How to Stop DAX From Splitting One Complaint Into Multiple Sections

A one-sentence structural fix that prevents the most common DAX prompt failure.

If you've built custom DAX prompts, you've probably seen this:

Patient presents with shortness of breath and cough. DAX captures both. Your prompt generates:

• —Shortness of Breath — full assessment, full plan
• —Cough — nearly identical assessment, duplicated plan

Now you're deleting one section, copying pieces from the other, merging plans manually. The tool that was supposed to save time just created more work.

This isn't a DAX bug. It's a prompt architecture problem. And the fix is one sentence.

Why This Happens

If you run DAX's "summarize my note" function, you can see exactly how DAX thinks. It outputs a flat list under "Medical Diagnoses":

Medical Diagnoses: - Esophageal dysmotility - Esophageal obstruction - Achalasia - Aspiration pneumonitis - Dehydration

No hierarchy. No grouping. Just labels.

When your prompt says "repeat for each problem," DAX takes this list and generates one A&P section per item. Five diagnoses become five sections — even when esophageal dysmotility, achalasia, and esophageal obstruction are all aspects of the same clinical picture and should live under one heading.

DAX doesn't know the difference. And if you try to explain it within your prompt, DAX often gets more confused, not less.

The fix isn't explanation. It's structure.

The Fix

Add this instruction to your prompt:

"Repeat this section for each primary complaint or system involved, not for each differential diagnosis or symptom mentioned."

Then add a Differential Diagnosis section within your Assessment and Plan template. This gives the model a place to capture medical complexity without creating duplicate sections.

How to Implement

Find the line in your prompt that says something like:

{Repeat for each problem}

Replace it with:

{Repeat for each primary complaint or system involved}

Then add this rule:

Do NOT create separate sections for differential diagnoses, symptoms, or related conditions. List these inside the Differential Diagnosis section of the relevant complaint.

And ensure your A&P template includes a differential section:

[Complaint or System] Assessment: Differential Diagnosis: Plan:

Before and After

Before (problem-based architecture):

Esophageal dysmotility Assessment: difficulty swallowing, likely motility disorder... Plan: GI consult, NPO, IV fluids

Achalasia Assessment: difficulty swallowing, likely motility disorder... Plan: GI consult, NPO, IV fluids (duplicated)

Esophageal obstruction Assessment: difficulty swallowing... Plan: GI consult, NPO, IV fluids (duplicated again)

Dehydration Assessment: decreased intake... Plan: IV fluids (duplicated)

After (complaint-based architecture):

Dysphagia Assessment: progressive difficulty swallowing solids and liquids, imaging consistent with esophageal dilation Differential Diagnosis: achalasia (most likely), esophageal dysmotility, mechanical obstruction (less likely given imaging) Plan: GI consult, NPO, IV fluids for dehydration, admission for further workup

One section. Full clinical complexity captured. No merging required.

Why This Works

LLMs respond to structure before rules. If your architecture says "repeat for each problem" and DAX provides five diagnostic labels, you get five sections — regardless of any other instructions you've written.

Complaint-based architecture forces the model to group related items. The differential lives inside a dedicated section. The plan appears once.

In repeated testing across multiple case types, this structural change consistently prevented duplication where other prompt adjustments failed.

Want to Go Deeper?

This fix works. But understanding why DAX creates this problem in the first place changes how you approach every prompt you build.

The core issue is that DAX does not understand clinical hierarchy — it treats every diagnosis, symptom, and differential item as equal. When your prompt architecture doesn't account for that, duplication is inevitable.

For the full explanation of how DAX processes clinical information and why complaint-based architecture is the structural solution, read: DAX Does Not Understand Clinical Hierarchy (And Why Your Prompts Need To).