem half-solved.
Call it # Streptococcal pneumonia
But what should you think / talk about now?
3/4

Consider a different framework:
# A diagnosis
- Specific parameters we are following to assess response to treatment, and how those are doing
- Ongoing therapeutic plan and endpoints
- Any needed/pending diagnostics for further specification or follow-up
4/4

This obviously translates well from/to chronic outpatient problems.
Feedback, #medtwitter ?