Chiropractors play a critical role in helping patients recover from accidents, while also providing documentation that supports personal injury claims. One of the most common questions we hear from practitioners is: When should I use a narrative report versus SOAP notes? Understanding the difference—and when each is appropriate—ensures patients receive optimal care and that records are legally useful.
Understanding SOAP Notes
SOAP notes—standing for Subjective, Objective, Assessment, and Plan—are the standard documentation for daily chiropractic care. They are concise, structured, and focus on clinical observations. Benefits of SOAP notes include:
- Clear, consistent documentation of each visit.
- Efficient record-keeping for ongoing treatment.
- Objective data that demonstrates progress over time.
For personal injury patients, SOAP notes are essential to show:
- The patient’s reported symptoms (subjective).
- Observable signs and test results (objective).
- Your clinical impressions (assessment).
- Recommended treatment and frequency (plan).
SOAP notes are particularly useful for routine updates and when the patient is following a standard treatment plan. They provide a day-to-day timeline that attorneys and insurance adjusters can review to understand care progression.
Understanding Narrative Reports
Narrative reports are more detailed, comprehensive documents that summarize a patient’s overall condition, treatment history, and prognosis. Unlike SOAP notes, they are written in paragraph form and provide context, explanations, and professional opinions. Benefits of narrative reports include:
- Offering a broader view of the patient’s injury and recovery.
- Explaining causation and linking the accident to the injury.
- Providing a professional opinion on medical necessity, permanency, and functional limitations.
Narrative reports are often requested at key points in a personal injury claim, such as at the initial evaluation for legal purposes, prior to settlement discussions, and when an attorney needs expert input on ongoing care or prognosis.
When to Use Which Type of Notes
In personal injury cases, use SOAP notes for routine visits to track progress, when documenting patient-reported symptoms, objective findings, and treatment plans, and to create a continuous record of care that demonstrates consistency. Otherwise, use narrative reports when a comprehensive summary is required for legal proceedings, to explain causation, treatment rationale, and medical necessity, and to provide opinions on long-term outcomes, permanency, or functional limitations.
In practice, SOAP notes and narrative reports complement each other. SOAP notes provide detailed, day-to-day tracking, while narrative reports synthesize that information into a document that clearly communicates the patient’s overall situation and prognosis to attorneys or insurance adjusters.
Documentation Tips
Regardless of format selected, chiropractors should:
- Maintain consistency: Ensure SOAP notes are thorough and objective to support any narrative report.
- Be specific: Both notes and reports should include objective findings, symptom progression, and treatment rationale.
- Avoid duplication: Narrative reports should summarize and interpret, not simply copy SOAP notes.
- Collaborate with attorneys: Ask if they need a narrative report for settlement, trial, or other legal purposes.
Knowing when to use SOAP notes versus narrative reports is crucial for both patient care and legal advocacy. SOAP notes track ongoing treatment and objective progress, while narrative reports provide a comprehensive summary that explains the injury, causation, and treatment in context.
