Lawrence “Larry” Weed (born December 1923, died June 3, 2017) was an American physician, researcher, educator, entrepreneur, and author, who is best known for creating the problem-oriented medical record as well as one of the first electronic health records. (https://en.wikipedia.org/wiki/Lawrence_Weed )
The POMR, including what evolved into the current standard for structured medical visit notes (SOAP: Subjective impressions, Objective data, Assessment of the situation, and Plan) was first introduced in 1964 as a response to the growing importance of data and evidence in medicine. The previous approach had been to organize medical information by source: x-ray reports in one section, lab reports in another, operative reports in another. By organizing the information in the medical record around problems, the POMR and SOAP note supported better data collection and retrieval, more organized clinical analysis, and better care over time.
An excellent way to understand how revolutionary his concepts were (and how good a speaker he was) is to view this video of him presenting at a 1971 grand rounds on the POMR.
Physicians who trained in the late 1960s and early 1970s will remember how transformative the POMR and associated SOAP note were, not just for the record, but for the practice of medicine.
Here are a few links to previous posts we had about Larry Weed:
JOPM: Is Larry Weed Right? – Terry Graedon – March 18, 2013
An excerpt from this last article shows that Larry Weed predicted Precision Medicine:
“In their book Medicine in Denial, Larry and Lincoln Weed argue that no single clinician has the cognitive capacity to match each patient’s presenting signs and symptoms to the correct choice out of hundreds of possible disease conditions that might correspond. According to the Weeds, misdiagnoses “are not failures of individual physicians. Rather they are failures of a non-system that imposes burdens too great for physicians to bear.”
They argue that software tools should be employed first. Software linked to the medical evidence base could present a true list of probable diagnoses for physician and patient to consider together, rather than the ad hoc list of differential diagnoses that a doctor may construct based on his or her particular interests or specialization.”
Let us know how the work and life of Larry Weed influenced your work!