None of us got into massage to do paperwork. We are in search of a painless way to document our sessions. With advancements in integrative medicine and the inclusion of massage therapy in health care, we no longer can avoid charting. But we can keep it simple. Here’s how.
F-DAR is a recent format adopted by the nursing profession, primarily for brief interactions with patients in a hospital setting. Other practitioners are adopting this because of its simple format and clear topic categories, preferring this over the SOAP format.
F-DAR stands for Focus, Data, Action, Response. The categories don’t require much training, unlike Subjective, Objective, Assessment, Plan. Here’s how they compare:
I love this category. It highlights why the client is getting a massage.
- Pro: You don’t have to wade through the entire Subjective section to figure out what’s most important.
- Con: The only drawback is when the client has multiple issues. SOAP was designed to address all client conditions in one note.
- Adaptation: Prioritize the client’s goals for the session and list them under Focus.
This section houses both subjective and objective data.
- Pro: If you have one focus, this is convenient.
- Con: This section can become overwhelming, especially if you chart details about their symptoms and you assess posture, ROM, and/or document palpation findings.
- Adaption: Limit your use of this format for wellness or attach measurement tools such as figures, scales, or photos of posture for clients with health conditions.
I have always wanted a separate section for treatment. Here it is!
- Pro: This takes the treatment charting out of the Objective section of a SOAP chart, where it can stand alone.
- Con: This is the best place to include self-care homework, but I worry people will leave it out. It’s not obvious.
- Adaptation: Train yourself and others to include self-care homework in this section.
Replaces part of the Objective section and part of the Assessment section.
- Pro: This is way more practical and to the point than an assessment section of a SOAP chart.
- Con: In a hospital setting, nurses can drop by in 30 minutes to check in and see how the patient responded to treatment. It might be days or weeks before we see our client again.
- Adaptation: Chart both the changes to palpation and the client’s initial response pain (for example) in the current chart and follow up on function and other responses to treatment at the next appointment.
F-DAR is a great replacement for SOAP. It fits our scope and our client population well. When treating clients with health conditions, however, I recommend electronic record keeping (EHR). There is no need to follow specific formats like SOAP or F-DAR. An EHR provides sections that are both broader and more detailed, giving you the flexibility to tailor your charts to the individual client and your practice. Choose one that takes advantage of technology, tracks outcome measures, and provides visuals of progress over time.
A licensed massage therapist for over 30 years, Diana Thompson has a private practice in Seattle, WA, USA, treating acute and chronic pain disorders. Her newest endeavor, Hands Heal Electronic Health Record, is an intuitive cloud-based EHR that turns bland treatment notes into expressive graphs that chart meaningful results.
Diana authored Hands Heal: Communication, Documentation and Insurance Billing for Manual Therapists, now in its fourth edition, and has a new book called Integrative Pain Management: Massage, Movement, and Mindfulness Based Approaches.
The proud recipient of four National awards in 2013, Diana has been recognized for her leadership, volunteerism, and clinical expertise. Her awards include: Massage Therapist of the Year, One Concept; and Humanitarian of the Year, Performance Health.