DATEXIS/aci_bench_intent_annotated · Datasets at Hugging Face

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doctor: a seven out of 10 pain . um , and no other injuries while you went down this double black diamond ? patient: no , interestingly enough , this is the only one .	D2N094	8	[ "Personal History" ]	[ "Subjective" ]	a seven out of 10 pain . um , and no other injuries while you went down this double black diamond ?	2,400
doctor: okay . well , i guess you escaped ... i mean ... patient: could have been much worse .	D2N094	9	[ "Chitchat" ]	[ "Null" ]	okay . well , i guess you escaped ... i mean ...	2,401
doctor: could have been much worse , yes . so , um , do you have any medical problems ? patient: um ... yeah , i'm ... i have chronic constipation .	D2N094	10	[ "Personal History" ]	[ "Subjective" ]	could have been much worse , yes . so , um , do you have any medical problems ?	2,402
doctor: do you take any medicine for it ? patient: miralax .	D2N094	11	[ "Personal History", "Therapeutic History" ]	[ "Subjective" ]	do you take any medicine for it ?	2,403
doctor: and does that help ? patient: seems to flow nicely .	D2N094	12	[ "Personal History", "Therapeutic History" ]	[ "Subjective" ]	and does that help ?	2,404
doctor: good for you . um ... have you ever had any surgeries before ? patient: yes , i had my appendix out when i was seven .	D2N094	13	[ "Personal History" ]	[ "Subjective" ]	good for you . um ... have you ever had any surgeries before ?	2,405
doctor: okay . um , let's look at your x-ray together . hey , dragon , show me the last x-ray . all right . so looking at your right hand here , and that index finger looks great . so all the joints , bones are in the right places , no fractures , so you've got a normal right hand x-ray . um , let's go ahead and check your finger out . now does it hurt when i push on your finger like this ? patient: yes .	D2N094	14	[ "Physical Examination", "Radiology Examination" ]	[ "Objective" ]	okay . um , let's look at your x-ray together . hey , dragon , show me the last x-ray . all right . so looking at your right hand here , and that index finger looks great . so all the joints , bones are in the right places , no fractures , so you've got a normal right hand x-ray . um , let's go ahead and check your finger out . now does it hurt when i push on your finger like this ?	2,406
doctor: does it hurt when i pull your finger like this ? patient: yes .	D2N094	15	[ "Physical Examination" ]	[ "Objective" ]	does it hurt when i pull your finger like this ?	2,407
doctor: does it hurt when i squeeze over this joint here ? patient: yes . please do n't do that .	D2N094	16	[ "Physical Examination" ]	[ "Objective" ]	does it hurt when i squeeze over this joint here ?	2,408
doctor: does it hurt when i squeeze over this ? patient: yes .	D2N094	17	[ "Physical Examination" ]	[ "Objective" ]	does it hurt when i squeeze over this ?	2,409
doctor: okay . um ... so with your x-ray , and with your exam , looks like you have a sprain of your distar- distal interphalangeal joint . it's called your dip joint , of your right index finger , and so what we're gon na do for that is we're gon na put a splint on that right finger . i'm gon na give you a strong antiinflammatory called mobic . you'll take 15 milligrams once a day . i'll prescribe 14 of those for you . and i want you to come back and see me in two weeks , and let's make sure it's all healed up and if we need to start any hand therapy at that point , then we can . do you have any questions for me ? patient: no questions . thank you .	D2N094	18	[ "Discussion", "Follow-up", "Medication", "Other Treatments", "Acute Assessment" ]	[ "Assessment", "Plan" ]	okay . um ... so with your x-ray , and with your exam , looks like you have a sprain of your distar- distal interphalangeal joint . it's called your dip joint , of your right index finger , and so what we're gon na do for that is we're gon na put a splint on that right finger . i'm gon na give you a strong antiinflammatory called mobic . you'll take 15 milligrams once a day . i'll prescribe 14 of those for you . and i want you to come back and see me in two weeks , and let's make sure it's all healed up and if we need to start any hand therapy at that point , then we can . do you have any questions for me ?	2,410
doctor: you're welcome . hey , dragon , order the medications and procedures mentioned . and why do n't you come with me , and we'll get you checked out ? patient: okay .	D2N094	19	[ "Chitchat" ]	[ "Null" ]	you're welcome . hey , dragon , order the medications and procedures mentioned . and why do n't you come with me , and we'll get you checked out ?	2,411
doctor: hey , dragon , finalize the report .	D2N094	20	[ "Chitchat" ]	[ "Null" ]	doctor: hey , dragon , finalize the report .	2,412
doctor: hi , cheryl . how are you ? patient: i'm doing well . how are you ?	D2N095	0	[ "Greetings" ]	[ "Subjective" ]	hi , cheryl . how are you ?	2,413
doctor: i'm doing well . so i know the nurse told you a little bit about dax . i'd like to tell dax about you . patient: okay .	D2N095	1	[ "Chitchat" ]	[ "Null" ]	i'm doing well . so i know the nurse told you a little bit about dax . i'd like to tell dax about you .	2,414
doctor: cheryl is a 34-year-old female with a past medical history significant for hypertension , who presents today with back pain . cheryl , what happened to your back ? patient: so i've been walking a lot lately . i've been walking to ... 30 minutes to an hour or so a day . and all of a sudden , um , when i was walking , my , um , back just kind of seized up on me . and i do n't really know what it was . maybe i was going a little bit faster . but it just all kind of clenched .	D2N095	2	[ "Acute Symptoms", "Personal History" ]	[ "Subjective" ]	cheryl is a 34-year-old female with a past medical history significant for hypertension , who presents today with back pain . cheryl , what happened to your back ?	2,415
doctor: okay . so you felt like , maybe like a spasm or something like that ? patient: yeah .	D2N095	3	[ "Acute Symptoms" ]	[ "Subjective" ]	okay . so you felt like , maybe like a spasm or something like that ?	2,416
doctor: okay . and how many days ago was that ? patient: that was about six days ago now .	D2N095	4	[ "Acute Symptoms" ]	[ "Subjective" ]	okay . and how many days ago was that ?	2,417
doctor: okay . and what have you taken for the pain ? patient: i've been taking ibuprofen . um , and then i've been putting some heat on it . but it's still pretty stiff .	D2N095	5	[ "Acute Symptoms", "Therapeutic History" ]	[ "Subjective" ]	okay . and what have you taken for the pain ?	2,418
doctor: okay . all right . um , and did you have any trauma before that happened ? were you doing anything strenuous like crossfit or lifting boxes or anything like that before you went for , for the walk ? patient: i have been lifting more , um , probably around three times a week . so i do n't know if it was because i was doing deadlifts that day and then walked .	D2N095	6	[ "Personal History" ]	[ "Subjective" ]	okay . all right . um , and did you have any trauma before that happened ? were you doing anything strenuous like crossfit or lifting boxes or anything like that before you went for , for the walk ?	2,419
doctor: okay . all right . and was it any particular area in your back ? was it the lower back ? patient: yeah , it was .	D2N095	8	[ "Acute Symptoms" ]	[ "Subjective" ]	okay . all right . and was it any particular area in your back ? was it the lower back ?	2,420
doctor: okay . on one side versus the other ? patient: um , kind of both equally .	D2N095	9	[ "Acute Symptoms" ]	[ "Subjective" ]	okay . on one side versus the other ?	2,421
doctor: okay . all right . and any numbing or tingling in your legs or your feet ? patient: no , i have n't felt anything like that .	D2N095	10	[ "Acute Symptoms" ]	[ "Subjective" ]	okay . all right . and any numbing or tingling in your legs or your feet ?	2,422
doctor: okay . any weakness in your lower extremities ? patient: no .	D2N095	11	[ "Vegetative History" ]	[ "Subjective" ]	okay . any weakness in your lower extremities ?	2,423
doctor: okay . all right .and then in terms of your blood pressure , how are you doing ? patient: so i got that cuff that you suggested the ... our ... the last visit , and i've been doing readings at home . and that's been looking great , too . i've been watching my diet . again , my boyfriend's been great and dieting with me so i do n't have to do it alone . and everything's been good .	D2N095	12	[ "Personal History" ]	[ "Subjective" ]	okay . all right .and then in terms of your blood pressure , how are you doing ?	2,424
doctor: okay . excellent . and you're taking the lisinopril ? patient: yes .	D2N095	13	[ "Personal History", "Therapeutic History" ]	[ "Subjective" ]	okay . excellent . and you're taking the lisinopril ?	2,425
doctor: okay . wonderful . okay . so i know you did a review of systems sheet with the nurse , and i know you endorse , you know , this back pain . um , do you have any other symptoms ? fever , chills , congestion , cough , chest pain , shortness of breath ? patient: i have a little bit of nasal congestion , but that's just from my seasonal allergies .	D2N095	14	[ "Vegetative History" ]	[ "Subjective" ]	okay . wonderful . okay . so i know you did a review of systems sheet with the nurse , and i know you endorse , you know , this back pain . um , do you have any other symptoms ? fever , chills , congestion , cough , chest pain , shortness of breath ?	2,426
doctor: okay . all right . well , let's go ahead . i want to do a quick physical exam on you . patient: okay .	D2N095	15	[ "Physical Examination" ]	[ "Objective" ]	okay . all right . well , let's go ahead . i want to do a quick physical exam on you .	2,427
doctor: okay ? hey , dragon , show me the vital signs . so good- you know , here in the office , your vital signs look great . your blood pressure's really well controlled , which is good . so that's a good job . so i'm going to take a listen to your heart and lungs . i'm going to examine your back , and i'm going to let you know what i find . okay ? patient: okay .	D2N095	16	[ "Physical Examination" ]	[ "Objective" ]	okay ? hey , dragon , show me the vital signs . so good- you know , here in the office , your vital signs look great . your blood pressure's really well controlled , which is good . so that's a good job . so i'm going to take a listen to your heart and lungs . i'm going to examine your back , and i'm going to let you know what i find . okay ?	2,428
doctor: okay . all right . so on physical examination , you know , everything looks good . you know , on your heart exam , i do hear that slight two out of six systolic ejection murmur , but you've had that before . that seems stable to me . on your back exam , you do have some pain to palpation on the right lateral aspect of your lumbar spine , and you do have pain with flexion and extension as well , and you have a negative straight leg raise . so what does that mean ? so we're going to go over that . okay ? let's ... let me look at some of your results , though , first . okay ? patient: okay .	D2N095	17	[ "Physical Examination" ]	[ "Objective" ]	okay . all right . so on physical examination , you know , everything looks good . you know , on your heart exam , i do hear that slight two out of six systolic ejection murmur , but you've had that before . that seems stable to me . on your back exam , you do have some pain to palpation on the right lateral aspect of your lumbar spine , and you do have pain with flexion and extension as well , and you have a negative straight leg raise . so what does that mean ? so we're going to go over that . okay ? let's ... let me look at some of your results , though , first . okay ?	2,429
doctor: we did an x-ray before you saw me , so let's look at that . hey , dragon , show me the back x-ray . so looking here at this x-ray of the lumbar spine , everything looks good . there's good boney alignment . there's no obvious fracture , you know , which is not surprising based on your history . okay ? patient: hmm .	D2N095	18	[ "Radiology Examination" ]	[ "Objective" ]	we did an x-ray before you saw me , so let's look at that . hey , dragon , show me the back x-ray . so looking here at this x-ray of the lumbar spine , everything looks good . there's good boney alignment . there's no obvious fracture , you know , which is not surprising based on your history . okay ?	2,430
doctor: hey , dragon , show me the labs . and your labs that we did before you came in all look great . there's no elevated white blood cell count . there's no signs of infection . again , those are all really good . okay ? so let me go over with you about my assessment and my plan for you . so for your first problem , this back pain , i think you have a lumbar strain , and , you know , that might've happened , you know , lifting something or exercising . and so what i want to do is prescribe meloxicam , 15 milligrams once a day . uh , i want you ... you can ice the area , and you can also apply heat sometimes as well . um , you know , i'm going to refer you to physical therapy just to do some strengthening exercises of your back , um , because i do want you to continue to be able to work out and exercise . okay ? patient: okay .	D2N095	19	[ "Medication", "Lab Examination", "Referral", "Acute Assessment" ]	[ "Objective", "Assessment", "Plan" ]	hey , dragon , show me the labs . and your labs that we did before you came in all look great . there's no elevated white blood cell count . there's no signs of infection . again , those are all really good . okay ? so let me go over with you about my assessment and my plan for you . so for your first problem , this back pain , i think you have a lumbar strain , and , you know , that might've happened , you know , lifting something or exercising . and so what i want to do is prescribe meloxicam , 15 milligrams once a day . uh , i want you ... you can ice the area , and you can also apply heat sometimes as well . um , you know , i'm going to refer you to physical therapy just to do some strengthening exercises of your back , um , because i do want you to continue to be able to work out and exercise . okay ?	2,431
doctor: and for your last problem , your high blood pressure , again , everything looks great here . um , you know , i think you're doing a really good job with that as well . i want you to continue on the lisinopril , 10 milligrams a day . and then , uh , let me know if you notice any increases in your blood pressure readings . okay ? patient: okay .	D2N095	20	[ "Medication", "Reassessment" ]	[ "Assessment", "Plan" ]	and for your last problem , your high blood pressure , again , everything looks great here . um , you know , i think you're doing a really good job with that as well . i want you to continue on the lisinopril , 10 milligrams a day . and then , uh , let me know if you notice any increases in your blood pressure readings . okay ?	2,432
doctor: do you need a refill of the lisinopril ? patient: yes , i do , actually .	D2N095	21	[ "Discussion", "Medication" ]	[ "Plan" ]	do you need a refill of the lisinopril ?	2,433
doctor: okay . hey , dragon ? order lisinopril 10 milligrams po daily . okay . uh , so the nurse will be in soon , and she'll get you checked out . okay ? patient: okay .	D2N095	22	[ "Chitchat" ]	[ "Null" ]	okay . hey , dragon ? order lisinopril 10 milligrams po daily . okay . uh , so the nurse will be in soon , and she'll get you checked out . okay ?	2,434
doctor: all right . hey , dragon ? finalize the note .	D2N095	23	[ "Chitchat" ]	[ "Null" ]	doctor: all right . hey , dragon ? finalize the note .	2,435
doctor: um , hi mrs. anderson . right ? patient: yeah . yes , doctor .	D2N096	0	[ "Greetings" ]	[ "Subjective" ]	um , hi mrs. anderson . right ?	2,436
doctor: what brings you here today ? patient: hi , doctor . um , i'm having this left shoulder pain lately , uh , and it's paining a lot .	D2N096	1	[ "Acute Symptoms" ]	[ "Subjective" ]	what brings you here today ?	2,437
doctor: okay . all right . hey , dragon . i am seeing mrs. anderson , a 44-years-old female , uh , complaining to check the left shoulder pain . um , so how long how has this lasted ? patient: it's been a week , doctor . yeah .	D2N096	2	[ "Acute Symptoms" ]	[ "Subjective" ]	okay . all right . hey , dragon . i am seeing mrs. anderson , a 44-years-old female , uh , complaining to check the left shoulder pain . um , so how long how has this lasted ?	2,438
doctor: a week . patient: yeah .	D2N096	3	[ "Acute Symptoms" ]	[ "Subjective" ]	a week .	2,439
doctor: um , did you take any medication yourself ? patient: no , i did not take any pain medications . actually , i did . i did take a tylenol for two or three days , but then that did n't help at all . so , uh , the reason why it started or when it started to happen is-	D2N096	4	[ "Acute Symptoms", "Therapeutic History" ]	[ "Subjective" ]	um , did you take any medication yourself ?	2,440
doctor: yeah , okay . patient: and , uh , i do n't know . maybe i must have toppled over into some weird position , so it started to pain since then , uh , because of a certain move .	D2N096	6	[ "Acute Symptoms" ]	[ "Subjective" ]	yeah , okay .	2,441
doctor: okay , uh- patient: i went overboard , i think . yeah .	D2N096	7	[ "Acute Symptoms" ]	[ "Subjective" ]	okay , uh-	2,442
doctor: all right , lem me , uh , take a quick look . uh , can you move up a little bit ? yeah . patient: uh , yeah . in fact , that's hurts .	D2N096	8	[ "Physical Examination" ]	[ "Objective" ]	all right , lem me , uh , take a quick look . uh , can you move up a little bit ? yeah .	2,443
doctor: does that- does it hurt ? patient: yeah , it does .	D2N096	9	[ "Physical Examination" ]	[ "Objective" ]	does that- does it hurt ?	2,444
doctor: what if you move back a little bit ? patient: uh , that also hurts , doctor .	D2N096	10	[ "Physical Examination" ]	[ "Objective" ]	what if you move back a little bit ?	2,445
doctor: yeah , okay . patient: any kind of movement on my left shoulder actually hurts .	D2N096	11	[ "Physical Examination" ]	[ "Objective" ]	yeah , okay .	2,446
doctor: okay . all right , um , so let's ... hey , dragon . show me the last x-ray . all right , from the x-ray , it does n't look like there is any , uh , broken bone or fracture . my guess is you probably , um , hurt your joint , uh- patient: uh- .	D2N096	12	[ "Radiology Examination", "Acute Assessment" ]	[ "Objective", "Assessment" ]	okay . all right , um , so let's ... hey , dragon . show me the last x-ray . all right , from the x-ray , it does n't look like there is any , uh , broken bone or fracture . my guess is you probably , um , hurt your joint , uh-	2,447
doctor: . a little bit . patient: mm-hmm .	D2N096	13	[ "Radiology Examination" ]	[ "Objective" ]	. a little bit .	2,448
doctor: so i would , uh , suggest you continue using the pain reliever , maybe just like 600 milligram of ibuprofen three times a day and use it for a week . patient: and for how long ? yes .	D2N096	14	[ "Medication" ]	[ "Plan" ]	so i would , uh , suggest you continue using the pain reliever , maybe just like 600 milligram of ibuprofen three times a day and use it for a week .	2,449
doctor: for a week . patient: a week , okay .	D2N096	15	[ "Discussion", "Medication" ]	[ "Plan" ]	for a week .	2,450
doctor: and then if you ... if it's still painful , you can use , uh , ice or , um , heat pad- patient: okay .	D2N096	16	[ "Discussion", "Medication" ]	[ "Plan" ]	and then if you ... if it's still painful , you can use , uh , ice or , um , heat pad-	2,451
doctor: . 'cause that might help relieve your pain . patient: okay .	D2N096	17	[ "Discussion", "Medication" ]	[ "Plan" ]	. 'cause that might help relieve your pain .	2,452
doctor: mm-hmm . patient: . so , um , i hope that should n't matter , right ?	D2N096	19	[ "Discussion" ]	[ "Plan" ]	mm-hmm .	2,453
doctor: um , that does n't seem related to your pain . patient: okay .	D2N096	20	[ "Discussion" ]	[ "Plan" ]	um , that does n't seem related to your pain .	2,454
doctor: so ... but i would try to rest my , your left arm- patient: okay .	D2N096	21	[ "Discussion" ]	[ "Plan" ]	so ... but i would try to rest my , your left arm-	2,455
doctor: . while it's healing . patient: okay .	D2N096	22	[ "Discussion" ]	[ "Plan" ]	. while it's healing .	2,456
doctor: so , um- patient: can i , uh , carry any heavy weights or-	D2N096	23	[ "Discussion" ]	[ "Plan" ]	so , um-	2,457
doctor: no , no . definitely not . patient: . anything like that ?	D2N096	24	[ "Discussion" ]	[ "Plan" ]	no , no . definitely not .	2,458
doctor: definitely not . patient: okay . okay .	D2N096	25	[ "Discussion" ]	[ "Plan" ]	definitely not .	2,459
doctor: yeah , use , um , right hand- patient: okay .	D2N096	26	[ "Discussion" ]	[ "Plan" ]	yeah , use , um , right hand-	2,460
doctor: . instead- patient: mm-hmm .	D2N096	27	[ "Discussion" ]	[ "Plan" ]	. instead-	2,461
doctor: . for the next , uh , at least just three to four weeks . patient: mm-hmm .	D2N096	28	[ "Discussion" ]	[ "Plan" ]	. for the next , uh , at least just three to four weeks .	2,462
doctor: uh , come back to see me if the pain , you know , still there after maybe three weeks- patient: sure .	D2N096	29	[ "Follow-up" ]	[ "Plan" ]	uh , come back to see me if the pain , you know , still there after maybe three weeks-	2,463
doctor: . so we can take a further look . patient: okay . sure .	D2N096	30	[ "Follow-up" ]	[ "Plan" ]	. so we can take a further look .	2,464
doctor: but you should be fine- patient: yeah .	D2N096	31	[ "Chitchat" ]	[ "Null" ]	but you should be fine-	2,465
doctor: . after just resting and regular pain reliever . patient: okay . all right .	D2N096	32	[ "Chitchat" ]	[ "Null" ]	. after just resting and regular pain reliever .	2,466
doctor: um , maybe . let's see how you're doing in the next three weeks . patient: uh .	D2N096	34	[ "Discussion", "Follow-up" ]	[ "Plan" ]	um , maybe . let's see how you're doing in the next three weeks .	2,467
doctor: hey , dragon . um , order medications and procedures as discussed . all right . patient: okay .	D2N096	35	[ "Chitchat" ]	[ "Null" ]	hey , dragon . um , order medications and procedures as discussed . all right .	2,468
doctor: um , i think that's good for today . hope you feel better soon . patient: okay . thank you , doctor .	D2N096	36	[ "Chitchat" ]	[ "Null" ]	um , i think that's good for today . hope you feel better soon .	2,469
doctor: um , you can also try advil . patient: okay .	D2N096	39	[ "Discussion", "Medication" ]	[ "Plan" ]	um , you can also try advil .	2,470
doctor: yeah , so , um ... patient: yeah .	D2N096	40	[ "Chitchat" ]	[ "Null" ]	yeah , so , um ...	2,471
doctor: ale- , aleve . i mean , aleve . patient: i see . okay , thank you , doctor .	D2N096	41	[ "Discussion", "Medication" ]	[ "Plan" ]	ale- , aleve . i mean , aleve .	2,472
doctor: thank you .	D2N096	42	[ "Chitchat" ]	[ "Null" ]	doctor: thank you .	2,473
doctor: elizabeth , how are you ? patient: i'm doing okay . how are you ?	D2N097	0	[ "Greetings" ]	[ "Subjective" ]	elizabeth , how are you ?	2,474
doctor: doing okay . so i know the nurse told you about dax . i'd like to tell dax a little bit about you , okay ? patient: okay .	D2N097	1	[ "Chitchat" ]	[ "Null" ]	doing okay . so i know the nurse told you about dax . i'd like to tell dax a little bit about you , okay ?	2,475
doctor: all right . elizabeth is a 66-year-old female with a past medical history of significant for depression and hypertension who presents for her annual exam . so elizabeth , it's been a year since i've seen you . patient: mm-hmm .	D2N097	2	[ "Personal History" ]	[ "Subjective" ]	all right . elizabeth is a 66-year-old female with a past medical history of significant for depression and hypertension who presents for her annual exam . so elizabeth , it's been a year since i've seen you .	2,476
doctor: how are you doing ? patient: i'm doing well . there's been so many events now that we've been able to get vaccinated , i've been able to see my grandkids again , go to more birthday parties , it's been fantastic .	D2N097	3	[ "Acute Symptoms" ]	[ "Subjective" ]	how are you doing ?	2,477
doctor: yeah , i know . i've ... i mean , we've had some communication over telehealth and that type of thing , but it's not the same as being in-person , so i'm happy to see you today . now tell me a little bit about , you know , we have n't really got a chance to talk about your depression . how are you ... how are you doing with that ? i know we have n't had you on medication in the past because you're on medication for other things . what are your strategies with dealing with it ? patient: so i've been going to therapy once a week for the past year . um , mostly virtually , um , but starting to get in-person . virtual was a bit of a struggle , but i feel like being in-person with someone really helps me .	D2N097	4	[ "Personal History", "Therapeutic History" ]	[ "Subjective" ]	yeah , i know . i've ... i mean , we've had some communication over telehealth and that type of thing , but it's not the same as being in-person , so i'm happy to see you today . now tell me a little bit about , you know , we have n't really got a chance to talk about your depression . how are you ... how are you doing with that ? i know we have n't had you on medication in the past because you're on medication for other things . what are your strategies with dealing with it ?	2,478
doctor: okay . and do y- do you have a good support system at home ? patient: yes , i do . i have my husband and , uh , my kids are right down the street from me , so i'm very lucky .	D2N097	5	[ "Other Socials" ]	[ "Subjective" ]	okay . and do y- do you have a good support system at home ?	2,479
doctor: okay . all right . so that's good to hear . how about your blood pressure ? did you buy the blood pressure cuff that i- patient: yes .	D2N097	6	[ "Personal History" ]	[ "Subjective" ]	okay . all right . so that's good to hear . how about your blood pressure ? did you buy the blood pressure cuff that i-	2,480
doctor: . told you to ? okay . i know that we've been in communication and your blood pressures have been running okay . the last time i spoke with you , how are they doing since we last spoke ? patient: they've been doing well . i've been using the cuff , um , once a day , and they seem pretty normal .	D2N097	7	[ "Physical Examination", "Personal History" ]	[ "Subjective", "Objective" ]	. told you to ? okay . i know that we've been in communication and your blood pressures have been running okay . the last time i spoke with you , how are they doing since we last spoke ?	2,481
doctor: okay . and are you taking the lisinopril that i prescribed ? patient: yes .	D2N097	8	[ "Personal History", "Therapeutic History" ]	[ "Subjective" ]	okay . and are you taking the lisinopril that i prescribed ?	2,482
doctor: okay . great . all right . so i know that you did a review of systems sheet with the nurse when you checked in . you know , i know that you were talking about some nasal congestion . do you have any other symptoms , chest pain , shortness of breath , abdominal pain , nausea or vomiting , anything like that ? patient: no .	D2N097	9	[ "Vegetative History" ]	[ "Subjective" ]	okay . great . all right . so i know that you did a review of systems sheet with the nurse when you checked in . you know , i know that you were talking about some nasal congestion . do you have any other symptoms , chest pain , shortness of breath , abdominal pain , nausea or vomiting , anything like that ?	2,483
doctor: no ? okay . all right . well , i wan na go ahead and do a quick physical exam , okay ? patient: okay .	D2N097	10	[ "Physical Examination" ]	[ "Objective" ]	no ? okay . all right . well , i wan na go ahead and do a quick physical exam , okay ?	2,484
doctor: hey , dragon , show me the vital signs . so here in the office , you know , your blood pressure looks really good , as does your heart rate . so you are doing a good job managing your blood pressure . so i'm gon na take a listen to your heart and lungs , okay ? patient: okay .	D2N097	11	[ "Physical Examination" ]	[ "Objective" ]	hey , dragon , show me the vital signs . so here in the office , you know , your blood pressure looks really good , as does your heart rate . so you are doing a good job managing your blood pressure . so i'm gon na take a listen to your heart and lungs , okay ?	2,485
doctor: okay . so on physical examination , i do n't appreciate any carotid bruits in your neck . on your heart exam i do notice a slight 2/6 systolic ejection murmur , which we've heard in the past , so i think that's stable . your lungs in- are nice and clear , and you have some trace lower extremity edema bilaterally , so all that means is , you know , i agree , you know , maybe we should watch your diet a little bit better , okay ? but i wan na take a look at some of your results , okay ? patient: okay .	D2N097	12	[ "Physical Examination" ]	[ "Objective" ]	okay . so on physical examination , i do n't appreciate any carotid bruits in your neck . on your heart exam i do notice a slight 2/6 systolic ejection murmur , which we've heard in the past , so i think that's stable . your lungs in- are nice and clear , and you have some trace lower extremity edema bilaterally , so all that means is , you know , i agree , you know , maybe we should watch your diet a little bit better , okay ? but i wan na take a look at some of your results , okay ?	2,486
doctor: all right . hey , dragon , show me the ekg . and the nurses did an ekg before you came in , and that looks perfectly fine , okay ? so i wan na just go ahead and talk a little about your assessment and my plan for you . so for your first problem , your depression , i think you're doing a really good job with your strategies . i do n't think ... it does n't sound to me like i need to start you on any medication at this time , unless you feel differently . patient: no , i'm , i'm , good in that department .	D2N097	13	[ "Discussion", "Radiology Examination", "Reassessment" ]	[ "Objective", "Assessment", "Plan" ]	all right . hey , dragon , show me the ekg . and the nurses did an ekg before you came in , and that looks perfectly fine , okay ? so i wan na just go ahead and talk a little about your assessment and my plan for you . so for your first problem , your depression , i think you're doing a really good job with your strategies . i do n't think ... it does n't sound to me like i need to start you on any medication at this time , unless you feel differently .	2,487
doctor: for your second problem , your high blood pressure , i agree , everything looks fine here now . i wan na just continue on the lisinopril , 20 milligrams a day . and i want you to continue to watch your blood pressures as well , and if they start rising , i want you to contact me , okay ? patient: okay .	D2N097	14	[ "Medication", "Reassessment" ]	[ "Assessment", "Plan" ]	for your second problem , your high blood pressure , i agree , everything looks fine here now . i wan na just continue on the lisinopril , 20 milligrams a day . and i want you to continue to watch your blood pressures as well , and if they start rising , i want you to contact me , okay ?	2,488
doctor: and for your third problem , for an annual exam maintenance , you know , you're due for a mammogram , so we'll go ahead and schedule that , okay ? patient: all right .	D2N097	15	[ "Diagnostic Testing", "Reassessment" ]	[ "Assessment", "Plan" ]	and for your third problem , for an annual exam maintenance , you know , you're due for a mammogram , so we'll go ahead and schedule that , okay ?	2,489
doctor: all right . do you have any questions ? patient: um , can i take all my medicine at the same time ? does it matter ?	D2N097	16	[ "Discussion" ]	[ "Plan" ]	all right . do you have any questions ?	2,490
doctor: yeah . you can set an alarm so that it reminds you to take your medication . but yeah , you can , you can take them altogether . patient: okay .	D2N097	17	[ "Discussion", "Medication" ]	[ "Plan" ]	yeah . you can set an alarm so that it reminds you to take your medication . but yeah , you can , you can take them altogether .	2,491
doctor: all right . hey , dragon , finalize the note .	D2N097	18	[ "Chitchat" ]	[ "Null" ]	doctor: all right . hey , dragon , finalize the note .	2,492
doctor: all right . today i am seeing jose james . uh , date of birth 9/29/1957 . mr . james is a new patient who's having pain in his left shoulder and elbow . he fell five months ago going up a stairs , and the pain has been present since . hi mr . james , i'm doctor isabella . how are you doing ? patient: i'm okay . thank you .	D2N098	0	[ "Acute Symptoms", "Greetings" ]	[ "Subjective" ]	all right . today i am seeing jose james . uh , date of birth 9/29/1957 . mr . james is a new patient who's having pain in his left shoulder and elbow . he fell five months ago going up a stairs , and the pain has been present since . hi mr . james , i'm doctor isabella . how are you doing ?	2,493
doctor: that's good . that's good . tell me what's brings you in today . patient: sure . so i've been having constant pain in my left shoulder and left elbow for a while , about five months or so . hurts all the time . pretty bad at times .	D2N098	1	[ "Acute Symptoms" ]	[ "Subjective" ]	that's good . that's good . tell me what's brings you in today .	2,494
doctor: mm . that does not sound like fun . it sounds like you injured it going up the stairs ? patient: yes , that's correct . it was icy , and i have to walk up a flight of stairs to my house . i stepped and my feet just went out . fell on my left side . seems like my shoulder and wrist took the brunt . it's been hurting since .	D2N098	2	[ "Acute Symptoms" ]	[ "Subjective" ]	mm . that does not sound like fun . it sounds like you injured it going up the stairs ?	2,495
doctor: yeah , that does seem like a likely cause of your symptoms . anything seem to make the pain worse ? patient: well , i've always hit the gym and lifted weights . i've been trying to keep with my routine of two days a week , but it's been hard . the pain is worse when i lift , and i have n't been able to lift more than 15 or 20 pounds which is very frustrating .	D2N098	3	[ "Acute Symptoms" ]	[ "Subjective" ]	yeah , that does seem like a likely cause of your symptoms . anything seem to make the pain worse ?	2,496
doctor: mm-hmm . i can imagine it is when you're so accustomed to your routine . patient: exactly . i really enjoy my exercise , but over the past one to two weeks , i've stopped hitting the gym because the pain just was n't worth it honestly . i do keep up with my walking , though . my wife and i walk about 30 minutes almost every day . we have done this since i retired from my office job last year .	D2N098	4	[ "Acute Symptoms" ]	[ "Subjective" ]	mm-hmm . i can imagine it is when you're so accustomed to your routine .	2,497
doctor: i do not blame you , mr . james . does anything seem to help the pain that you've tried ? patient: not too much . i have iced a bit , but i have not taken anything for the pain . stopping exercise and some ice has helped a bit , but it still hurts enough for me to come to see you .	D2N098	5	[ "Acute Symptoms", "Therapeutic History" ]	[ "Subjective" ]	i do not blame you , mr . james . does anything seem to help the pain that you've tried ?	2,498
doctor: yeah , okay . how about any numbness or tingling ? have you felt that at any point ? patient: no , doc . just pain . no tingling or numbless , numbness , thankfully .	D2N098	6	[ "Acute Symptoms" ]	[ "Subjective" ]	yeah , okay . how about any numbness or tingling ? have you felt that at any point ?	2,499

doctor: a seven out of 10 pain . um , and no other injuries while you went down this double black diamond ? patient: no , interestingly enough , this is the only one .

D2N094

8

[ "Personal History" ]

[ "Subjective" ]

a seven out of 10 pain . um , and no other injuries while you went down this double black diamond ?

2,400

doctor: okay . well , i guess you escaped ... i mean ... patient: could have been much worse .

D2N094

9

[ "Chitchat" ]

[ "Null" ]

okay . well , i guess you escaped ... i mean ...

2,401

doctor: could have been much worse , yes . so , um , do you have any medical problems ? patient: um ... yeah , i'm ... i have chronic constipation .

D2N094

10

[ "Personal History" ]

[ "Subjective" ]

could have been much worse , yes . so , um , do you have any medical problems ?

2,402

doctor: do you take any medicine for it ? patient: miralax .

D2N094

11

[ "Personal History", "Therapeutic History" ]

[ "Subjective" ]

do you take any medicine for it ?

2,403

doctor: and does that help ? patient: seems to flow nicely .

D2N094

12

[ "Personal History", "Therapeutic History" ]

[ "Subjective" ]

and does that help ?

2,404

doctor: good for you . um ... have you ever had any surgeries before ? patient: yes , i had my appendix out when i was seven .

D2N094

13

[ "Personal History" ]

[ "Subjective" ]

good for you . um ... have you ever had any surgeries before ?

2,405

doctor: okay . um , let's look at your x-ray together . hey , dragon , show me the last x-ray . all right . so looking at your right hand here , and that index finger looks great . so all the joints , bones are in the right places , no fractures , so you've got a normal right hand x-ray . um , let's go ahead and check your finger out . now does it hurt when i push on your finger like this ? patient: yes .

D2N094

14

[ "Physical Examination", "Radiology Examination" ]

[ "Objective" ]

okay . um , let's look at your x-ray together . hey , dragon , show me the last x-ray . all right . so looking at your right hand here , and that index finger looks great . so all the joints , bones are in the right places , no fractures , so you've got a normal right hand x-ray . um , let's go ahead and check your finger out . now does it hurt when i push on your finger like this ?

2,406

doctor: does it hurt when i pull your finger like this ? patient: yes .

D2N094

15

[ "Physical Examination" ]

[ "Objective" ]

does it hurt when i pull your finger like this ?

2,407

doctor: does it hurt when i squeeze over this joint here ? patient: yes . please do n't do that .

D2N094

16

[ "Physical Examination" ]

[ "Objective" ]

does it hurt when i squeeze over this joint here ?

2,408

doctor: does it hurt when i squeeze over this ? patient: yes .

D2N094

17

[ "Physical Examination" ]

[ "Objective" ]

does it hurt when i squeeze over this ?

2,409

doctor: okay . um ... so with your x-ray , and with your exam , looks like you have a sprain of your distar- distal interphalangeal joint . it's called your dip joint , of your right index finger , and so what we're gon na do for that is we're gon na put a splint on that right finger . i'm gon na give you a strong antiinflammatory called mobic . you'll take 15 milligrams once a day . i'll prescribe 14 of those for you . and i want you to come back and see me in two weeks , and let's make sure it's all healed up and if we need to start any hand therapy at that point , then we can . do you have any questions for me ? patient: no questions . thank you .

D2N094

18

[ "Discussion", "Follow-up", "Medication", "Other Treatments", "Acute Assessment" ]

[ "Assessment", "Plan" ]

okay . um ... so with your x-ray , and with your exam , looks like you have a sprain of your distar- distal interphalangeal joint . it's called your dip joint , of your right index finger , and so what we're gon na do for that is we're gon na put a splint on that right finger . i'm gon na give you a strong antiinflammatory called mobic . you'll take 15 milligrams once a day . i'll prescribe 14 of those for you . and i want you to come back and see me in two weeks , and let's make sure it's all healed up and if we need to start any hand therapy at that point , then we can . do you have any questions for me ?

2,410

doctor: you're welcome . hey , dragon , order the medications and procedures mentioned . and why do n't you come with me , and we'll get you checked out ? patient: okay .

D2N094

19

[ "Chitchat" ]

[ "Null" ]

you're welcome . hey , dragon , order the medications and procedures mentioned . and why do n't you come with me , and we'll get you checked out ?

2,411

doctor: hey , dragon , finalize the report .

D2N094

20

[ "Chitchat" ]

[ "Null" ]

doctor: hey , dragon , finalize the report .

2,412

doctor: hi , cheryl . how are you ? patient: i'm doing well . how are you ?

D2N095

0

[ "Greetings" ]

[ "Subjective" ]

hi , cheryl . how are you ?

2,413

doctor: i'm doing well . so i know the nurse told you a little bit about dax . i'd like to tell dax about you . patient: okay .

D2N095

1

[ "Chitchat" ]

[ "Null" ]

i'm doing well . so i know the nurse told you a little bit about dax . i'd like to tell dax about you .

2,414

doctor: cheryl is a 34-year-old female with a past medical history significant for hypertension , who presents today with back pain . cheryl , what happened to your back ? patient: so i've been walking a lot lately . i've been walking to ... 30 minutes to an hour or so a day . and all of a sudden , um , when i was walking , my , um , back just kind of seized up on me . and i do n't really know what it was . maybe i was going a little bit faster . but it just all kind of clenched .

D2N095

2

[ "Acute Symptoms", "Personal History" ]

[ "Subjective" ]

cheryl is a 34-year-old female with a past medical history significant for hypertension , who presents today with back pain . cheryl , what happened to your back ?

2,415

doctor: okay . so you felt like , maybe like a spasm or something like that ? patient: yeah .

D2N095

3

[ "Acute Symptoms" ]

[ "Subjective" ]

okay . so you felt like , maybe like a spasm or something like that ?

2,416

doctor: okay . and how many days ago was that ? patient: that was about six days ago now .

D2N095

4

[ "Acute Symptoms" ]

[ "Subjective" ]

okay . and how many days ago was that ?

2,417

doctor: okay . and what have you taken for the pain ? patient: i've been taking ibuprofen . um , and then i've been putting some heat on it . but it's still pretty stiff .

D2N095

5

[ "Acute Symptoms", "Therapeutic History" ]

[ "Subjective" ]

okay . and what have you taken for the pain ?

2,418

doctor: okay . all right . um , and did you have any trauma before that happened ? were you doing anything strenuous like crossfit or lifting boxes or anything like that before you went for , for the walk ? patient: i have been lifting more , um , probably around three times a week . so i do n't know if it was because i was doing deadlifts that day and then walked .

D2N095

6

[ "Personal History" ]

[ "Subjective" ]

okay . all right . um , and did you have any trauma before that happened ? were you doing anything strenuous like crossfit or lifting boxes or anything like that before you went for , for the walk ?

2,419

doctor: okay . all right . and was it any particular area in your back ? was it the lower back ? patient: yeah , it was .

D2N095

8

[ "Acute Symptoms" ]

[ "Subjective" ]

okay . all right . and was it any particular area in your back ? was it the lower back ?

2,420

doctor: okay . on one side versus the other ? patient: um , kind of both equally .

D2N095

9

[ "Acute Symptoms" ]

[ "Subjective" ]

okay . on one side versus the other ?

2,421

doctor: okay . all right . and any numbing or tingling in your legs or your feet ? patient: no , i have n't felt anything like that .

D2N095

10

[ "Acute Symptoms" ]

[ "Subjective" ]

okay . all right . and any numbing or tingling in your legs or your feet ?

2,422

doctor: okay . any weakness in your lower extremities ? patient: no .

D2N095

11

[ "Vegetative History" ]

[ "Subjective" ]

okay . any weakness in your lower extremities ?

2,423

doctor: okay . all right .and then in terms of your blood pressure , how are you doing ? patient: so i got that cuff that you suggested the ... our ... the last visit , and i've been doing readings at home . and that's been looking great , too . i've been watching my diet . again , my boyfriend's been great and dieting with me so i do n't have to do it alone . and everything's been good .

D2N095

12

[ "Personal History" ]

[ "Subjective" ]

okay . all right .and then in terms of your blood pressure , how are you doing ?

2,424

doctor: okay . excellent . and you're taking the lisinopril ? patient: yes .

D2N095

13

[ "Personal History", "Therapeutic History" ]

[ "Subjective" ]

okay . excellent . and you're taking the lisinopril ?

2,425

doctor: okay . wonderful . okay . so i know you did a review of systems sheet with the nurse , and i know you endorse , you know , this back pain . um , do you have any other symptoms ? fever , chills , congestion , cough , chest pain , shortness of breath ? patient: i have a little bit of nasal congestion , but that's just from my seasonal allergies .

D2N095

14

[ "Vegetative History" ]

[ "Subjective" ]

okay . wonderful . okay . so i know you did a review of systems sheet with the nurse , and i know you endorse , you know , this back pain . um , do you have any other symptoms ? fever , chills , congestion , cough , chest pain , shortness of breath ?

2,426

doctor: okay . all right . well , let's go ahead . i want to do a quick physical exam on you . patient: okay .

D2N095

15

[ "Physical Examination" ]

[ "Objective" ]

okay . all right . well , let's go ahead . i want to do a quick physical exam on you .

2,427

doctor: okay ? hey , dragon , show me the vital signs . so good- you know , here in the office , your vital signs look great . your blood pressure's really well controlled , which is good . so that's a good job . so i'm going to take a listen to your heart and lungs . i'm going to examine your back , and i'm going to let you know what i find . okay ? patient: okay .

D2N095

16

[ "Physical Examination" ]

[ "Objective" ]

okay ? hey , dragon , show me the vital signs . so good- you know , here in the office , your vital signs look great . your blood pressure's really well controlled , which is good . so that's a good job . so i'm going to take a listen to your heart and lungs . i'm going to examine your back , and i'm going to let you know what i find . okay ?

2,428

doctor: okay . all right . so on physical examination , you know , everything looks good . you know , on your heart exam , i do hear that slight two out of six systolic ejection murmur , but you've had that before . that seems stable to me . on your back exam , you do have some pain to palpation on the right lateral aspect of your lumbar spine , and you do have pain with flexion and extension as well , and you have a negative straight leg raise . so what does that mean ? so we're going to go over that . okay ? let's ... let me look at some of your results , though , first . okay ? patient: okay .

D2N095

17

[ "Physical Examination" ]

[ "Objective" ]

okay . all right . so on physical examination , you know , everything looks good . you know , on your heart exam , i do hear that slight two out of six systolic ejection murmur , but you've had that before . that seems stable to me . on your back exam , you do have some pain to palpation on the right lateral aspect of your lumbar spine , and you do have pain with flexion and extension as well , and you have a negative straight leg raise . so what does that mean ? so we're going to go over that . okay ? let's ... let me look at some of your results , though , first . okay ?

2,429

doctor: we did an x-ray before you saw me , so let's look at that . hey , dragon , show me the back x-ray . so looking here at this x-ray of the lumbar spine , everything looks good . there's good boney alignment . there's no obvious fracture , you know , which is not surprising based on your history . okay ? patient: hmm .

D2N095

18

[ "Radiology Examination" ]

[ "Objective" ]

we did an x-ray before you saw me , so let's look at that . hey , dragon , show me the back x-ray . so looking here at this x-ray of the lumbar spine , everything looks good . there's good boney alignment . there's no obvious fracture , you know , which is not surprising based on your history . okay ?

2,430

doctor: hey , dragon , show me the labs . and your labs that we did before you came in all look great . there's no elevated white blood cell count . there's no signs of infection . again , those are all really good . okay ? so let me go over with you about my assessment and my plan for you . so for your first problem , this back pain , i think you have a lumbar strain , and , you know , that might've happened , you know , lifting something or exercising . and so what i want to do is prescribe meloxicam , 15 milligrams once a day . uh , i want you ... you can ice the area , and you can also apply heat sometimes as well . um , you know , i'm going to refer you to physical therapy just to do some strengthening exercises of your back , um , because i do want you to continue to be able to work out and exercise . okay ? patient: okay .

D2N095

19

[ "Medication", "Lab Examination", "Referral", "Acute Assessment" ]

[ "Objective", "Assessment", "Plan" ]

hey , dragon , show me the labs . and your labs that we did before you came in all look great . there's no elevated white blood cell count . there's no signs of infection . again , those are all really good . okay ? so let me go over with you about my assessment and my plan for you . so for your first problem , this back pain , i think you have a lumbar strain , and , you know , that might've happened , you know , lifting something or exercising . and so what i want to do is prescribe meloxicam , 15 milligrams once a day . uh , i want you ... you can ice the area , and you can also apply heat sometimes as well . um , you know , i'm going to refer you to physical therapy just to do some strengthening exercises of your back , um , because i do want you to continue to be able to work out and exercise . okay ?

2,431

doctor: and for your last problem , your high blood pressure , again , everything looks great here . um , you know , i think you're doing a really good job with that as well . i want you to continue on the lisinopril , 10 milligrams a day . and then , uh , let me know if you notice any increases in your blood pressure readings . okay ? patient: okay .

D2N095

20

[ "Medication", "Reassessment" ]

[ "Assessment", "Plan" ]

and for your last problem , your high blood pressure , again , everything looks great here . um , you know , i think you're doing a really good job with that as well . i want you to continue on the lisinopril , 10 milligrams a day . and then , uh , let me know if you notice any increases in your blood pressure readings . okay ?

2,432

doctor: do you need a refill of the lisinopril ? patient: yes , i do , actually .

D2N095

21

[ "Discussion", "Medication" ]

[ "Plan" ]

do you need a refill of the lisinopril ?

2,433

doctor: okay . hey , dragon ? order lisinopril 10 milligrams po daily . okay . uh , so the nurse will be in soon , and she'll get you checked out . okay ? patient: okay .

D2N095

22

[ "Chitchat" ]

[ "Null" ]

okay . hey , dragon ? order lisinopril 10 milligrams po daily . okay . uh , so the nurse will be in soon , and she'll get you checked out . okay ?

2,434

doctor: all right . hey , dragon ? finalize the note .

D2N095

23

[ "Chitchat" ]

[ "Null" ]

doctor: all right . hey , dragon ? finalize the note .

2,435

doctor: um , hi mrs. anderson . right ? patient: yeah . yes , doctor .

D2N096

0

[ "Greetings" ]

[ "Subjective" ]

um , hi mrs. anderson . right ?

2,436

doctor: what brings you here today ? patient: hi , doctor . um , i'm having this left shoulder pain lately , uh , and it's paining a lot .

D2N096

1

[ "Acute Symptoms" ]

[ "Subjective" ]

what brings you here today ?

2,437

doctor: okay . all right . hey , dragon . i am seeing mrs. anderson , a 44-years-old female , uh , complaining to check the left shoulder pain . um , so how long how has this lasted ? patient: it's been a week , doctor . yeah .

D2N096

2

[ "Acute Symptoms" ]

[ "Subjective" ]

okay . all right . hey , dragon . i am seeing mrs. anderson , a 44-years-old female , uh , complaining to check the left shoulder pain . um , so how long how has this lasted ?

2,438

doctor: a week . patient: yeah .

D2N096

3

[ "Acute Symptoms" ]

[ "Subjective" ]

a week .

2,439

doctor: um , did you take any medication yourself ? patient: no , i did not take any pain medications . actually , i did . i did take a tylenol for two or three days , but then that did n't help at all . so , uh , the reason why it started or when it started to happen is-

D2N096

4

[ "Acute Symptoms", "Therapeutic History" ]

[ "Subjective" ]

um , did you take any medication yourself ?

2,440

doctor: yeah , okay . patient: and , uh , i do n't know . maybe i must have toppled over into some weird position , so it started to pain since then , uh , because of a certain move .

D2N096

6

[ "Acute Symptoms" ]

[ "Subjective" ]

yeah , okay .

2,441

doctor: okay , uh- patient: i went overboard , i think . yeah .

D2N096

7

[ "Acute Symptoms" ]

[ "Subjective" ]

okay , uh-

2,442

doctor: all right , lem me , uh , take a quick look . uh , can you move up a little bit ? yeah . patient: uh , yeah . in fact , that's hurts .

D2N096

8

[ "Physical Examination" ]

[ "Objective" ]

all right , lem me , uh , take a quick look . uh , can you move up a little bit ? yeah .

2,443

doctor: does that- does it hurt ? patient: yeah , it does .

D2N096

9

[ "Physical Examination" ]

[ "Objective" ]

does that- does it hurt ?

2,444

doctor: what if you move back a little bit ? patient: uh , that also hurts , doctor .

D2N096

10

[ "Physical Examination" ]

[ "Objective" ]

what if you move back a little bit ?

2,445

doctor: yeah , okay . patient: any kind of movement on my left shoulder actually hurts .

D2N096

11

[ "Physical Examination" ]

[ "Objective" ]

yeah , okay .

2,446

doctor: okay . all right , um , so let's ... hey , dragon . show me the last x-ray . all right , from the x-ray , it does n't look like there is any , uh , broken bone or fracture . my guess is you probably , um , hurt your joint , uh- patient: uh- .

D2N096

12

[ "Radiology Examination", "Acute Assessment" ]

[ "Objective", "Assessment" ]

okay . all right , um , so let's ... hey , dragon . show me the last x-ray . all right , from the x-ray , it does n't look like there is any , uh , broken bone or fracture . my guess is you probably , um , hurt your joint , uh-

2,447

doctor: . a little bit . patient: mm-hmm .

D2N096

13

[ "Radiology Examination" ]

[ "Objective" ]

. a little bit .

2,448

doctor: so i would , uh , suggest you continue using the pain reliever , maybe just like 600 milligram of ibuprofen three times a day and use it for a week . patient: and for how long ? yes .

D2N096

14

[ "Medication" ]

[ "Plan" ]

so i would , uh , suggest you continue using the pain reliever , maybe just like 600 milligram of ibuprofen three times a day and use it for a week .

2,449

doctor: for a week . patient: a week , okay .

D2N096

15

[ "Discussion", "Medication" ]

[ "Plan" ]

for a week .

2,450

doctor: and then if you ... if it's still painful , you can use , uh , ice or , um , heat pad- patient: okay .

D2N096

16

[ "Discussion", "Medication" ]

[ "Plan" ]

and then if you ... if it's still painful , you can use , uh , ice or , um , heat pad-

2,451

doctor: . 'cause that might help relieve your pain . patient: okay .

D2N096

17

[ "Discussion", "Medication" ]

[ "Plan" ]

. 'cause that might help relieve your pain .

2,452

doctor: mm-hmm . patient: . so , um , i hope that should n't matter , right ?

D2N096

19

[ "Discussion" ]

[ "Plan" ]

mm-hmm .

2,453

doctor: um , that does n't seem related to your pain . patient: okay .

D2N096

20

[ "Discussion" ]

[ "Plan" ]

um , that does n't seem related to your pain .

2,454

doctor: so ... but i would try to rest my , your left arm- patient: okay .

D2N096

21

[ "Discussion" ]

[ "Plan" ]

so ... but i would try to rest my , your left arm-

2,455

doctor: . while it's healing . patient: okay .

D2N096

22

[ "Discussion" ]

[ "Plan" ]

. while it's healing .

2,456

doctor: so , um- patient: can i , uh , carry any heavy weights or-

D2N096

23

[ "Discussion" ]

[ "Plan" ]

so , um-

2,457

doctor: no , no . definitely not . patient: . anything like that ?

D2N096

24

[ "Discussion" ]

[ "Plan" ]

no , no . definitely not .

2,458

doctor: definitely not . patient: okay . okay .

D2N096

25

[ "Discussion" ]

[ "Plan" ]

definitely not .

2,459

doctor: yeah , use , um , right hand- patient: okay .

D2N096

26

[ "Discussion" ]

[ "Plan" ]

yeah , use , um , right hand-

2,460

doctor: . instead- patient: mm-hmm .

D2N096

27

[ "Discussion" ]

[ "Plan" ]

. instead-

2,461

doctor: . for the next , uh , at least just three to four weeks . patient: mm-hmm .

D2N096

28

[ "Discussion" ]

[ "Plan" ]

. for the next , uh , at least just three to four weeks .

2,462

doctor: uh , come back to see me if the pain , you know , still there after maybe three weeks- patient: sure .

D2N096

29

[ "Follow-up" ]

[ "Plan" ]

uh , come back to see me if the pain , you know , still there after maybe three weeks-

2,463

doctor: . so we can take a further look . patient: okay . sure .

D2N096

30

[ "Follow-up" ]

[ "Plan" ]

. so we can take a further look .

2,464

doctor: but you should be fine- patient: yeah .

D2N096

31

[ "Chitchat" ]

[ "Null" ]

but you should be fine-

2,465

doctor: . after just resting and regular pain reliever . patient: okay . all right .

D2N096

32

[ "Chitchat" ]

[ "Null" ]

. after just resting and regular pain reliever .

2,466

doctor: um , maybe . let's see how you're doing in the next three weeks . patient: uh .

D2N096

34

[ "Discussion", "Follow-up" ]

[ "Plan" ]

um , maybe . let's see how you're doing in the next three weeks .

2,467

doctor: hey , dragon . um , order medications and procedures as discussed . all right . patient: okay .

D2N096

35

[ "Chitchat" ]

[ "Null" ]

hey , dragon . um , order medications and procedures as discussed . all right .

2,468

doctor: um , i think that's good for today . hope you feel better soon . patient: okay . thank you , doctor .

D2N096

36

[ "Chitchat" ]

[ "Null" ]

um , i think that's good for today . hope you feel better soon .

2,469

doctor: um , you can also try advil . patient: okay .

D2N096

39

[ "Discussion", "Medication" ]

[ "Plan" ]

um , you can also try advil .

2,470

doctor: yeah , so , um ... patient: yeah .

D2N096

40

[ "Chitchat" ]

[ "Null" ]

yeah , so , um ...

2,471

doctor: ale- , aleve . i mean , aleve . patient: i see . okay , thank you , doctor .

D2N096

41

[ "Discussion", "Medication" ]

[ "Plan" ]

ale- , aleve . i mean , aleve .

2,472

doctor: thank you .

D2N096

42

[ "Chitchat" ]

[ "Null" ]

doctor: thank you .

2,473

doctor: elizabeth , how are you ? patient: i'm doing okay . how are you ?

D2N097

0

[ "Greetings" ]

[ "Subjective" ]

elizabeth , how are you ?

2,474

doctor: doing okay . so i know the nurse told you about dax . i'd like to tell dax a little bit about you , okay ? patient: okay .

D2N097

1

[ "Chitchat" ]

[ "Null" ]

doing okay . so i know the nurse told you about dax . i'd like to tell dax a little bit about you , okay ?

2,475

doctor: all right . elizabeth is a 66-year-old female with a past medical history of significant for depression and hypertension who presents for her annual exam . so elizabeth , it's been a year since i've seen you . patient: mm-hmm .

D2N097

2

[ "Personal History" ]

[ "Subjective" ]

all right . elizabeth is a 66-year-old female with a past medical history of significant for depression and hypertension who presents for her annual exam . so elizabeth , it's been a year since i've seen you .

2,476

doctor: how are you doing ? patient: i'm doing well . there's been so many events now that we've been able to get vaccinated , i've been able to see my grandkids again , go to more birthday parties , it's been fantastic .

D2N097

3

[ "Acute Symptoms" ]

[ "Subjective" ]

how are you doing ?

2,477

doctor: yeah , i know . i've ... i mean , we've had some communication over telehealth and that type of thing , but it's not the same as being in-person , so i'm happy to see you today . now tell me a little bit about , you know , we have n't really got a chance to talk about your depression . how are you ... how are you doing with that ? i know we have n't had you on medication in the past because you're on medication for other things . what are your strategies with dealing with it ? patient: so i've been going to therapy once a week for the past year . um , mostly virtually , um , but starting to get in-person . virtual was a bit of a struggle , but i feel like being in-person with someone really helps me .

D2N097

4

[ "Personal History", "Therapeutic History" ]

[ "Subjective" ]

yeah , i know . i've ... i mean , we've had some communication over telehealth and that type of thing , but it's not the same as being in-person , so i'm happy to see you today . now tell me a little bit about , you know , we have n't really got a chance to talk about your depression . how are you ... how are you doing with that ? i know we have n't had you on medication in the past because you're on medication for other things . what are your strategies with dealing with it ?

2,478

doctor: okay . and do y- do you have a good support system at home ? patient: yes , i do . i have my husband and , uh , my kids are right down the street from me , so i'm very lucky .

D2N097

5

[ "Other Socials" ]

[ "Subjective" ]

okay . and do y- do you have a good support system at home ?

2,479

doctor: okay . all right . so that's good to hear . how about your blood pressure ? did you buy the blood pressure cuff that i- patient: yes .

D2N097

6

[ "Personal History" ]

[ "Subjective" ]

okay . all right . so that's good to hear . how about your blood pressure ? did you buy the blood pressure cuff that i-

2,480

doctor: . told you to ? okay . i know that we've been in communication and your blood pressures have been running okay . the last time i spoke with you , how are they doing since we last spoke ? patient: they've been doing well . i've been using the cuff , um , once a day , and they seem pretty normal .

D2N097

7

[ "Physical Examination", "Personal History" ]

[ "Subjective", "Objective" ]

. told you to ? okay . i know that we've been in communication and your blood pressures have been running okay . the last time i spoke with you , how are they doing since we last spoke ?

2,481

doctor: okay . and are you taking the lisinopril that i prescribed ? patient: yes .

D2N097

8

[ "Personal History", "Therapeutic History" ]

[ "Subjective" ]

okay . and are you taking the lisinopril that i prescribed ?

2,482

doctor: okay . great . all right . so i know that you did a review of systems sheet with the nurse when you checked in . you know , i know that you were talking about some nasal congestion . do you have any other symptoms , chest pain , shortness of breath , abdominal pain , nausea or vomiting , anything like that ? patient: no .

D2N097

9

[ "Vegetative History" ]

[ "Subjective" ]

okay . great . all right . so i know that you did a review of systems sheet with the nurse when you checked in . you know , i know that you were talking about some nasal congestion . do you have any other symptoms , chest pain , shortness of breath , abdominal pain , nausea or vomiting , anything like that ?

2,483

doctor: no ? okay . all right . well , i wan na go ahead and do a quick physical exam , okay ? patient: okay .

D2N097

10

[ "Physical Examination" ]

[ "Objective" ]

no ? okay . all right . well , i wan na go ahead and do a quick physical exam , okay ?

2,484

doctor: hey , dragon , show me the vital signs . so here in the office , you know , your blood pressure looks really good , as does your heart rate . so you are doing a good job managing your blood pressure . so i'm gon na take a listen to your heart and lungs , okay ? patient: okay .

D2N097

11

[ "Physical Examination" ]

[ "Objective" ]

hey , dragon , show me the vital signs . so here in the office , you know , your blood pressure looks really good , as does your heart rate . so you are doing a good job managing your blood pressure . so i'm gon na take a listen to your heart and lungs , okay ?

2,485

doctor: okay . so on physical examination , i do n't appreciate any carotid bruits in your neck . on your heart exam i do notice a slight 2/6 systolic ejection murmur , which we've heard in the past , so i think that's stable . your lungs in- are nice and clear , and you have some trace lower extremity edema bilaterally , so all that means is , you know , i agree , you know , maybe we should watch your diet a little bit better , okay ? but i wan na take a look at some of your results , okay ? patient: okay .

D2N097

12

[ "Physical Examination" ]

[ "Objective" ]

okay . so on physical examination , i do n't appreciate any carotid bruits in your neck . on your heart exam i do notice a slight 2/6 systolic ejection murmur , which we've heard in the past , so i think that's stable . your lungs in- are nice and clear , and you have some trace lower extremity edema bilaterally , so all that means is , you know , i agree , you know , maybe we should watch your diet a little bit better , okay ? but i wan na take a look at some of your results , okay ?

2,486

doctor: all right . hey , dragon , show me the ekg . and the nurses did an ekg before you came in , and that looks perfectly fine , okay ? so i wan na just go ahead and talk a little about your assessment and my plan for you . so for your first problem , your depression , i think you're doing a really good job with your strategies . i do n't think ... it does n't sound to me like i need to start you on any medication at this time , unless you feel differently . patient: no , i'm , i'm , good in that department .

D2N097

13

[ "Discussion", "Radiology Examination", "Reassessment" ]

[ "Objective", "Assessment", "Plan" ]

all right . hey , dragon , show me the ekg . and the nurses did an ekg before you came in , and that looks perfectly fine , okay ? so i wan na just go ahead and talk a little about your assessment and my plan for you . so for your first problem , your depression , i think you're doing a really good job with your strategies . i do n't think ... it does n't sound to me like i need to start you on any medication at this time , unless you feel differently .

2,487

doctor: for your second problem , your high blood pressure , i agree , everything looks fine here now . i wan na just continue on the lisinopril , 20 milligrams a day . and i want you to continue to watch your blood pressures as well , and if they start rising , i want you to contact me , okay ? patient: okay .

D2N097

14

[ "Medication", "Reassessment" ]

[ "Assessment", "Plan" ]

for your second problem , your high blood pressure , i agree , everything looks fine here now . i wan na just continue on the lisinopril , 20 milligrams a day . and i want you to continue to watch your blood pressures as well , and if they start rising , i want you to contact me , okay ?

2,488

doctor: and for your third problem , for an annual exam maintenance , you know , you're due for a mammogram , so we'll go ahead and schedule that , okay ? patient: all right .

D2N097

15

[ "Diagnostic Testing", "Reassessment" ]

[ "Assessment", "Plan" ]

and for your third problem , for an annual exam maintenance , you know , you're due for a mammogram , so we'll go ahead and schedule that , okay ?

2,489

doctor: all right . do you have any questions ? patient: um , can i take all my medicine at the same time ? does it matter ?

D2N097

16

[ "Discussion" ]

[ "Plan" ]

all right . do you have any questions ?

2,490

doctor: yeah . you can set an alarm so that it reminds you to take your medication . but yeah , you can , you can take them altogether . patient: okay .

D2N097

17

[ "Discussion", "Medication" ]

[ "Plan" ]

yeah . you can set an alarm so that it reminds you to take your medication . but yeah , you can , you can take them altogether .

2,491

doctor: all right . hey , dragon , finalize the note .

D2N097

18

[ "Chitchat" ]

[ "Null" ]

doctor: all right . hey , dragon , finalize the note .

2,492

doctor: all right . today i am seeing jose james . uh , date of birth 9/29/1957 . mr . james is a new patient who's having pain in his left shoulder and elbow . he fell five months ago going up a stairs , and the pain has been present since . hi mr . james , i'm doctor isabella . how are you doing ? patient: i'm okay . thank you .

D2N098

0

[ "Acute Symptoms", "Greetings" ]

[ "Subjective" ]

all right . today i am seeing jose james . uh , date of birth 9/29/1957 . mr . james is a new patient who's having pain in his left shoulder and elbow . he fell five months ago going up a stairs , and the pain has been present since . hi mr . james , i'm doctor isabella . how are you doing ?

2,493

doctor: that's good . that's good . tell me what's brings you in today . patient: sure . so i've been having constant pain in my left shoulder and left elbow for a while , about five months or so . hurts all the time . pretty bad at times .

D2N098

1

[ "Acute Symptoms" ]

[ "Subjective" ]

that's good . that's good . tell me what's brings you in today .

2,494

doctor: mm . that does not sound like fun . it sounds like you injured it going up the stairs ? patient: yes , that's correct . it was icy , and i have to walk up a flight of stairs to my house . i stepped and my feet just went out . fell on my left side . seems like my shoulder and wrist took the brunt . it's been hurting since .

D2N098

2

[ "Acute Symptoms" ]

[ "Subjective" ]

mm . that does not sound like fun . it sounds like you injured it going up the stairs ?

2,495

doctor: yeah , that does seem like a likely cause of your symptoms . anything seem to make the pain worse ? patient: well , i've always hit the gym and lifted weights . i've been trying to keep with my routine of two days a week , but it's been hard . the pain is worse when i lift , and i have n't been able to lift more than 15 or 20 pounds which is very frustrating .

D2N098

3

[ "Acute Symptoms" ]

[ "Subjective" ]

yeah , that does seem like a likely cause of your symptoms . anything seem to make the pain worse ?

2,496

doctor: mm-hmm . i can imagine it is when you're so accustomed to your routine . patient: exactly . i really enjoy my exercise , but over the past one to two weeks , i've stopped hitting the gym because the pain just was n't worth it honestly . i do keep up with my walking , though . my wife and i walk about 30 minutes almost every day . we have done this since i retired from my office job last year .

D2N098

4

[ "Acute Symptoms" ]

[ "Subjective" ]

mm-hmm . i can imagine it is when you're so accustomed to your routine .

2,497

doctor: i do not blame you , mr . james . does anything seem to help the pain that you've tried ? patient: not too much . i have iced a bit , but i have not taken anything for the pain . stopping exercise and some ice has helped a bit , but it still hurts enough for me to come to see you .

D2N098

5

[ "Acute Symptoms", "Therapeutic History" ]

[ "Subjective" ]

i do not blame you , mr . james . does anything seem to help the pain that you've tried ?

2,498

doctor: yeah , okay . how about any numbness or tingling ? have you felt that at any point ? patient: no , doc . just pain . no tingling or numbless , numbness , thankfully .

D2N098

6

[ "Acute Symptoms" ]

[ "Subjective" ]

yeah , okay . how about any numbness or tingling ? have you felt that at any point ?

2,499