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aci_bench_intent_annotated

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doctor: understood . understood . all right . well , let's go ahead and take a look and see what's going on . patient: sounds good . thank you .
D2N098
7
[ "Chitchat" ]
[ "Null" ]
understood . understood . all right . well , let's go ahead and take a look and see what's going on .
2,500
doctor: okay . use my general physical exam template . mr . james , i'm going to gently press around your shoulder and elbow here to see where your pain might be stemming from . just let me know when it hurts . patient: okay . it hurts when you press there on my elbow and here on my shoulder .
D2N098
8
[ "Physical Examination" ]
[ "Objective" ]
okay . use my general physical exam template . mr . james , i'm going to gently press around your shoulder and elbow here to see where your pain might be stemming from . just let me know when it hurts .
2,501
doctor: okay . left shoulder and elbow , tender sa space , no warmth , erythema or deformity . positive hawkins-kennedy and neer's test . normal proximal and distar , distal upper extremity strength . intact median radial ulnar sensation and abduction to 90 degrees . normal empty tan , can test . okay , mr . james , w-...
D2N098
9
[ "Physical Examination", "Acute Assessment" ]
[ "Objective", "Assessment" ]
okay . left shoulder and elbow , tender sa space , no warmth , erythema or deformity . positive hawkins-kennedy and neer's test . normal proximal and distar , distal upper extremity strength . intact median radial ulnar sensation and abduction to 90 degrees . normal empty tan , can test . okay , mr . james , w-what i t...
2,502
doctor: well , we have a few options you can try . first option would be to start with physical therapy . i would recommend two sessions per week as well as any other exercises they give you to do at home . we can start there and if that does n't improve your pain , then we could try a cortisone injection . patient: i ...
D2N098
10
[ "Discussion", "Medication", "Referral" ]
[ "Plan" ]
well , we have a few options you can try . first option would be to start with physical therapy . i would recommend two sessions per week as well as any other exercises they give you to do at home . we can start there and if that does n't improve your pain , then we could try a cortisone injection .
2,503
doctor: all right . great . i'll get a referral order , and they will call you within the next day or two to get you scheduled . patient: okay .
D2N098
11
[ "Chitchat" ]
[ "Null" ]
all right . great . i'll get a referral order , and they will call you within the next day or two to get you scheduled .
2,504
doctor: mm-hmm . also , please continue to ice , especially your shoulder , and rest as much as you can . patient: okay . i will .
D2N098
12
[ "Discussion", "Medication" ]
[ "Plan" ]
mm-hmm . also , please continue to ice , especially your shoulder , and rest as much as you can .
2,505
doctor: give us a call or email us if you have symptoms worsen , if your symptoms worsen or do not improve with the therapy . patient: will do . thank you . i appreciate your help .
D2N098
13
[ "Discussion", "Follow-up" ]
[ "Plan" ]
give us a call or email us if you have symptoms worsen , if your symptoms worsen or do not improve with the therapy .
2,506
doctor: you're welcome . have a great day . patient: you too .
D2N098
14
[ "Chitchat" ]
[ "Null" ]
you're welcome . have a great day .
2,507
doctor: all right . assessment is impingement syndrome of left shoulder . plan discussed with patient . referral is requested for dr. martha rivera to be in physical therapy two days per week .
D2N098
15
[ "Chitchat" ]
[ "Null" ]
doctor: all right . assessment is impingement syndrome of left shoulder . plan discussed with patient . referral is requested for dr. martha rivera to be in physical therapy two days per week .
2,508
doctor: next patient is randy gutierrez . date of birth , 8/10/2020 . please use review of symptoms . all text to write . physical exam , auto text uri . hello , how are you doing today ? patient_guest: we're okay , thank you .
D2N099
0
[ "Greetings" ]
[ "Subjective" ]
next patient is randy gutierrez . date of birth , 8/10/2020 . please use review of symptoms . all text to write . physical exam , auto text uri . hello , how are you doing today ?
2,509
doctor: that's good to hear . so , how many days has randy been feeling sick ? patient_guest: well , i would say it started around supper time last night .
D2N099
1
[ "Acute Symptoms" ]
[ "Subjective" ]
that's good to hear . so , how many days has randy been feeling sick ?
2,510
doctor: last night , okay , and what's been going on ? patient_guest: well , he started to get a runny nose .
D2N099
2
[ "Acute Symptoms" ]
[ "Subjective" ]
last night , okay , and what's been going on ?
2,511
doctor: okay , and is he stuffy too ? patient_guest: yeah . yeah .
D2N099
3
[ "Acute Symptoms" ]
[ "Subjective" ]
okay , and is he stuffy too ?
2,512
doctor: okay , and have you noticed , is his mucous clear right now ? patient_guest: it is , it is right now , yes .
D2N099
4
[ "Acute Symptoms" ]
[ "Subjective" ]
okay , and have you noticed , is his mucous clear right now ?
2,513
doctor: okay . and , does he also have a cough ? patient_guest: yes , but it's not barky .
D2N099
5
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
okay . and , does he also have a cough ?
2,514
doctor: and does he act like he has a sore throat or is he pulling on his ears ? patient_guest: well , i know he's been pulling on his ears , yeah .
D2N099
6
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
and does he act like he has a sore throat or is he pulling on his ears ?
2,515
doctor: okay . patient_guest: you know , he also , he's also been going crazy rubbing at his nose too .
D2N099
7
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
okay .
2,516
doctor: okay . and , any fever you've noticed ? patient_guest: i checked his rectal temperature and it was 100.3 .
D2N099
8
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
okay . and , any fever you've noticed ?
2,517
doctor: okay . so , a little bit of a low-grade fever there , definitely . and , how was his appetite ? did he eat last night ? patient_guest: yes , he did . yeah .
D2N099
9
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
okay . so , a little bit of a low-grade fever there , definitely . and , how was his appetite ? did he eat last night ?
2,518
doctor: and how about this morning ? did he eat his breakfast ? patient_guest: uh , this morning he ate about seven ounces from the bottle .
D2N099
10
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
and how about this morning ? did he eat his breakfast ?
2,519
doctor: okay . patient_guest: and then he got another bottle , and he barely ate that . um , i offered him cereal and he would n't eat that either .
D2N099
11
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
okay .
2,520
doctor: okay . patient_guest: so , he varies i guess .
D2N099
12
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
okay .
2,521
doctor: how is his energy ? does he seem like he wants to take more naps , or does he have pretty good energy ? patient_guest: mmm , it seems like he's irritable .
D2N099
13
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
how is his energy ? does he seem like he wants to take more naps , or does he have pretty good energy ?
2,522
doctor: irritable because he is n't feeling good ? patient_guest: yeah . he is energetic , but it seems like he ca n't go to sleep , like , he's fighting it really hard .
D2N099
14
[ "Acute Symptoms" ]
[ "Subjective" ]
irritable because he is n't feeling good ?
2,523
doctor: okay , and just for the chart , is there anyone , anybody else exposed to him who has been sick ? patient_guest: yes , his older sister's been sick .
D2N099
15
[ "Other Socials" ]
[ "Subjective" ]
okay , and just for the chart , is there anyone , anybody else exposed to him who has been sick ?
2,524
doctor: thank you . patient_guest: we also had a play date with my nephew , who i learned later had a sinus infection .
D2N099
16
[ "Other Socials" ]
[ "Subjective" ]
thank you .
2,525
doctor: and what medication have you tried for him ? anything at all ? patient_guest: um , i've been doing the saline mist in his nose .
D2N099
17
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
and what medication have you tried for him ? anything at all ?
2,526
doctor: good , good . that's a good choice . patient_guest: i did give him tylenol really early this morning because he was warm when i took the sleeper off of him , and we had the ac on in the house , but his whole body was sweating .
D2N099
18
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
good , good . that's a good choice .
2,527
doctor: i see . and , any other medications ? patient_guest: we did put some baby vick's on his feet last night to try and help him breathe . and , i also used the humidifier .
D2N099
19
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
i see . and , any other medications ?
2,528
doctor: okay . that's good . patient_guest: okay . okay .
D2N099
20
[ "Chitchat" ]
[ "Null" ]
okay . that's good .
2,529
doctor: so , there was another thing i wanted to bring up since we're here . it appears that his cradle cap has gotten a little worse . what are you using on it ? patient_guest: i've been using the cradle cap brush , and then i use regular aveno shampoo .
D2N099
21
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
so , there was another thing i wanted to bring up since we're here . it appears that his cradle cap has gotten a little worse . what are you using on it ?
2,530
doctor: is it a dandruff shampoo ? patient_guest: no , i do n't think so .
D2N099
22
[ "Therapeutic History" ]
[ "Subjective" ]
is it a dandruff shampoo ?
2,531
doctor: okay , thank you . well , let's complete his exam and then we'll talk about the next steps . patient_guest: okay , sounds good .
D2N099
23
[ "Chitchat" ]
[ "Null" ]
okay , thank you . well , let's complete his exam and then we'll talk about the next steps .
2,532
doctor: can you take a big breath randy . patient_guest: where's mama ?
D2N099
24
[ "Physical Examination" ]
[ "Objective" ]
can you take a big breath randy .
2,533
doctor: do n't forget to breathe little one . okay . let's try the front too . patient_guest: yeah , it's okay buddy .
D2N099
25
[ "Physical Examination" ]
[ "Objective" ]
do n't forget to breathe little one . okay . let's try the front too .
2,534
doctor: excellent . he's doing excellent . next let's- let's check out those ears . patient_guest: okay .
D2N099
26
[ "Physical Examination" ]
[ "Objective" ]
excellent . he's doing excellent . next let's- let's check out those ears .
2,535
doctor: let's try to make sure you do n't tip all the way over . patient_guest: dino , you're doing so good .
D2N099
27
[ "Physical Examination" ]
[ "Objective" ]
let's try to make sure you do n't tip all the way over .
2,536
doctor: all right . ears look okay . we're going to slide you forward so you do n't bump your head when i lay you down . patient_guest: hey , you're- hey you're okay . you're okay .
D2N099
28
[ "Physical Examination" ]
[ "Objective" ]
all right . ears look okay . we're going to slide you forward so you do n't bump your head when i lay you down .
2,537
doctor: okay , you can go ahead and sit him back up if you like . patient_guest: all right . thank you .
D2N099
29
[ "Physical Examination" ]
[ "Objective" ]
okay , you can go ahead and sit him back up if you like .
2,538
doctor: all right . so , he's just kind of getting started with this , and i think we're seeing something viral right now . often sinus infections will start out as a virus and then will become bacterial infections if left alone and does n't go away . but , i do n't think he needs any antibiotics , at least not at this...
D2N099
30
[ "Acute Assessment", "Other Treatments", "Medication" ]
[ "Assessment", "Plan" ]
all right . so , he's just kind of getting started with this , and i think we're seeing something viral right now . often sinus infections will start out as a virus and then will become bacterial infections if left alone and does n't go away . but , i do n't think he needs any antibiotics , at least not at this point i...
2,539
doctor: actually , i will . i'll go ahead and just give you some as well . patient_guest: okay . okay .
D2N099
31
[ "Medication" ]
[ "Plan" ]
actually , i will . i'll go ahead and just give you some as well .
2,540
doctor: but , if he does n't become barky , you do n't have to use it . it only works for the barky cough . patient_guest: mm-hmm , got it .
D2N099
32
[ "Discussion", "Medication" ]
[ "Plan" ]
but , if he does n't become barky , you do n't have to use it . it only works for the barky cough .
2,541
doctor: okay . we'll do the same thing with him , as long as nothing gets worse , and we'll see him back in one week . so , it wo n't get rid of a regular cough . he can use zarbee's , but use the dose for kids under a year of age . so , if you wan na get some of that , you can definitely try that for him , it can help...
D2N099
33
[ "Follow-up", "Medication" ]
[ "Plan" ]
okay . we'll do the same thing with him , as long as nothing gets worse , and we'll see him back in one week . so , it wo n't get rid of a regular cough . he can use zarbee's , but use the dose for kids under a year of age . so , if you wan na get some of that , you can definitely try that for him , it can help out a l...
2,542
doctor: yes , that's a great question . you do n't give honey to kids under a year , instead , you can give them agave , which is a different type of nectar . um , now you can give honey to his older sister , that is okay , but for him , it would not be very good because his stomach acid's not good enough to break down...
D2N099
34
[ "Discussion", "Other Treatments" ]
[ "Plan" ]
yes , that's a great question . you do n't give honey to kids under a year , instead , you can give them agave , which is a different type of nectar . um , now you can give honey to his older sister , that is okay , but for him , it would not be very good because his stomach acid's not good enough to break down the bot...
2,543
doctor: now , whether that would really hurt a baby , i am unsure , but it has real honey in it . so , no honey for him , but agave is definitely fine . patient_guest: okay . so , zarbee's for the stuffy nose .
D2N099
35
[ "Discussion", "Other Treatments" ]
[ "Plan" ]
now , whether that would really hurt a baby , i am unsure , but it has real honey in it . so , no honey for him , but agave is definitely fine .
2,544
doctor: yes , zarbee's . patient_guest: and then you said , uh , which medicine to give him just in case ?
D2N099
36
[ "Discussion", "Medication" ]
[ "Plan" ]
yes , zarbee's .
2,545
doctor: i'm gon na give him the same medicine as his sister , and just hang onto it , um , just to watch and see . if this was a monday and we had a whole week to watch , i would say to just call us if things got worse , um , but since , um , if it's gon na be the weekend , and things might worsen tonight or tomorrow n...
D2N099
37
[ "Follow-up", "Medication" ]
[ "Plan" ]
i'm gon na give him the same medicine as his sister , and just hang onto it , um , just to watch and see . if this was a monday and we had a whole week to watch , i would say to just call us if things got worse , um , but since , um , if it's gon na be the weekend , and things might worsen tonight or tomorrow night , i...
2,546
doctor: right , does that make sense ? patient_guest: yeah , yeah . that makes sense .
D2N099
38
[ "Chitchat" ]
[ "Null" ]
right , does that make sense ?
2,547
doctor: okay , great . and that way you do n't have to share , um , with his sister . patient_guest: right , okay .
D2N099
39
[ "Chitchat" ]
[ "Null" ]
okay , great . and that way you do n't have to share , um , with his sister .
2,548
doctor: and since he's about half her size , we'll do half the dose , which is a half a teaspoon . patient_guest: okay . will this information all be in the papers ?
D2N099
40
[ "Discussion", "Medication" ]
[ "Plan" ]
and since he's about half her size , we'll do half the dose , which is a half a teaspoon .
2,549
doctor: yes . and so , if he ends up starting the medicine , just give him a half a teaspoon for five days . patient_guest: okay .
D2N099
41
[ "Discussion", "Medication" ]
[ "Plan" ]
yes . and so , if he ends up starting the medicine , just give him a half a teaspoon for five days .
2,550
doctor: yeah , that's the only thing it wo n't say is , " as needed , " or anything like that . patient_guest: mm-hmm , understood , thank you .
D2N099
42
[ "Discussion", "Medication" ]
[ "Plan" ]
yeah , that's the only thing it wo n't say is , " as needed , " or anything like that .
2,551
doctor: you're welcome . patient_guest: and the cradle cap ?
D2N099
43
[ "Chitchat" ]
[ "Null" ]
you're welcome .
2,552
doctor: what i would do is use something like either head & shoulder's , or selsun blue , or nizoral ad . now , do n't get the extra strength stuff , just use the regular strength . um , cradle cap , it's just basically a fancy way of saying dandruff . so , those shampoos will help get rid of it . it's not an immediate...
D2N099
44
[ "Discussion", "Medication" ]
[ "Plan" ]
what i would do is use something like either head & shoulder's , or selsun blue , or nizoral ad . now , do n't get the extra strength stuff , just use the regular strength . um , cradle cap , it's just basically a fancy way of saying dandruff . so , those shampoos will help get rid of it . it's not an immediate thing '...
2,553
doctor: all right . and , if it keeps getting worse , definitely let us know . patient_guest: okay . sounds good .
D2N099
45
[ "Discussion", "Follow-up" ]
[ "Plan" ]
all right . and , if it keeps getting worse , definitely let us know .
2,554
doctor: good . and , since they do n't have covid-19 , you can go right ahead and check out . patient_guest: okay . and both appointments in the week ?
D2N099
46
[ "Chitchat" ]
[ "Null" ]
good . and , since they do n't have covid-19 , you can go right ahead and check out .
2,555
doctor: correct . we'll see you all then . bye randy , feel better . patient_guest: all right , great . thank you so much .
D2N099
47
[ "Chitchat" ]
[ "Null" ]
correct . we'll see you all then . bye randy , feel better .
2,556
doctor: you are welcome , and have a good rest of your day .
D2N099
48
[ "Chitchat" ]
[ "Null" ]
doctor: you are welcome , and have a good rest of your day .
2,557
doctor: kayla ward , date of birth , 4/28/07 . mrn 3-8-4-9-2-0 . she's here for a new visit with her mother for acne located on the face , which started about two years ago and is present most every day . she has been using persa-gel and washing regularly , which is somewhat helpful . there are no associated symptoms i...
D2N100
0
[ "Acute Symptoms", "Therapeutic History", "Personal History", "Other Socials", "Family History", "Greetings" ]
[ "Subjective" ]
kayla ward , date of birth , 4/28/07 . mrn 3-8-4-9-2-0 . she's here for a new visit with her mother for acne located on the face , which started about two years ago and is present most every day . she has been using persa-gel and washing regularly , which is somewhat helpful . there are no associated symptoms including...
2,558
doctor: so , it's not bad on the chest or back . you've used some over the counter items like washes and persa-gel ? patient: yeah .
D2N100
1
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
so , it's not bad on the chest or back . you've used some over the counter items like washes and persa-gel ?
2,559
doctor: do those seem to be helping ? patient: yes , i think so , a little bit .
D2N100
2
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
do those seem to be helping ?
2,560
doctor: good . what's your skin care routine like now ? patient: do you wan na know , like , the things i currently use ?
D2N100
3
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
good . what's your skin care routine like now ?
2,561
doctor: yes . what do you do for your acne in the morning ? and then what do you do at nighttime ? patient: i wash my face , more like i wipe it down in the morning . then at night i use an elf facial cleanser called the super clarity cleanser . i finish with a toner and then the persa-gel .
D2N100
4
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
yes . what do you do for your acne in the morning ? and then what do you do at nighttime ?
2,562
doctor: when you say , " wipe your face in the morning , " do you use a product or just water ? patient: mm , just water and a washcloth , really . if i feel really greasy , sometimes i'll use the elf cleanser in the morning , too .
D2N100
5
[ "Therapeutic History" ]
[ "Subjective" ]
when you say , " wipe your face in the morning , " do you use a product or just water ?
2,563
doctor: okay . and is today a good day , bad day , or an average day for you ? patient: mm , i would say it's probably a good day for me , of course , since i'm here , right ?
D2N100
6
[ "Acute Symptoms" ]
[ "Subjective" ]
okay . and is today a good day , bad day , or an average day for you ?
2,564
doctor: acne is always good when you come to see the doctor . do you find that your acne flares with your periods ? patient: no , not really .
D2N100
7
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
acne is always good when you come to see the doctor . do you find that your acne flares with your periods ?
2,565
doctor: and do you get a regular period ? patient: yup .
D2N100
8
[ "Vegetative History" ]
[ "Subjective" ]
and do you get a regular period ?
2,566
doctor: how long have you been getting a regular period ? patient: mm , i think about two years .
D2N100
9
[ "Vegetative History" ]
[ "Subjective" ]
how long have you been getting a regular period ?
2,567
doctor: okay . patient_guest: the biggest flare , probably , was when she started school sports in the fall , just with all the sweating .
D2N100
10
[ "Vegetative History" ]
[ "Subjective" ]
okay .
2,568
doctor: yup , that will do it . is there anything else that you've noticed , mrs. ward ? patient_guest: no . kayla really has been doing a good job with the facial care regimen . it just does n't seem to help as much as we wanted .
D2N100
11
[ "Acute Symptoms" ]
[ "Subjective" ]
yup , that will do it . is there anything else that you've noticed , mrs. ward ?
2,569
doctor: got it . okay . well , let's take a look then . full exam is performed today , except for under the underwear and under the bra . multiple benign nevi on the trunk and extremities . scattered skin colored papules . open and closed comedones . and erythmateous papules on the face , primarily on the forehead and ...
D2N100
12
[ "Physical Examination", "Acute Assessment" ]
[ "Objective", "Assessment" ]
got it . okay . well , let's take a look then . full exam is performed today , except for under the underwear and under the bra . multiple benign nevi on the trunk and extremities . scattered skin colored papules . open and closed comedones . and erythmateous papules on the face , primarily on the forehead and with als...
2,570
doctor: yes . i would like to start with a topical therapy first . every morning , you will wash your face with a mild cleanser then use a moisturizer labeled , " noncomedogenic , " with sunscreen spf 30 or higher . this means it wo n't clog your pores . now , in the evening , wash your face with the same cleanser and ...
D2N100
13
[ "Medication" ]
[ "Plan" ]
yes . i would like to start with a topical therapy first . every morning , you will wash your face with a mild cleanser then use a moisturizer labeled , " noncomedogenic , " with sunscreen spf 30 or higher . this means it wo n't clog your pores . now , in the evening , wash your face with the same cleanser and allow it...
2,571
doctor: you also have multiple benign moles on your arms , legs , back and abdomen . this means they all look normal with no worrisome features . we will see if you have any progress over the next six months and follow up at that time . patient: okay , that sounds good . thank you .
D2N100
14
[ "Physical Examination", "Follow-up" ]
[ "Objective", "Plan" ]
you also have multiple benign moles on your arms , legs , back and abdomen . this means they all look normal with no worrisome features . we will see if you have any progress over the next six months and follow up at that time .
2,572
doctor: do you have any questions for me ? patient: no , i do n't think so .
D2N100
15
[ "Discussion" ]
[ "Plan" ]
do you have any questions for me ?
2,573
doctor: okay . if you have questions or concerns before your next visit , please call the office . patient: thank you , doctor , we will .
D2N100
16
[ "Discussion", "Follow-up" ]
[ "Plan" ]
okay . if you have questions or concerns before your next visit , please call the office .
2,574
doctor: patient is julia jones , date of birth 5/16/1996 . she is a new breast reduction consult . hello , how are you doing today ? i'm dr. gonzalez . it's nice to meet you . patient: nice to meet you , ma'am . how are you ?
D2N101
0
[ "Greetings" ]
[ "Subjective" ]
patient is julia jones , date of birth 5/16/1996 . she is a new breast reduction consult . hello , how are you doing today ? i'm dr. gonzalez . it's nice to meet you .
2,575
doctor: i'm doing good , thank you . so you're here to discuss a breast reduction , correct ? patient: yes . that's right .
D2N101
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[ "Acute Symptoms" ]
[ "Subjective" ]
i'm doing good , thank you . so you're here to discuss a breast reduction , correct ?
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doctor: okay . perfect . let me just get logged in , here . have you met with anyone before about a breast reduction ? patient: no , i have n't .
D2N101
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[ "Personal History" ]
[ "Subjective" ]
okay . perfect . let me just get logged in , here . have you met with anyone before about a breast reduction ?
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doctor: okay . and how long have you been considering this ? patient: it's probably been about six or seven years . but i mean , it's always been in the back of my mind .
D2N101
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[ "Personal History" ]
[ "Subjective" ]
okay . and how long have you been considering this ?
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doctor: well , i perform a lot of breast reduction surgeries , pretty much every week , so it is a very common procedure . patient: okay , that's reassuring .
D2N101
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[ "Personal History" ]
[ "Subjective" ]
well , i perform a lot of breast reduction surgeries , pretty much every week , so it is a very common procedure .
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doctor: yeah . so what i wan na do first is just get a little bit of history about the sort of symptoms that you're having . and then i'll do a quick exam . patient: okay . that sounds good .
D2N101
5
[ "Personal History" ]
[ "Subjective" ]
yeah . so what i wan na do first is just get a little bit of history about the sort of symptoms that you're having . and then i'll do a quick exam .
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doctor: and then we'll talk more about the surgery and what it entails . and , um , at this point , who is your insurance provider ? patient: i have blue cross blue shield . well , actually , my husband just accepted a new job , and i will be on his plan , uh , which i believe is not going to be blue cross , but it may...
D2N101
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[ "Other Socials" ]
[ "Subjective" ]
and then we'll talk more about the surgery and what it entails . and , um , at this point , who is your insurance provider ?
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doctor: okay . what we typically do when we do a breast reduction consult , i'll document your symptoms , symptoms , we'll take some pictures , then , um , they get sent to the insurance company . and what they'll do is decide whether it's approved , or medically necessary , or not . but we wan na make sure we send it ...
D2N101
7
[ "Discussion", "Other Socials" ]
[ "Subjective", "Plan" ]
okay . what we typically do when we do a breast reduction consult , i'll document your symptoms , symptoms , we'll take some pictures , then , um , they get sent to the insurance company . and what they'll do is decide whether it's approved , or medically necessary , or not . but we wan na make sure we send it to the r...
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doctor: okay . so we may just wait until july to submit for approval at that time . patient: okay .
D2N101
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[ "Other Socials" ]
[ "Subjective" ]
okay . so we may just wait until july to submit for approval at that time .
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doctor: so regarding your symptoms , do you experience back pain ? patient: well , i've been going to the chiropractor for a few years . i do have a lotta pain here and here . but i do n't know if it's all from my breasts or not . it gets painful and builds up . so i think i could attribute it to my breasts , when i'm ...
D2N101
9
[ "Personal History" ]
[ "Subjective" ]
so regarding your symptoms , do you experience back pain ?
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doctor: okay . and in your neck and your upper back . and how long has this been going on ? would you say five years , 10 years , or even since puberty ? patient: i would say since i was in high school .
D2N101
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[ "Personal History" ]
[ "Subjective" ]
okay . and in your neck and your upper back . and how long has this been going on ? would you say five years , 10 years , or even since puberty ?
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doctor: okay . and do you have the bra strap indentations in your shoulders ? um , i saw that you're wearing about a g cup . patient: yes . i do get indentations , but i do n't really wear a regular bra that often . i mostly were a 34 e sports bra because it's more comfortable . and the others are expensive in my size ...
D2N101
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[ "Personal History" ]
[ "Subjective" ]
okay . and do you have the bra strap indentations in your shoulders ? um , i saw that you're wearing about a g cup .
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doctor: yeah , i have heard that as well . and , um , have you had any children , or are you planning to have any children in the future ? patient: no , i do not have any kids now . but we might plan to in the future .
D2N101
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[ "Other Socials" ]
[ "Subjective" ]
yeah , i have heard that as well . and , um , have you had any children , or are you planning to have any children in the future ?
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doctor: okay . and at this time , are you experiencing any numbness or tingling in the s- in the hands or any nipple pain ? patient: sometimes , yes .
D2N101
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[ "Personal History" ]
[ "Subjective" ]
okay . and at this time , are you experiencing any numbness or tingling in the s- in the hands or any nipple pain ?
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doctor: okay . and rashes , do you get any rashes underneath your breasts ? and , and it could be from sweating . patient: no , but they are always sweaty .
D2N101
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[ "Personal History" ]
[ "Subjective" ]
okay . and rashes , do you get any rashes underneath your breasts ? and , and it could be from sweating .
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doctor: okay . and then do you feel like your activities are limited because of the size ? patient: there's certain things i do when i have to hold them , like working out and any jumping or running . and it hurts .
D2N101
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[ "Other Socials" ]
[ "Subjective" ]
okay . and then do you feel like your activities are limited because of the size ?
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doctor: and it hurts , okay . and , and you saw a chiropractor . but what about physical therapy for your back pain ? or do you take any pain medicine for it ? patient: y- no , but i do take a migraine medication , propranolol .
D2N101
16
[ "Personal History", "Therapeutic History" ]
[ "Subjective" ]
and it hurts , okay . and , and you saw a chiropractor . but what about physical therapy for your back pain ? or do you take any pain medicine for it ?
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doctor: that's okay . so let's see . i know that you have a history of breast cancer in your family . have you had any mammograms ? and how old was your mother when she had it ? patient: mom was 40 . and they recommended me starting at age 30 for mammogram . i'm still ... i mean , i'm 25 . so i'm still a little bit you...
D2N101
17
[ "Family History" ]
[ "Subjective" ]
that's okay . so let's see . i know that you have a history of breast cancer in your family . have you had any mammograms ? and how old was your mother when she had it ?
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doctor: okay . and otherwise , it seems like you're really healthy ? patient: yes , for the most part . i lost about 10 pounds over the past few months , and i still would like to lose about 20 more pounds .
D2N101
18
[ "Personal History" ]
[ "Subjective" ]
okay . and otherwise , it seems like you're really healthy ?
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doctor: congratulations . that's great . and then , um- patient: thank you .
D2N101
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[ "Chitchat" ]
[ "Null" ]
congratulations . that's great . and then , um-
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doctor: . so then ... you're welcome . and so do you use any tobacco , drugs , or alcohol ? and then , um , you said that you were going to school . what are you going to school for ? patient: uh , i drink a little wine on occasion , and for school , i'm currently studying psychology .
D2N101
20
[ "Other Socials", "Drug History" ]
[ "Subjective" ]
. so then ... you're welcome . and so do you use any tobacco , drugs , or alcohol ? and then , um , you said that you were going to school . what are you going to school for ?
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doctor: okay , that's great . all right . so what we'll do is we'll go ahead and take a look . i'm gon na take a couple of measurements . and we'll kinda talk about the surgery afterwards . um , so go ahead and stand up for me , julia . okay . so , looking at the measurements , it looks like one breast is a little lowe...
D2N101
21
[ "Physical Examination" ]
[ "Objective" ]
okay , that's great . all right . so what we'll do is we'll go ahead and take a look . i'm gon na take a couple of measurements . and we'll kinda talk about the surgery afterwards . um , so go ahead and stand up for me , julia . okay . so , looking at the measurements , it looks like one breast is a little lower than t...
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doctor: okay . well , thank you so much . it looks like i have all the measurements that we need . you can go ahead and cover up now . patient: okay .
D2N101
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[ "Chitchat" ]
[ "Null" ]
okay . well , thank you so much . it looks like i have all the measurements that we need . you can go ahead and cover up now .
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doctor: so i think you're a great candidate for a breast reduction . when we talk about a breast reduction , what happens is that we remove the tissue out of the breast . patient: okay . that's fine .
D2N101
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[ "Discussion", "Other Treatments" ]
[ "Plan" ]
so i think you're a great candidate for a breast reduction . when we talk about a breast reduction , what happens is that we remove the tissue out of the breast .
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doctor: and we would then lift them and elevate the nipple position in order to help with your back pain , neck pain , and because i'm a plastic surgeon , of course i want them to look nice as well . patient: right .
D2N101
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[ "Discussion", "Other Treatments" ]
[ "Plan" ]
and we would then lift them and elevate the nipple position in order to help with your back pain , neck pain , and because i'm a plastic surgeon , of course i want them to look nice as well .
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