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med_intent_classification

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all right , so for today we'll go ahead and we'll give you the steroid shot . i'll try to see if i can get a little bit of fluid out before i do give you the injection . there might be no fluid , but i'll see if i can get anything out regardless .
[ "Medication" ]
[ "Plan" ]
2,700
yeah . right now the numbers are low . even with the delta variant , when it starts mutating , it's actually good because it becomes more contagious , but less deadly .
[ "Discussion" ]
[ "Plan" ]
2,701
okay . excellent . and you're taking the lisinopril ?
[ "Personal History", "Therapeutic History" ]
[ "Subjective" ]
2,702
yeah you ca n't get a doctor's note so if you if i write a note i'm gon na tell your boss that you have to go to work
[ "Discussion" ]
[ "Plan" ]
2,703
that sounds good what what do you what's your favorite there
[ "Chitchat" ]
[ "Null" ]
2,704
alright
[ "Chitchat" ]
[ "Null" ]
2,705
terrific , terrific . so , did it swell up on you ?
[ "Acute Symptoms" ]
[ "Subjective" ]
2,706
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 ?
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
2,707
all right . so , the nurse will be in soon , and she'll get you situated with all of that , okay ?
[ "Chitchat" ]
[ "Null" ]
2,708
okay . all right . uh , well , sounds like we just did the review of systems with you . it sounds like you're endorsing this , you know , nausea , vomiting , abdominal distension . um , any other symptoms ?
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
2,709
good to see you mister edwards tell me what's been going on
[ "Acute Symptoms" ]
[ "Subjective" ]
2,710
is n't that the best we we could get along really well outside of here alright and then tell me a little bit about your diabetes now are you are you watching your blood sugars are you taking them at home
[ "Personal History" ]
[ "Subjective" ]
2,711
okay and did your elbows hurt at that time or is this a a new injury
[ "Personal History" ]
[ "Subjective" ]
2,712
okay you know and i see here that you have a history of playing sports looks like you played soccer in college and then played a little bit of a inner marrow soccer now
[ "Other Socials" ]
[ "Subjective" ]
2,713
and then , i just wanted to make sure that the white count is okay , because if it remains elevated then that means there's something else going on with your bowels .
[ "Discussion", "Diagnostic Testing" ]
[ "Plan" ]
2,714
absolutely my goal is to get you out there and maybe we can cross pads on the the bike trail some day you are gon na have to take it a little bit easy for now but we are gon na get you back and once we do that i think you will be really pleased is there anything else
[ "Chitchat" ]
[ "Null" ]
2,715
no pain with palpation outside of the elbow you have do you have normal sensation in your fingers
[ "Physical Examination" ]
[ "Objective" ]
2,716
yeah , use , um , right hand-
[ "Discussion" ]
[ "Plan" ]
2,717
it's always a little bit of trial and error to figure out what the right dosing that would work for you but some common side effects can include you know memory loss tingling imbalance some people can actually have like dermatologic skin reaction to this medication and particularly people who have eustachian descent so that we may do some genetic testing just to make sure that it will be safe for you
[ "Discussion", "Diagnostic Testing", "Medication" ]
[ "Plan" ]
2,718
okay i agree alright i also want you to go ahead and continue with your toprol fifty milligrams once a day and i'm gon na go ahead and order a some liver function studies and a lipid panel to follow up with the next time we meet and i want to see you again in probably six weeks okay
[ "Follow-up", "Medication", "Diagnostic Testing" ]
[ "Plan" ]
2,719
all right , let's review your blood work real quick . i checked your hemoglobin level because you have had some anemia in the past but that is still doing great .
[ "Lab Examination" ]
[ "Objective" ]
2,720
well , that's great .
[ "Vegetative History" ]
[ "Subjective" ]
2,721
mm-hmm .
[ "Personal History" ]
[ "Subjective" ]
2,722
okay , great . so we will complete that today , um , to assess your overall cardiac structure and function , as well as , uh , the valve view of where diseased .
[ "Discussion", "Diagnostic Testing" ]
[ "Plan" ]
2,723
and i would avoid doing it you know as we get older you know our bones get a little bit weaker so i would avoid the tackle football maybe flag football in the future okay
[ "Discussion" ]
[ "Plan" ]
2,724
okay yeah yeah definitely if you if you ca n't walk on it we definitely good thing that you came in today and we were able to see you so have you experienced any numbness in your foot at all
[ "Acute Symptoms" ]
[ "Subjective" ]
2,725
okay . and do you have any other , um , medical problems ?
[ "Personal History" ]
[ "Subjective" ]
2,726
okay . the , um , the optimum optometrists , right ?
[ "Personal History" ]
[ "Subjective" ]
2,727
okay . no swelling . push your leg out . good . pull it back . mm-hmm . go . good . okay . so , on my exam , um , essentially , your exam is normal . your , um , heart is regular . you do have that grade 2 , um , systolic ejection fraction back ejection murmur that you , um , that we've heard in the past . okay ? so , um , we definitely know that's there . that's unchanged , okay ? um , your lungs are clear . um , your grips are equal . neurovascular's intact . you do n't have any carotid bruits in your neck , no thyromegaly . no edema . um , pulses are good , so essentially , your exam is , is essentially normal . let's take a look at some of your lab work , okay ?
[ "Physical Examination" ]
[ "Objective" ]
2,728
hey dragon , order amoxicillin , 500 milligrams , three times a day for 10 days . um ... okay . and from ... , and from all- ... a positive lyme titer aspect , we should go ahead and order a western blot , just pcr to see if you have any , um , to see if it's actually acute lyme , okay ?
[ "Medication", "Diagnostic Testing" ]
[ "Plan" ]
2,729
you know , i , i think , you know , you're doing a ... it sounds like a doing a good job watching your diet . you could ... you just are retaining a little bit of fluid , maybe just from standing all day .
[ "Acute Assessment" ]
[ "Assessment" ]
2,730
okay so it feels like it's gon na buckle
[ "Acute Symptoms" ]
[ "Subjective" ]
2,731
hi , ms. brooks . i'm dr. baker . how are you ?
[ "Greetings" ]
[ "Subjective" ]
2,732
so carolyn is a 49-year-old female here for follow-up of her chronic problems . so , how are you doing , carolyn ?
[ "Personal History" ]
[ "Subjective" ]
2,733
hey dragon ? show me the blood pressure . so it's a little elevated . your blood pressure's a little elevated here in the office , but you know you could be in some pain , which could make your-
[ "Physical Examination" ]
[ "Objective" ]
2,734
gotcha okay alright well let's go ahead and take a look at your knee here real quick before i take a look at your knee here i'm gon na do a physical exam and in terms of your gait here i did notice that you do have a marked limp on your looks like it's your right leg upon ambulation so let me go ahead and take a look at that right knee real quick i do appreciate some significant effusion in the right knee just a slight bit of ecchymosis let me just feel around here scott how does that feel does that hurt when i kinda press on that there
[ "Physical Examination" ]
[ "Objective" ]
2,735
okay did so you just got the two vaccines you did n't get the booster
[ "Therapeutic History" ]
[ "Subjective" ]
2,736
wow that sounds kinda stressful like what are you moving for
[ "Other Socials" ]
[ "Subjective" ]
2,737
okay , good . and how about irregular heartbeats ? do you ever feel like your heart is going too fast or like it skips a beat ?
[ "Acute Symptoms" ]
[ "Subjective" ]
2,738
yeah i love riding over there way we will we will get you all fixed up we will have to go for a bike ride
[ "Chitchat" ]
[ "Null" ]
2,739
okay . great . well , let's review , uh , some of your vital signs . hey , dragon , show me the vitals . all right . blood pressure looks good right now . your oxygen level's great . uh , your temperature's good . so i know you checked in with the review of systems with my assistant before coming in . uh , anything else bothering you today except for the abnormal blood work ? no chest pain ? no shortness of breath ?
[ "Acute Symptoms", "Physical Examination" ]
[ "Subjective", "Objective" ]
2,740
okay yeah i know i i play with my kids sometimes and i think i'm getting too old to do all that so i just i've hurt myself before as well alright so with your your elbow what part of your elbow would you say hurts
[ "Acute Symptoms" ]
[ "Subjective" ]
2,741
no , okay . so on exam you do have some tenderness over the medial portion of your knee over the medial meniscus area . uh , there is no , uh , there is a little bit of tenderness when i flex your , uh , when i , uh , uh , do some valgus stressing on your , on your leg . um , you have normal sensation . so let's take a look at your x-rays .
[ "Physical Examination" ]
[ "Objective" ]
2,742
okay i ca n't treat people like you you you you need to work harder
[ "Chitchat" ]
[ "Null" ]
2,743
yeah i mean certainly it could be it is you know sometimes that medication can cause that so i'll i'll examine you in a second and see if we need to make any modifications okay
[ "Personal History" ]
[ "Subjective" ]
2,744
alright
[ "Chitchat" ]
[ "Null" ]
2,745
doctor: thank you , mr. allen .
[ "Chitchat" ]
[ "Null" ]
2,746
okay no problem
[ "Chitchat" ]
[ "Null" ]
2,747
you feel warm okay alright any chills
[ "Vegetative History" ]
[ "Subjective" ]
2,748
you are okay you are not great okay well how long have you been having some shortness of breath
[ "Acute Symptoms" ]
[ "Subjective" ]
2,749
hi , ms. thompson . i'm dr. moore . how are you ?
[ "Greetings" ]
[ "Subjective" ]
2,750
okay how long have you been feeling not too well
[ "Acute Symptoms" ]
[ "Subjective" ]
2,751
okay , good , all right . um , let's take a quick look at your x-ray , okay ?
[ "Radiology Examination" ]
[ "Objective" ]
2,752
hey , dragon , show me the vital signs . so your vital signs here in the office look really good .
[ "Physical Examination" ]
[ "Objective" ]
2,753
okay . all right . and any problems laying flat while you go to bed ?
[ "Acute Symptoms" ]
[ "Subjective" ]
2,754
does it hurt when i squeeze over this joint here ?
[ "Physical Examination" ]
[ "Objective" ]
2,755
alright teresa i see here in your chart that you seem to be experiencing some elbow pain could you tell me where it hurts
[ "Acute Symptoms", "Greetings" ]
[ "Subjective" ]
2,756
all right . well , i'm going to tell the front desk six months and we'll revisit those scars .
[ "Follow-up" ]
[ "Plan" ]
2,757
okay and have you ever been a smoker ?
[ "Vegetative History" ]
[ "Subjective" ]
2,758
hey dragon , show me the event- event monitor results . okay . so , you know , this is the results of your event monitor which shows that , you know , you're in and out of a-fib , you have what we call a conversion pause . you know , you're in a-fib , you pause , and then you go back to regular rhythm . so , we'll talk about that , okay ?
[ "Physical Examination" ]
[ "Objective" ]
2,759
okay . and on your review systems form , you indicated that you've not had any recent weight loss or gain , headaches , bone pain , urinary symptoms , or blood in the stools . but you did indicate that you have some back pain , joint pain , and high cholesterol . tell me some more about those .
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
2,760
julie cruz is a 17 -year-old non- binary immensipated minor with no significant past medical history presents for evaluation of newly diagnosed hypercholesterolemia patient is here at the clinic hi julie how're you doing
[ "Acute Symptoms", "Greetings" ]
[ "Subjective" ]
2,761
okay . well , you know , you can only do what you can do .
[ "Chitchat" ]
[ "Null" ]
2,762
constipation , diarrhea , rectal bleeding ?
[ "Vegetative History" ]
[ "Subjective" ]
2,763
okay alright alright well i wan na go ahead and just move on to a physical exam i'm gon na be calling out some of my exam findings
[ "Physical Examination" ]
[ "Objective" ]
2,764
okay okay and then any how about any body aches for you
[ "Vegetative History" ]
[ "Subjective" ]
2,765
so i will see you in a week or so and hopefully you've passed that stone and i'll send my nurse in with that prescription
[ "Follow-up" ]
[ "Plan" ]
2,766
or how have you been feeling in general with this ?
[ "Personal History" ]
[ "Subjective" ]
2,767
okay so you do n't have any history of seasonal allergies which is good so it looks like here that you put down that you enjoyed hiking so you do n't have any trouble getting out and going hiking and and have you tried the new trails there behind behind the wreck center
[ "Personal History" ]
[ "Subjective" ]
2,768
all right .
[ "Chitchat" ]
[ "Null" ]
2,769
medication therapy . and then , i just wan na be reminded about , um , the results of your skin biopsy . hey , dragon , show me the skin biopsy results . okay . and in reviewing the pathology report for your skin cancer-
[ "Lab Examination" ]
[ "Objective" ]
2,770
okay got it . and do you have a nebulizer that you would , uh , need refills on ?
[ "Discussion", "Medication" ]
[ "Plan" ]
2,771
and does it seem to work pretty well still ? are you happy with it ?
[ "Therapeutic History" ]
[ "Subjective" ]
2,772
hey steven so i see that you're here and you've been experiencing some back pain for a while could you tell me a bit about that
[ "Greetings", "Acute Symptoms" ]
[ "Subjective" ]
2,773
okay . and what happened ?
[ "Therapeutic History" ]
[ "Subjective" ]
2,774
all right . well lets go ahead and do a quick physical exam .
[ "Physical Examination" ]
[ "Objective" ]
2,775
okay okay not not too bad it does look like you're a little bit elevated today i i maybe i'm just making you nervous though so i hope not so are you but you're still on lisinopril twenty milligrams per day correct it looks like you might be running low do you need a refill of that
[ "Discussion", "Medication", "Therapeutic History" ]
[ "Subjective", "Plan" ]
2,776
okay , that's good . so ... i'm proud of you with the course of your labs , so before i forget , i'm going to , uh , just put your labs into the computer today , and i wo n't be checking your vitamin d level for some time .
[ "Discussion" ]
[ "Plan" ]
2,777
okay . and then lastly , i know that you had had some early arthritis in your knee . how- how are you doing with that ?
[ "Personal History" ]
[ "Subjective" ]
2,778
you may recall it was extremely hot during that period leading up to you going to the hospital . i do n't know if you were inside for the most part ?
[ "Personal History" ]
[ "Subjective" ]
2,779
okay . so as i understand it , ashley was found to have a small ... kind of a small kidney on one side . tell me about when that was . um , i do also have records of everything , but i'd just like to hear the story of how it was found out and what you're doing that got us here , uh , today .
[ "Personal History" ]
[ "Subjective" ]
2,780
okay , all right . hey dragon , finalize the note . so , it was good to see you , the nurse will come in , she'll help you get your scheduled for all of those things , and i'll be in touch , okay ?
[ "Chitchat" ]
[ "Null" ]
2,781
and we did go through the golive in november and december , so that can be pretty stressful also .
[ "Personal History", "Other Socials" ]
[ "Subjective" ]
2,782
okay . how about this way ? not too bad ?
[ "Physical Examination" ]
[ "Objective" ]
2,783
okay and
[ "Personal History", "Therapeutic History" ]
[ "Subjective" ]
2,784
well i'm really glad you took it seriously and got it checked . who in your family has had skin cancer , and do you know if it was melanoma or was it basal cell or squamous cell ?
[ "Family History" ]
[ "Subjective" ]
2,785
really ?
[ "Acute Symptoms" ]
[ "Subjective" ]
2,786
okay ra i'm not suspicious but we're just gon na go with that okay because looking at your vitals it it is of still a bit high i'm not really comfortable i see like a hundred and eighty over you know eighty and that's not where we wan na be so i wonder if we might need to adjust your medication but let's talk about your diabetes how are your blood sugars
[ "Physical Examination", "Personal History" ]
[ "Subjective", "Objective" ]
2,787
okay i'm gon na have my nurse come in and get you discharged but i the we will see you again in three months or and again please if it gets worse please do n't hesitate to call me and come in sooner
[ "Follow-up" ]
[ "Plan" ]
2,788
okay so it's really high i was looking back and it looks like your blood pressure was pretty normal last time we saw you is one twenty four over eighty two have you been able to take your blood pressure medicine the lisinopril that you've been prescribed
[ "Therapeutic History" ]
[ "Subjective" ]
2,789
five days ago .
[ "Acute Symptoms" ]
[ "Subjective" ]
2,790
okay so moderate tenderness at the medial epicondyle when you turn like when you turn your wrist is if you're trying to open a door knob do you experience pain
[ "Physical Examination" ]
[ "Objective" ]
2,791
but , if he does n't become barky , you do n't have to use it . it only works for the barky cough .
[ "Discussion", "Medication" ]
[ "Plan" ]
2,792
okay , all right . um , so i think we had started you at a , kind of , a moderate dose , so we'll have to talk about that a little bit , okay ?
[ "Therapeutic History" ]
[ "Subjective" ]
2,793
okay maybe you have a little white coat syndrome some of my patients do have it i have it myself and i'm a provider so i definitely understand yeah i know we we talked about last time you getting a blood pressure cuff and taking those about two to three times a week so what have those readings been i'm usually like one thirty to one forty over sixty to seventy
[ "Chitchat" ]
[ "Null" ]
2,794
no . okay . and then in terms of your a-fib , how are you doing with that ? are you having any palpitations ? or , i know that you've kind of been in and out of it over the past , you know , year or so .
[ "Personal History" ]
[ "Subjective" ]
2,795
is that it okay alright and then how often do you feel like you need to use that
[ "Therapeutic History" ]
[ "Subjective" ]
2,796
doctor: okay take care bye
[ "Chitchat" ]
[ "Null" ]
2,797
wonderful . i'm glad to see you doing so well . do you have any questions or concerns i can address for you today ?
[ "Discussion" ]
[ "Plan" ]
2,798
okay alright so i'm just gon na check your reflexes okay alright now on your on the neurological exam the patient is awake alert and oriented times three speech is clear and fluent gait is steady heel toe walking is normal and the cranial nerves are intact without focal neurologic findings there is no pronator drift sensation is intact reflexes are two plus and symmetric at the biceps triceps knees and ankles so this means everything looks good karen
[ "Physical Examination" ]
[ "Objective" ]
2,799