The clinical chart constitutes an evolving patient care document. This article compares charts from the turn of the century with those of today. It has changed from a simple user-friendly personal note record to a major medical-legal documentation system. With this evolution have come shifts in clinicians' attitudes toward the chart, a more active role in influencing care for the record, a much more public position of it, and a more homogenized record. It concludes with methods for the practitioners to incorporate the evolving chart into their work so as to further improve their documentation and care.

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