It's up to the doctor to write patient notes. Patient notes aren't really so the doctor knows how to treat you next time you come in. They're for the insurance companies to inspect to decide how much to pay you. And trust me, they don't want to pay you. They only make money when they don't pay you. Whether it's a private insurer or the gov (they're the worst), they won't give you a dime for a service that isn't documented in the notes. To fill out notes correctly, you have to be extensively trained in the art of bullshit administrative work, as all services have "codes", and each service rendered needs to be coded correctly to obtain reimbursement. It's a crazy system, and it forces doctors to work mega overtime just to get paid, and detracts from their one-on-one time with patients (you know, actual patient care). Administrators are ruining medicine, and the ACA is only going to make that worse, I'm afraid.