What is the meaning of a doctor's notes in a patient's clinical record?
British Columbia, Canada
The following excerpt is from Hopp v. Lopez, 2012 BCSC 2179 (CanLII):
As Justice Smith said in Edmondson v. Payer, 2011 BCSC 118, clinical records are not intended to be, and usually are not, a verbatim record of everything that was said: ... They are usually a brief summary or paraphrase, reflecting the information that the doctor considered most pertinent to the medical advice or treatment being sought on that day. (para. 32)
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