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med_intent_classification

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absolutely okay totally understand that glad to hear that you're back out on the court playing with your son how is he doing by the way
[ "Chitchat" ]
[ "Null" ]
2,800
okay and are you feeling any palpitations or your heart racing anything unusual there
[ "Vegetative History" ]
[ "Subjective" ]
2,801
okay . and ... okay . i'm looking here . it looks like ... do you know what the name of diagnosis ? it does n't seem to be mentioned .
[ "Family History" ]
[ "Subjective" ]
2,802
all right , well , i know the nurse told you about dax . i'd like to tell dax a little bit about you , okay ?
[ "Chitchat" ]
[ "Null" ]
2,803
how much damage to your car ?
[ "Chitchat" ]
[ "Null" ]
2,804
okay so we got to get those down too so we will talk about getting you consult nutrition just try to get you a better diet i think you know we wan na get you off the medications totally but you know we got ta get you on the right track here alright so let me do a quick physical exam on you i'm gon na check your your your lungs lungs sound good check your heart so listen to your heart you still do have that grade two out of systolic ejection murmur alright but we we knew about that already you've had that for a couple of years so i'm not really worried about that at this at this time so let me take a look at your knee here so when i press right here on the inside the right knee is that painful
[ "Physical Examination" ]
[ "Objective" ]
2,805
and um , do you have any allergies to medicines ? i did n't ask .
[ "Personal History" ]
[ "Subjective" ]
2,806
yeah so sorry so barbara is a 31 -year-old female and she has history of diabetes type two and asthma and she is here today with abdominal pain so barbara tell me a little more about your abdominal pain what's been going on
[ "Acute Symptoms", "Personal History", "Greetings" ]
[ "Subjective" ]
2,807
okay well i'm just gon na go ahead and do a physical examination i'm gon na be calling out some of my exam findings and i'm going to explain what what those mean when i'm done okay
[ "Physical Examination" ]
[ "Objective" ]
2,808
sensation is decreased in the fourth and fifth fingers on the left okay , let's test your reflexes now . reflexes are 1+ and symmetric ; 2+ knees ; toes are downgoing bilaterally . all right , i'm going to tap on your right wrist . do you feel anything ?
[ "Acute Symptoms", "Physical Examination" ]
[ "Subjective", "Objective" ]
2,809
okay alright so it's been going on a few months now you mentioned that you and your wife go out to eat every night have you tried the new the new italium place over there on main street
[ "Chitchat" ]
[ "Null" ]
2,810
i see that i see that here in the nurse's notes it looks like you're having some right shoulder pain says here that you've guys have been remodeling your house what do you do you remember what you were doing when that right shoulder pain started
[ "Acute Symptoms" ]
[ "Subjective" ]
2,811
all right , have a good rest of your day .
[ "Chitchat" ]
[ "Null" ]
2,812
you know , it's hard because you ca n't take certain medications 'cause of your kidney transplant .
[ "Personal History", "Therapeutic History" ]
[ "Subjective" ]
2,813
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 .
[ "Physical Examination", "Follow-up" ]
[ "Objective", "Plan" ]
2,814
hey , dragon , order combivent , uh , two puffs twice a day . order albuterol , two puffs as needed . and order , uh , prednisone uh taper pack . okay , so and then it sounds like your depression's stable , so we're not gon na change anything . you're gon na keep taking the effexor . um , do yoga for depression and your back pain , so for your back pain , stay on the neurontin , and we just wo n't do anything different . any questions for me .
[ "Discussion", "Medication" ]
[ "Plan" ]
2,815
your lungs sound nice and clear , but i notice , you know , 1+ , uh , edema in your lower extremities . okay ?
[ "Physical Examination" ]
[ "Objective" ]
2,816
hey , dragon . show me the vital signs . so , looking here right now , your vital signs look great . you know , your pulse ox is great . your h- your blood pressure and heart rate are right where they should be .
[ "Physical Examination" ]
[ "Objective" ]
2,817
they have the best colors not going to lie but i i grew up manu so sorry
[ "Chitchat" ]
[ "Null" ]
2,818
yes yeah i i strongly believe this is our best course of action and that you will get better given enough time i i see that you are making efforts i'm really glad that you are out there walking and that you're cognizant of your diet and willing to make changes we will just you know monitor it over time okay
[ "Chitchat" ]
[ "Null" ]
2,819
okay so for your other conditions that we talked about briefly your second condition of type two diabetes we'll let's go ahead and continue to maintain that with diet and exercise and we'll just monitor your type two diabetes i am gon na go ahead and order a hemoglobin a1c for your next blood draw since i'll see you in two weeks go ahead and have that done and we will talk about that when you come back in now for your third problem of your history of gout let's go ahead and continue you on your allopurinol and just you know continue to watch those foods that will exacerbate your uric acid levels any other questions about those
[ "Follow-up", "Medication", "Reassessment" ]
[ "Assessment", "Plan" ]
2,820
well , it looks like you have one stone in the left kidney but it's not obstructing anything .
[ "Acute Assessment" ]
[ "Assessment" ]
2,821
doctor: alright well thank you hope that you feel better
[ "Chitchat" ]
[ "Null" ]
2,822
okay well did you hear or feel a pop at any point
[ "Acute Symptoms" ]
[ "Subjective" ]
2,823
okay you know you do have the stage three ckd so that's the the stage three kidney disease so it is gon na be important for you to follow up with your nephrologist just to make sure that everything is okay now i did check your kidney function and and it was fine but are you staying away from things like motrin and advil
[ "Personal History", "Therapeutic History" ]
[ "Subjective" ]
2,824
just couple cigarettes a day ?
[ "Vegetative History" ]
[ "Subjective" ]
2,825
okay do you you find that you're dropping things when you're picking it up is it to that level or
[ "Physical Examination" ]
[ "Objective" ]
2,826
all right . great . i'll get a referral order , and they will call you within the next day or two to get you scheduled .
[ "Chitchat" ]
[ "Null" ]
2,827
of course . so , do you want me to try to get you into that study ? or , would you just like to try , me to prescribe something ? it's kind of up to you .
[ "Discussion" ]
[ "Plan" ]
2,828
okay . and when you have a bowel movement , does the pain change ?
[ "Acute Symptoms", "Vegetative History" ]
[ "Subjective" ]
2,829
all right , so no numbing and tingling in your hands ?
[ "Acute Symptoms" ]
[ "Subjective" ]
2,830
okay , thank you . well , let's complete his exam and then we'll talk about the next steps .
[ "Chitchat" ]
[ "Null" ]
2,831
okay , well i'll be happy to provide you with more information . so tell me when did you last have a drink ?
[ "Vegetative History" ]
[ "Subjective" ]
2,832
it was good to see you .
[ "Chitchat" ]
[ "Null" ]
2,833
mm-hmm
[ "Acute Symptoms" ]
[ "Subjective" ]
2,834
and what medication have you tried for him ? anything at all ?
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
2,835
okay . is your s- skin pretty sensitive ?
[ "Personal History" ]
[ "Subjective" ]
2,836
okay . any blood in your urine that you've seen ?
[ "Vegetative History" ]
[ "Subjective" ]
2,837
and so by inhaler do they mean both your daily and rescue inhalers ?
[ "Therapeutic History" ]
[ "Subjective" ]
2,838
okay that's good and i'm glad to hear that you were able to to to stop and and stay tobacco free that that's great to hear do you have any pain or any shortness of breath or anything like that
[ "Drug History" ]
[ "Subjective" ]
2,839
alright so the lateral aspect not a problem and you said that you heard a pop when you landed right
[ "Acute Symptoms" ]
[ "Subjective" ]
2,840
uh , okay . so any blood in your stool ?
[ "Vegetative History" ]
[ "Subjective" ]
2,841
just to gauge where you are so you can tell how much food you should actually be be eating
[ "Discussion", "Other Treatments" ]
[ "Plan" ]
2,842
alright have you noticed any nausea vomiting fever chills
[ "Vegetative History" ]
[ "Subjective" ]
2,843
doctor: hey dragon , finalize the report .
[ "Chitchat" ]
[ "Null" ]
2,844
okay well i i'm lucky enough my friends had an adult easter hag hunt for me and so i was able to find a couple eggs yesterday myself so i i'm glad you were able to get a few of them alright so let's do that that physical exam on you so your vitals look good you do n't have any fever your blood pressure heart rate is fine so when i press here on your belly does that hurt
[ "Physical Examination" ]
[ "Objective" ]
2,845
good to see you as well . are you ready to get started ?
[ "Chitchat" ]
[ "Null" ]
2,846
then you're stuck with me okay i'm so sorry but here it's we're gon na try and make it as good as possible alright so last thing i do wan na do my physical exam alright and i need you to let me know as as much as you as much as you can verbalize right so when i push here in the middle of your neck on top of the bone does it hurt
[ "Physical Examination" ]
[ "Objective" ]
2,847
okay so let's go ahead and i want to do a quick examination here your blood pressure and was one twenty over sixty that's phenomenal your heart rate was fifty eight and you can tell that you're a runner with that that level of a heart rate and your respirations were fourteen so all of that looked very good there was no fever when you came in when i'm gon na just quickly listen to your heart and lungs okay those those sound good but let me get let's focus here on your lower extremities i'm i'm gon na look at your your left knee first when i move your left knee do you get any type of pain or is it just feel like normal and it's always your pain's always isolated to the right
[ "Physical Examination" ]
[ "Objective" ]
2,848
be still my heart okay that's fine i'll forgive you so
[ "Chitchat" ]
[ "Null" ]
2,849
hi michelle what's been going on the medical assistant told me that you injured your knee
[ "Acute Symptoms", "Greetings" ]
[ "Subjective" ]
2,850
a1c , if everything's getting back on track . okay ? anything else i can do for you today ?
[ "Discussion", "Diagnostic Testing" ]
[ "Plan" ]
2,851
okay have a great day
[ "Chitchat" ]
[ "Null" ]
2,852
yeah . i- i know that you had called , um , last month and we- we did that event monitor for you , uh , which we'll take a look at in a few minutes . okay ?
[ "Personal History" ]
[ "Subjective" ]
2,853
sure just , just keep it in moderation .
[ "Chitchat" ]
[ "Null" ]
2,854
hey , dragon , order a hemoglobin a1c . and for your last problem , your high blood pressure . it looks today like everything is fine . i think you're doing a really good job of managing your hypertension , and i'm going to continue you on the lisinopril , 10 milligrams a day , and i'm gon na go ahead and order a lipid panel , and , um , i want you to continue to record your blood , blood pressure regularly , okay ?
[ "Reassessment", "Discussion", "Diagnostic Testing", "Medication" ]
[ "Assessment", "Plan" ]
2,855
how much had- how much had you been drinking ?
[ "Drug History" ]
[ "Subjective" ]
2,856
okay , great . all right well i'm just going to look at your ankles and feet , i'm looking for any signs of swelling .
[ "Physical Examination" ]
[ "Objective" ]
2,857
so it only lasts a couple seconds . it does n't mean it's going to happen again . it's nothing bad . it will still work , so keep using it as long as you know you can stand it , okay ?
[ "Discussion", "Medication" ]
[ "Plan" ]
2,858
yeah do you ever get lip or throat swelling
[ "Personal History" ]
[ "Subjective" ]
2,859
a week .
[ "Acute Symptoms" ]
[ "Subjective" ]
2,860
okay and do you smoke
[ "Drug History" ]
[ "Subjective" ]
2,861
so i'll call around . now if you get that done and they tell you 10 years then you'll be good to go .
[ "Chitchat" ]
[ "Null" ]
2,862
well , your levels are high .
[ "Lab Examination" ]
[ "Objective" ]
2,863
good good to hear have you had any chest pain
[ "Vegetative History" ]
[ "Subjective" ]
2,864
i'm dr. evelyn , one of the kidney doctors . it's good to meet you guys .
[ "Chitchat" ]
[ "Null" ]
2,865
okay okay but it seems like you've been making good progress and that could be difficult sometimes and you mentioned being around i think you said your sister a few days ago or a family member
[ "Family History" ]
[ "Subjective" ]
2,866
okay have you noticed any blood in your urine i know you've been draining probably take a good look at it has it been darker than usual
[ "Vegetative History" ]
[ "Subjective" ]
2,867
lem me check your record quick for for pain management it's kind of a strong drug for vicodin and we do n't really like to prescribe that unless it's totally necessary so why do n't we start with the meloxicam and i also write a referral to pain management and they can talk to you a little bit about some of your pain and maybe not using narcotics to manage it
[ "Discussion", "Medication" ]
[ "Plan" ]
2,868
okay so if it's okay with you i'm gon na go ahead and do a quick physical exam your vital signs look good today blood pressure was one twenty eight over eighty eight respiratory rate was sixteen your pulse rate was sixty eight you were afebrile today which is a good thing and your oxygen saturation on room air was ninety nine percent taking a listen to your heart here your heart is regular of rate and rhythm no i do n't hear any ectopic beats no clicks rubs or murmurs noted listening to your lungs here they are clear and equal bilaterally to auscultation now i'm gon na go ahead and do an an abdominal exam i do note positive bowel sounds soft nondistended abdomen however you are positive for some slight guarding there to the right upper quadrant but i do n't note any rebound tenderness now i'm gon na press slightly here beneath your ribs on the right hand side now take a breath in does that hurt when i press so i i see that you're guarded there so i'm gon na say that that it did hurt when i it did hurt when i
[ "Physical Examination" ]
[ "Objective" ]
2,869
that would be surgery if if we went in and cleaned out the joint sometimes in really severe cases we even just have to fuse the big toe joint we put it in a position of optimal function and we fuse it there and then your pain goes away you lose some motion but you've already lost quite a bit of motion and and the pain goes away so that that surgery really is very effective but let's try to run from my knife a little bit longer
[ "Discussion", "Other Treatments" ]
[ "Plan" ]
2,870
well , maybe that's all it was .
[ "Chitchat" ]
[ "Null" ]
2,871
yeah that would
[ "Discussion" ]
[ "Plan" ]
2,872
yeah , i understand .
[ "Personal History" ]
[ "Subjective" ]
2,873
let's first look at your vital signs . hey , dragon , show me the vital signs . great , so everything looks good from that perspective . um , so looking at you , i do n't appreciate any cervical lymphadenopathy . your heart is a nice regular rate and rhythm , and your lungs sound really clear . on your right elbow , you do have some edema and inflammation of your right olecranon and there's some tenderness and an effusion right there . so um , does that hurt when i press it ?
[ "Physical Examination" ]
[ "Objective" ]
2,874
it's good to see you , too . so , i know the nurse told you about dax .
[ "Chitchat" ]
[ "Null" ]
2,875
hey , dragon , order allopurinol , 100 milligrams , once daily . and then from your last problem , your arthritis , i'm very pleased with how your right knee is doing and i want you to continue pilates and using the knee and let me know if you have any issues and we can , and we can talk about further imaging or intervention at that time , okay ?
[ "Discussion", "Medication", "Reassessment" ]
[ "Assessment", "Plan" ]
2,876
okay did that help at all
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
2,877
well , i mean they were last time .
[ "Lab Examination" ]
[ "Objective", "Plan" ]
2,878
and i remember , um , sometime previously you've had some testing for tree nuts , but you do have almonds and cashews , correct ? and- and you do okay with them , or do you avoid all tree nuts ?
[ "Personal History" ]
[ "Subjective" ]
2,879
i do n't think we need to do any- any further , you know , work up of that at this time , okay ?
[ "Discussion" ]
[ "Plan" ]
2,880
so barbara i i know you are here for some itchy scalp pain can you tell me a little bit about how you're doing
[ "Acute Symptoms", "Greetings" ]
[ "Subjective" ]
2,881
that was the first time okay where do you have a boat what lake do you have it on lake
[ "Other Socials" ]
[ "Subjective" ]
2,882
okay , great , we can get your chart up to date now , thank you . and other than the melanoma , how has your health been , any unintentional weight changes , headaches , fatigue , nausea , vomiting , vision changes ?
[ "Personal History", "Vegetative History" ]
[ "Subjective" ]
2,883
hey , dragon , show me the vital signs . so i'm looking here at your vital signs . they look great . you do n't have a fever at that ... at this time , so that's really encouraging . i'm just gon na check you out , and , uh , i'm gon na listen to your heart and lungs and look for any rashes and let you know what i find , okay ?
[ "Physical Examination", "Lab Examination" ]
[ "Objective" ]
2,884
okay and how about any difficulty or weakness in your legs
[ "Acute Symptoms" ]
[ "Subjective" ]
2,885
um , i'm not sure . what is c , cla ?
[ "Discussion", "Medication" ]
[ "Plan" ]
2,886
so there are definitely potential side effects to the vaccine . i mean , there's guillain-barre , and all these things that could happen from the vaccine , but they're just very rare . my thing for you is i'm not convinced that there's alternative stuff or even the treatment we have , like the monoclonal antibodies , that will give help , but it's just my opinion .
[ "Discussion", "Medication" ]
[ "Plan" ]
2,887
i ca n't picture you as a regade person so that's interesting to know okay alright and any numbing or tingling in your foot at all
[ "Acute Symptoms" ]
[ "Subjective" ]
2,888
so evelyn is a 56-year-old female with a past medical history significant for coronary artery disease , prior carpal tunnel release , and a herniated disc who presents for her annual exam . so evelyn it's been a little while since i've seen you , how have you been doing over the last year ?
[ "Personal History" ]
[ "Subjective" ]
2,889
all right , lem me , uh , take a quick look . uh , can you move up a little bit ? yeah .
[ "Physical Examination" ]
[ "Objective" ]
2,890
sure . go right ahead .
[ "Personal History" ]
[ "Subjective" ]
2,891
okay have you done anything to relieve the pain
[ "Acute Symptoms", "Therapeutic History" ]
[ "Subjective" ]
2,892
um , so that's what i would do . let's just get some pictures today so we can keep up um , with them . and keep an eye on these scars and then we'll go from there .
[ "Diagnostic Testing" ]
[ "Plan" ]
2,893
okay . so it sounds like you fell a couple days ago , and you've hurt something inside of your right knee .
[ "Acute Symptoms" ]
[ "Subjective" ]
2,894
uh , but overall , i think that , um , you know , this will resolve in a couple of days . i do n't think you have covid , you do n't have any exposures , that type of thing .
[ "Discussion" ]
[ "Plan" ]
2,895
okay . and any pain in your belly at all ?
[ "Personal History" ]
[ "Subjective" ]
2,896
absolutely .
[ "Lab Examination" ]
[ "Objective" ]
2,897
i'm doin' okay . so i know the nurse told you about dax and i'd like to tell dax a little bit about you okay ?
[ "Chitchat" ]
[ "Null" ]
2,898
sounds horrible
[ "Acute Symptoms" ]
[ "Subjective" ]
2,899